{"id":8907,"date":"2005-08-04T06:25:54","date_gmt":"2005-08-04T06:25:54","guid":{"rendered":"https:\/\/phlebotomyexaminer.com\/?p=8907"},"modified":"2019-08-04T06:28:59","modified_gmt":"2019-08-04T06:28:59","slug":"new-draw","status":"publish","type":"post","link":"https:\/\/phlebotomyexaminer.com\/new-draw\/","title":{"rendered":"Blood Collection Order of Draw"},"content":{"rendered":"<div align=\"center\"><strong>The New Order of Draw When Collecting Multiple Blood Samples into Different Tubes<\/strong><\/div>\n<p>When\u00a0blood is drawn\u00a0for laboratory testing and analysis\u00a0it requires special care, training\u00a0and skills. Every medical facility will pay particular attention to patient comfort, safety and protection of every one from injury and infection. Additionally it is very important that blood samples are not tainted, contaminated or handled in a manner that would affect the quality, or accuracy of the blood analysis, and\u00a0special considerations apply when it comes to collection for blood cultures and indwelling catheter line draws.\u00a0If unsure about the proper order of draw or proper techniques places you can contact as sources of free information are:<\/p>\n<ul>\n<li>\n<div>the manufacturer of the tubes you use (there should be a 1-800 number or website)<\/div>\n<\/li>\n<li>\n<div>your regional hospitals&#8217; s hematology lab (just give them a call and speak to the supervisor)<\/div>\n<\/li>\n<li>\n<div>your community college&#8217;s phlebotomy and nursing instructors<\/div>\n<\/li>\n<li>\n<div>American Red Cross blood donation centers (just walk in and tell them who you are)<\/div>\n<\/li>\n<\/ul>\n<p>Watch this video of multiple blood draws using different types of evacuated tubes:<\/p>\n<p align=\"center\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/tfx457q6pVI\" width=\"425\" height=\"344\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><br \/>\n<img title=\"attention\" src=\"http:\/\/phlebotomypages.com\/images\/8250f200.gif\" alt=\"attention\" border=\"0\" \/>\u00a0<span style=\"font-family: Bookman Old Style;\">ATTENTION: Please realize that this video (published from YouTube) is NOT HERE TO TEACH you phlebotomy techniques, but merely to show you different scenarios of the phlebotomist&#8217;s daily routine. The video may contain techniques, or procedures that do not conform to proper, and\/or safe venipuncture protocol.<\/span><\/p>\n<h3>Order of Draw When Using Evacuated Tubes<\/h3>\n<p>When collecting\u00a0<strong>diagnostic blood specimens by venipuncture<\/strong>\u00a0into evacuated tubes the order of draw is, b<span style=\"color: black;\">ased on Clinical and Laboratory Standards Institute&#8217;s (CLSI) standard H3-A6 from November, 2007, as follows:<\/span><\/p>\n<blockquote dir=\"ltr\"><p>1.) Blood cultures (yellow) SPS (sterile)<\/p>\n<p>2.) Light blue (buffered sodium citrate tube)<\/p>\n<p>3.) Red (plain), or Tiger-Top mottled red (gel separator tube)<\/p>\n<p>4.) Green heparin and light green (sodium or lithium with or without separators)<\/p>\n<p>5.) Lavender (EDTA)<\/p>\n<p>6.) Pink, white, or royal blue (EDTA)<\/p>\n<p>7.) Gray (Na flouride\/potassium oxalate)<\/p>\n<p>8.) Dark blue (FDP)<\/p><\/blockquote>\n<p>This order of draw should ALWAYS be followed to prevent erroneous results due to additive crossover. Incorrect order of draw can lead to problems and misdiagnosis of health conditions or disease.<span style=\"font-family: Arial;\"><br \/>\n<\/span><\/p>\n<p>If coagulation testing is the only laboratory work that needs to be drawn the phlebotomist should first draw a plain red top tube to remove tissue fluid contamination. This tube is then discarded into the biohazard receptacle. The next step is to draw the blood sample into a sodium citrate collection tube which must be filled to the proper level (filled to complete vacuum volume) and is then gently inverted to mix.<\/p>\n<p>If additional laboratory work is ordered, including coagulation testing, the second tube would be the sodium citrate collection tube. Remember that all of the processes involved in specimen collection, from ordering supplies, to selecting the proper collection devices, to proper collection site and technique, to adhering to all in-house and legal requirements when handling and shipping the specimens are all important steps of obtaining valid and timely laboratory test results.<\/p>\n<div align=\"center\"><\/div>\n<h3>Order of Draw When Using The Syringe System:<\/h3>\n<p>A document by the then National Committee for Clinical Laboratory Standards (NCCLS*) from 1991 established two distinct orders of draw for vacuum tube draws and by syringe method. This is now obsolete! NCCLS revised these standards in 1998 because there was a lack of evidence that syringes need a separate order of draw. And to avoid confusion, let us remind you that NCCLS\u00a0became Clinical and Laboratory Standards Institute (CLSI) in\u00a0January 2005.<\/p>\n<blockquote dir=\"ltr\"><p><img title=\"bullet\" src=\"http:\/\/phlebotomypages.com\/images\/blooddrop.png\" alt=\"bullet\" border=\"0\" \/>\u00a0BD Vacutainer\u00ae\u00a0<a title=\"order of draw multiple tubes\" href=\"http:\/\/www.bd.com\/vacutainer\/pdfs\/plus_plastic_tubes_wallchart_orderofdraw_VS5729.pdf\" target=\"_new\" rel=\"nofollow noopener noreferrer\">Order of Draw for Multiple Tube Collection<\/a>\u00a0PDF<\/p>\n<p><img title=\"bullet\" src=\"http:\/\/phlebotomypages.com\/images\/blooddrop.png\" alt=\"bullet\" border=\"0\" \/>\u00a0Proper Handling of\u00a0<a title=\"BD Vactuainer citrate tubes\" href=\"http:\/\/www.bd.com\/vacutainer\/pdfs\/techtalk\/BDVS-TechTalk-9947_D2.pdf\" target=\"_new\" rel=\"nofollow noopener noreferrer\">BD Vacutainer\u00ae Citrate Tubes<\/a>\u00a0(discard tube explained)<\/p>\n<p><img title=\"bullet\" src=\"http:\/\/phlebotomypages.com\/images\/blooddrop.png\" alt=\"bullet\" border=\"0\" \/>\u00a0University of Iowa&#8217;s\u00a0<a title=\"order of draw by tube top color\" href=\"http:\/\/www.healthcare.uiowa.edu\/path_handbook\/Appendix\/new_tubes\/tube_tops.html\" target=\"_new\" rel=\"nofollow noopener noreferrer\">illustration of the order of draw<\/a>\u00a0by tube top color<\/p><\/blockquote>\n<p>The current edition of the CLSI catalog and CLSI hematology standards are available upon request from either CLSI membership organizations as well as to non-members directly from CLSI. Contact\u00a0<a title=\"CLSI\" href=\"http:\/\/www.clsi.org\/\" target=\"_new\" rel=\"nofollow noopener noreferrer\">CLSI<\/a>\u00a0for the latest order of draw information.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The New Order of Draw When Collecting Multiple Blood Samples into Different Tubes When\u00a0blood is drawn\u00a0for laboratory testing and analysis\u00a0it requires special care, training\u00a0and skills. Every medical facility will pay [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/posts\/8907"}],"collection":[{"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/comments?post=8907"}],"version-history":[{"count":0,"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/posts\/8907\/revisions"}],"wp:attachment":[{"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/media?parent=8907"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/categories?post=8907"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phlebotomyexaminer.com\/wp-json\/wp\/v2\/tags?post=8907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}