Evacuated Tube Collection

Principle

Covenant HealthCare Laboratory provides Greiner Bio-One VACUETTE® plastic vacutainer tubes for the collection of venous blood specimens. VACUETTE® tubes are used to collect, transport, and process blood for testing serum, plasma or whole blood in the clinical laboratory.

VACUETTE® tubes are plastic, with a pre-defined vacuum for exact draw volumes. They are fitted with color-coded caps to distinguish between the additives in each tube. Tubes must be filled according to a specific order of draw in order to prevent contamination of specimen by carryover of anticoagulant from a previous tube. Each color-coded tube also has specific requirements as to handling and processing.

Equipment

Description

Cap Color

Draw Volume

Additive

Coagulation Tube

Light blue

2.7 ml

3.2 % Sodium Citrate

Serum Tubes

Red/Black

6 ml

Clot Activator

 

Red/Yellow

5 ml

Clot Activator and Gel Separator

Plasma Tube

Green/Yellow

5 ml

Lithium Heparin and Gel Separator

Hematology Tube

Lavender

4 ml

EDTA K3

BNP Tube

Lavender

6 ml

EDTA K3

Blood Bank Tube

Pink

6 ml

EDTA K3

Lactic Acid Tube

Gray

2 ml

Potassium Oxalate and Sodium Fluoride

Storage
  1. Store tubes at 4-25 ° C.
  2. Avoid exposure to direct sunlight. Exceeding the maximum recommended storage temperature may lead to impairment of the tube quality.

Procedure

  1. Order of Draw:
    1. Blood Culture tubes (BactT/ALERT® broth bottles or yellow SPS tubes)
    2. Blue top tubes
    3. Non-additive tubes (Note: the plastic red top tubes are now an additive tube)
    4. Red/Black top tube
    5. Red/Yellow top gel tube
    6. Green/Yellow top gel tube
    7. Lavender top, Pink top or Tan ARUP tube
    8. Gray top tube
    9. ARUP Glass Yellow stopper tube (ACD)
  2. Tube Requirements
    1. Blue Top Tubes
      • Must be filled to the fill line printed on the tube
      • Invert 4 times after filling
      • Blue tube used as discard for all coagulation tests except PT, TPT, APTT, TAPTT
        • It has been determined that for routine coagulation tests such as PT, TPT, APTT, TAPTT no discard tube is needed.
        • For any additional coagulation studies, such as factor assays, a discard tube (blue plastic) is recommended.
        • If collecting any coagulation test using a vacutainer system attached to a butterfly (not recommended) a blue discard tube must be filled first to bleed air out of the butterfly tubing.
    2. Red Top Tubes (serum tubes)
      • Invert 5-10 times after filling
      • Allow to clot at room temperature for 30 minutes prior to centrifugation
      • Allow to sit upright during clotting
    3. Green Top Tubes
      • Must be filled to the fill line printed on the tube
      • Invert 5-10 times after filling
    4. Lavender Top Tubes
      • Must be filled to the fill line printed on the tube
      • Invert 8-10 times after filling
    5. Gray Top Tubes
      • Invert 5-10 times after filling
      • Collect Lactic Acid specimens without using a tourniquet

Precautions

  1. Do not use tubes if foreign matter is present.
  2. Handle all biological samples and blood collection “sharps” according to Covenant HealthCare policy.
  3. Discard all blood collection “sharps” in biohazard containers approved for their disposal.
  4. Transferring a sample from a syringe to a tube using a needle is not recommended. Additional manipulation of sharps increases the potential for needle stick injury. Use a designated transfer device for specimen transfer.
  5. All liquid preservatives and anticoagulants are clear and colorless. Do not use if they are discolored or contain precipitates.
  6. Do not use tubes after their expiration date.

References

Garza, D. & Becan-McBride, K., Phlebotomy Handbook: Blood Collection Essentials, Sixth Edition, Prentice Hall, 2002.

Greiner Bio One Vacuette â plastic tube product insert, Greiner Bio One Technical Support Services (888) 286-3883

Clinical and Laboratory Standards Institute (CLSI): Procedures for theCollection of Diagnostic Blood Specimens by Venipuncture; Approved Standard – Fifth Edition, H3-A5, Wayne, PA, 2003.