Specimen collection cc

BLOODSPECIMEN COLLECTION

GENERAL CONSIDERATIONS

“No Laboratory test can be better than its manner of specimen collection”

PATIENT IDENTIFICATION PATIENT PREPARATION SPECIMEN IDENTIFICATION COLLECTION TECHNIQUE SPECIMEN CONTAINER ADDITIVES

BloodSpecimen Collection

PHLEBOTOMIST With good interpersonal skills Professional attitude Ensure Patient confidentiality

MACROSAMPLE (Venipuncture) Syringe Method Vacutainer Method Arterial Puncture

Radial Brachial Femoral

MACROSAMPLE

Equipment Needed

Tourniquet

Antiseptic solution

Syringe and needle

Vacutainer set

Butterfly Infusion Set

MACROSAMPLE

Blood CollectionMacrosample Collection

Blood CollectionOpen System

Blood CollectionClosed System

Blood CollectionClosed System

ADVANTAGES OF VENIPUNCTUREallows repetition of tests/follow up avoids tissue juices can be mailedFastest method from a large number of patients

DISADVANTAGES OF VENIPUNCTURE

More complications may ariseHard to do on some patients

SITES OF COLLECTION NB up to 18 months

Superior Longitudinal sinus veinExternal jugular veinTemporal vein


SITES OF COLLECTION Older than 18 months – 3 y/o

Femoral veinLong Saphenous veinAnkle veinPopliteal veinExternal Jugular veinTemporal vein


SITES OF COLLECTION Older than 3 y/o

Veins on the antecubital fossaWrist veinVeins of the dorsal handVeins of the Foot





Specimen Collection by Venipucture

Patient Identification Note Isolation Restrictions Note Dietary Restrictions Reassure patient Position the patient Select venipuncture location Assemble Supplies

Apply the tourniquet Cleanse the site Inspect needle Perform venipuncture Release tourniquet Withdraw needle & apply pressure Post Phlebotomy Procedures

Proper disposal Label specimen Check patient

Needle Insertion

Needle Insertion

Complications of Venipucture

1. Immediate Local complication Hematoma Hemoconcentration Circulatory failure Syncope Failure of blood to enter the syringe

Complications of Venipucture

2. Late Local Complications Thrombosis Thrombophlebitis

3. Delayed General Complications HIV Hepatitis

24

Situations in PhlebotomySituation Action

IV or blood transfusion running

Use opposite arm or perform fingerstick, if possible. *turn off IV for at least 2 minutes; select vein other than the

one with the IV. Draw and discard first 5 mL. Note that blood was taken from IV arm. Don’t draw from an IV site for 1 hour after IV is

discontinued.

25

Situation Action

Fistula Draw from opposite arm.

Indwelling lines and catheters, heparin locks, cannulas

Usually not drawn by lab. Lab may draw below heparin lock if nothing is being

infused. The first 5 mL of blood drawn should be discarded. Order of Draw: Catheter lines Culture tube, EDTA-Hep-Citrate-Clot tubes

Situations in Phlebotomy

26

Situation Action

Sclerosed veinsScars, burns, tattoosEdema

Select another site.

Hematoma Draw below.

Streptokinase/Tissue plasminogen activator (PA)

Minimize venipuncture. Hold pressure until bleeding has stopped.


27

Situation Action

Mastectomy Draw from opposite arm.

Patient refuses Try to persuade. If unsuccessful, respect wishes and

notify nurse.

Unidentified patient Ask nurse to properly identify patient before drawing.


Reasons for Specimen Rejection

Hemolysis/Lipemia Clots in an anticoagulated specimen Nonfasting specimen when test requires fasting Wrong volume Improper transport conditions Discrepancies bet requisition & specimen label Unlabeled or mislabeled specimen Contaminated specimen/Leaking container

Anticoagulants Anticoagulants inhibit clot formation. As soon as blood is removed from a vessel, activation of coagulation

begins. Although blood drawn directly into an evacuated tube contacts the

anticoagulant, it is necessary to immediately and gently invert the tube, mixing the content to prevent micro-formation.

DEFIBRINATION

Tube Stoppers:

Serum Preparation

Red (glass) Chemistry & Serology

Red (plastic/ hemogard) w/ clot activator(silica)

Chemistry & Serology

Yellow/gray & orange w/ clot activator(thrombin)

Chemistry

Red/gray & gold Clot activator separation gel

Chemistry

EDTA: (Na or K) K3EDTA or K2EDTA

Tube stoppers:

Commonly Used Anticoagulants

Lavender Hematology

Pink spray-dried Blood Bank

White EDTA & gel Molecular Diagnostics

Tan (plastic) K2EDTA Pb Testing

Sodium Citrate: Tube Stoppers:


Light Blue Na Citrate Coagulation

Black Na Citrate ESR

Heparin Tube Stoppers:


Light

Green/Black

Lithium heparin & gel Chemistry

Green Na Heparin, Li Heparin Chemistry

Tan (glass) Na heparin Pb testing

Royal Blue Na heparin, Na2EDTA Chem; Trace e. Toxicology

Other Tube Stoppers:


Gray w/ antiglycolytic agent NaF (3 days) Li iodoacetate ( 24 hrs)

Glucose

Yellow SPS Culture

Yellow ACD BB; HLA typing

Order of DrawOld Order Syringe NCCLS

Culture tubes Culture tubes Blood culture tube

Plain/Non-Additive tubes Citrate Na Citrate tube

Citrate EDTA Serum tubes

Heparin Heparin Heparin tubes (w/ or w/o gel)

EDTA Fluoride EDTA tubes

Oxalates/ Fluorides Plain Antiglycolytic tubes

44

Specimen Processing

Serum or plasma should be separated from cells within 2 hours of collection (unless collected in a gel separator tube).

Allow red top tubes to clot sufficiently (20-30 minutes) before centrifugation to avoid fibrin strands.

45

Specimen Processing

Centrifuge 10 ± 5 minutes at 1000-1200 × g.

Keep tubes capped during centrifugation to avoid loss of CO2, change of pH, evaporation, or aerosol formation.

Lipemic specimens can be ultracentrifuged to remove chylomicrons .

46

If analysis will be delayed more than 5 hours, serum or plasma for most tests can be capped and stored at 4°C. Some analytes should be frozen. Avoid repeated freezing and thawing.

Specimens for lactate dehydrogenase (LD) should be kept at room temperature.

Specimen Processing

47

For acid phosphate, add citrate (10 mg/mL) and freeze.

Glucose is stable in serum separator tubes for 24 hours and in sodium fluoride tubes for 24 hours at room temperature or 28 hrs at 4°C.

Specimen Processing

Tests Requiring a Fasting Specimen

Fasting blood sugarGlucose tolerance test

TriglyceridesLipid panel

GastrinInsulin

Specimens Requiring Special Handling

Requirement Tests Comments

Chilling Arterial blood gases, ACTH, ammonia, gastrin, glucagon, lactic acid, parathyroid hormone (PTH), renin

Place in crushed ice or a mixture of ice and water



Warming Cold agglutinins, cryoglobulins

Use 37°C heat block, heel warmer, or hold on hand.

Protection from light

Bilirubin, carotene, vitamin A, vitamin B12

Wrap in aluminum foil.


Chain of custody Any test used as evidence in legal proceedings ; (blood alcohol, drug screens, DNA analysis)

Chain of custody form; lock boxes may be required.


Open System

Components needed :

Syringes of different sizes

Blood taken transfer into

...

Containers of different sizes

Closed System

3 Basic Components :

BD Vacutainer® Standard Holder

BD Vacutainer® Multi Sampling Needle21G (Green), 22G (Black)

BD Vacutainer® Evacuated Tubes

Blood flows straight into tubes ...

LABOPN1

Collection System - Implication to Collectors

Open System Manual manipulation of plunger Manual transfer of specimen

Closed System Quick & easy fill, no manipulation

needed Auto & direct transfer of specimen

N&S Vacutainer® System

LABOPN1

Material Used - Collection

Disposable needle Non-evacuated specimen

tube Disposable syringe

Disposable needle Evacuated specimen tube Reusable holder


Collection System - Implication to Collectors

Possible spillage Exposure to blood,

contamination Inaccurate fill causing

inaccurate blood:additive ratio

Safety to patient and collector for good infection control

Reduce redraw from patient - Precise vacuum preserves precise ratio


LABOPN1

Manual Steps

Remove needle from vein Remove cap from

container Remove needle from

syringe Transfer blood into

container(s) Recap container(s)

Remove tube from needle holder

Remove needle from vein


Additional time saving during collection is approximately 20%

Risk of incomplete closure seal

LABOPN1

Collection System- Implication to Laboratory

Hemolysis redraw

Microclots (delay in contact with additive & this is a variable factor)

QNS redraw

No specific color code

Less hemolysis with full system usage

Specimen integrity is preserved - no microclots

Sufficient quantity

Int’l color code - easy ID


LABOPN1

Evacuated System Assembly

Screw on Needle Twist the seal of the needle and remove the clear

shield (cap) that covers the center-threaded section and back end of the needle. Insert the back end of the needle into the holder, and twist the needle tightly into the holder.

CAUTION: If the seal on a needle has already been broken, the needles no longer sterile. Discard the needle in a sharps container.

LABOPN1

Insert Tube Place the first tube into the holder and partially advance it onto the

needle. Do not fully push tube onto needle at this point, because this will

break the tube's vacuum. Needle sheath on the front end is removed just prior to needle insertion.

Once needle is in the vein, advance tube to the end of the holder. When needle fully punctures stopper, blood should begin to flow freely into tube. Lack of blood flow at this point suggest lack of tube vacuum or error in venipuncture technique.

Pay particular attention to enlarged graphic demonstrating both partial and fully inserted needle positions.

Butterfly The illustration shows a winged infusion set (butterfly) with an

attached adapter for evacuated tubes. Inserting the needle into the vein is facilitated by pressing and

holding the wings together between the thumb and forefinger. A Butterfly needle is useful when drawing from small, fragile, and

hard-to-locate veins. The phlebotomist should exercise caution when using the

apparatus. Because the needle is separated from the holder by the tubing, needle-stick injuries occur more easily to both patient and phlebotomist during disposal of the apparatus.

Tourniquet A variety of tourniquet types

are available and illustrated here. Each has advantages and disadvantages.

Latex is commonly used because it is stretchable, does not support bacterial growth, and can be cleaned with disinfectant.

CAUTION: Alternatives to latex must be used when patient has developed an allergy to latex. Anaphylactic shock occurs if a latex tourniquet is used.

Gloves The Occupational Safety and

Health Administration mandates that gloves must be worn as protection whenever blood, body fluids, or other possibly contaminated items are handled.

The gloves should be cleaned but need not be sterile. Gloves protect the phlebotomist and the patient. Fresh gloves should be worn for each patient.

Cart and Tray

Carts and trays are examples of devices used to store / carry equipment. They should contain all the equipment required to properly perform phlebotomy.

Cart

Tray

Antiseptics The venipuncture site must be

thoroughly cleansed prior to puncture. Isopropylalcohol (70%) is commonly used.

Alcohol wipes usually come in individually wrapped prep pads.

When opened, the pad should be fully saturated with alcohol; if it is not, discard the pad and open another.

Isopropylalcohol is not a disinfectant, e.g., iodine. If tubes are being drawn for blood culture, cleansing of the site must be done using a disinfectant. Follow the laboratory's standard operating procedure for blood culture draws.

Gauze Clean 2" x 2" gauze

pads are used to place pressure over the venipuncture site once the needle is removed.

Do not use cotton. It tends to stick to the wound site. Do not remove gauze too soon. The clot that is forming

may be disturbed and bleeding may restart.

Bandages Use an adhesive bandage to cover the site

once bleeding has ceased. Use paper, cloth, or knitted tape over a folded

gauze square for patients who are sensitive to adhesive bandages.

To prepare a gauze pad, fold the gauze in half, and then in half again to form a square. Place this over the puncture site and secure in place with tape.

Disposals Discard contaminated needles in a designated

container referred to as a "sharp container“ A variety of containers are manufactured. They

provide for safe removal of the needle from the holder whether an evacuated tube system or syringe is used.

They must be rigid, puncture-resistant, leak-proof, disposable, and easily sealed when full.They should have a locking lid which does not permit entry into the container.

They are usually red, bright orange, or yellow, and must be labeled "BIOHAZARD".

Site selection in Arm The highlighted area shows the antecubital

fossa where the major veins used for venipuncture are located.

• Choose one that is bouncy or resilient, large enough to support good blood flow, and well-anchored by tissue.

• Median cubital vein is the first choice because it is large, well-anchored, least painful, and least likely to bruise.

Site selection in Arm

Cephalic vein is the second choice. It is large, but not as well anchored and is more painful when punctured than the median cubital.

Basilic vein is the third choice. It is generally easy to palpate, but not well anchored. It lies near the brachial artery and the median nerve, either of which could accidentally be punctured.

Avoiding the Median NerveAvoiding the Median Nerve Avoid major nerves. Hitting a patient's nerve with a needle can cause sharp and

immediate pain. The patient may also experience an involuntary reflex action,

pulling the arm away from the needle. Arteries, which can be detected by a pulse, should not be used

for routine blood collection. To avoid inadvertently puncturing an artery, do not select a vein

that overlies or is close to an artery. As seen in the diagram, both the median nerve and the brachial

artery lie close to the basilic vein. Excessive or blind probing while performing a venipuncture can

lead to permanent injury of the nerve or artery that may result in legal action.

Site selection in Hand Hand or wrist veins may be used when antecubital

fossa veins are unsuitable or unavailable. Phlebotomist must use extra care to anchor them. These veins have a narrow diameter, it may be

necessary to use a small gauge needle and small volume evacuated tubes.

Use of a butterfly apparatus may enhance success and make the procedure less painful.

Site selection in FootSite selection in FootThe last resort for blood collection is from the

foot veins after the arm veins have been determine unsuitable.

Always check with the hospital policy before this type of sampling is carried out.

Inappropriate Sites for Venipuncture

Arms on side of Mastectomy Edematous areas Hematomas Arm in which blood is being transfused Scarred areas Arms with cannulas, fistulas or vascular grafts Arm above IV lines

Assemble Equipment Prior to initiating venipuncture, gather all

equipment needed. Place the necessary evacuated tubes in the

proper sequence for specimen collection. A sharps container should be easily accessible

for immediate needle disposal following completion of the venipuncture.

Wash HandsThe most important means of preventing and controlling the spread of infection is proper hand washing:

1. Remove watch and rings

2. Without touching the sink, wet hands under warm, running water. Apply soap and work up a lather, rubbing hands together to create friction for at least 15 seconds.

3. Rinse hands in a downward motion from wrists to fingertips.

4. Repeat steps 2 and 3.

5. Dry hands with a clean paper towel

6. Turn the faucet off with another clean paper towel.

Apply Gloves OSHA regulations require the wearing of

gloves during phlebotomy procedures. A new pair of gloves must be worn for each

patient. When donning gloves, pull them over the cuff of protective clothing.

Position Patient A patient should be either seated or lying

down while having blood drawn. The patient's arm should be firmly supported

and extended downward in a straight line from the shoulder to the wrist.

Ensure patient's hand is closed, which makes the veins more prominent.

Do not ask the patient to pump his / her hand.

Correct arm positioning: Allows gravity to help veins enlarge.

Helps assure the specimen collection tubes fill from the bottom up to prevent reflux and additive carryover between sample tubes.

Tie Tourniquet Position tourniquet under the arm 3-4 inches above the

intended venipuncture site, with each hand grasping one side of the tourniquet.

Apply and maintain tension. Without rolling or twisting the tourniquet, bring the two sides together.

Cross one side over the other and securely tuck a portion of the upper side under the lower side.

Note that the loop is below the tourniquet band and the free ends (flaps) of the tourniquet are pointing away from the venipuncture site. This prevents it from the interfering with the site of needle entry.

The flaps should be positioned so they can easily be grasped with one hand. Gently pulling on the flaps releases the tourniquet.

Apply Tourniquet Apply tourniquet to increase pressure in the veins and aid in vein

selection. When correctly placed on the patient's arm, it should be tight enough

to slow venous flow without affecting arterial flow. It should feel slightly tight to the patient, allowing more blood to flow into than out of the area.

The veins enlarge, making them easier to palpate and penetrate with a needle.

Ideally, never leave a tourniquet on the patient longer than one minute. Tourniquets left on longer may alter test results.

Do not apply a tourniquet over an open sore. Do not apply a tourniquet to the arm on the side of a recent

mastectomy.

Select Site Venipuncture is most commonly performed in

the anticubital fossa area of the arm where the median cubital, cephalic, and basilic veins lie fairly close to the surface.

Use the tip of the index finger to palpate (examine by feel) the vein. This helps determine the size, depth, and direction of the vein.

Select vein that is easily palpated, large enough to support good blood flow, and well-anchored or fixed by surrounding tissue.

Cleanse site Clean venipuncture site with antiseptic to help prevent microbial

contamination to the specimen and patient. Start at the center of the site and move outward in ever widening,

concentric circles. Failure to follow this procedure may re-introduce dirt and bacteria.Use sufficient pressure to remove surface dirt and debris.

Repeat the process with a fresh alcohol prep pad if the site's is still dirty.

Let the site air dry (30 - 60 seconds) prior to beginning the venipuncture.

Do not wipe, blow on, or fan the site, as these actions may re-introduce contaminations.

For blood culture draws, refer to the laboratory's standard operating procedure for instructions.

Insertion Angle

Insert the needle at a 15-30 degree angle when penetrating the skin and the vein.

Insertion Angle Above picture: Bevel of the needle is fully inserted within

the lumen of the vein within 15-30 degree angle. Middle picture: Needle angle is too steep. If needle

advances further into the vein, it may penetrate completely through the vein to tissue.

Lower picture: Needle angle is too shallow, causing bevel to rest on the wall of the vein. Needle may be partially in the lumen and partially in tissue, resulting in hematoma formation. Insert needle at a 15-30 degree angle when penetrating the skin and the vein.

Insert Needle Grasp patient's arm with thumb on top and fingers wrapped to the

back. Pull skin taut below the intended venipuncture site with thumb,

anchoring vein to keep it from moving or rolling. Using a smooth motion, quickly insert the needle, bevel up. Stop needle advancement when a slight decrease in resistance is

felt, signaling entry into the vein. Advance tube onto needle to the end of holder Use thumb to push tube while index and middle fingers grasp

flanges of tube holder. Blood should begin to flow into tube. Release tourniquet as soon as possible, depending upon blood

flow. Ideally, do not leave tourniquet on for more than one minute.

Fill Tube Maintain tube in a downward position so that blood

and any tube additive it contains does not touch the needle.

Fill tube until vacuum is exhausted and blood flow stops.

Remove tubes from holder by applying pressure against flanges of tube holder with thumb and index finger while using a slight twist to remove the tube.

Hold needle steady as tubes are removed and inserted. If tube contains an additive, invert it gently several

times after removal to mix the blood and additive. Additional mixing can be performed while other tubes are filling.

Remove Needle Release tourniquet prior to removing needle. Ensure

patient's hand is open After the last tube is removed from holder, hold a clean

gauze pad in position over the entry site. Gently and quickly remove needle from the arm.

It is necessary to apply pressure to the site to prevent leakage of blood and possible hematoma formation.

As soon as needle is fully withdrawn, but not before, apply pressure firmly to the puncture site using a gauze pad.

If the patient is alert, ask him / her to continue to apply pressure until bleeding has stopped.

Keep arm extended and preferably raised; arm should not be bent as this increases the risk of hematoma formation.

Dispose Needle Discard contaminated needles in a container referred to

as a "sharp container" Never cut, bend, break, or recap needles. A variety of containers are manufactured. They provide

safe removal of the needle from holder when using an evacuated tube system.

Place needle in the proper slot in the lid, and turn it clockwise until it unscrews from the holder.

Do not attempt to remove needle with your fingers. If needle doe not separate from the holder, throw the entire unit away in a sharps container.

Proper Needle Disposal

Improper Needle Disposal

Label Tube Always verify information on tube labels. All identifiers

on the labels must be accurate. Label tubes after they are drawn, while the patient is

still present, to reduce the risk of specimen misidentification.

If additional information must be added to the label (e.g., fasting, time to draw), write with ink, never pencil.

Never: Label tubes prior to venipuncture Leave an inpatient room before labeling the tubes Dismiss an outpatient before labeling is completed.

Transport Tube When transporting tubes through public

hallways, place them in a secondary container to minimize the risk of leakage and spillage.

The secondary container must be clearly labeled "BIOHAZARD.“

Once the tubes are in the container, seal it before transport.Securely attach paper requisition(s) to the secondary transport container.

Blood collection: Open System

Syringes of different sizes

Containers of different sizes

Blood taken and transferred to

Blood collection: Closed System

Needle

Holder

Evacuated tube

Blood collection: Closed System

How it works

BD Vacutainer FLASHBACK NEEDLE

Transparent Needle Hub


Black- G22x1”

Green- G21x1”


Do not eat or drink in the area of blood collection,transportation or specimen processing and analysis

Do not apply cosmetics anytime during blood collection,transportation or processing and analysis

Wash hands before and after eating, drinking and before and after using the restrooms

No long necklaces, large and or dangling earrings or loose bracelets during any type of blood collection, transportation or processing and analysis

Remove laboratory coat or smock used during blood collection or other patient care activities before going to an area where coffee breaks or meals are taken

Wear gloves for all blood collection and every skin puncture Wash hands before and after putting on gloves Use a new, clean pair of gloves for each procedure – use non-latex gloves Wear a laboratory coat, a gown or a smock during blood collection.

Remove garment and leave it at the facility for appropriate cleaning and disinfecting

Wear eye and face protectors if blood and body fluid splashing is anticipated

Follow procedure for disposing of blood collection items

Decontamination of tourniquets and trays after use is highly recommended

Never recap a needle by hand

Use safety lancets with self –retracting blade

Disposed of sharps, needles, blades and others in a puncture resistant container

for safer blood collection and

reliable test results.

PROCEDURAL STEPS


Introduction to Patient

Greet Patient Introducing yourself by

name Describe the procedure to

be performed, providing reassurance to the patient.

Patient Identification

Ask an outpatient to state his/her full name, spell the last name, and state his/her date of birth.

Verify the requisition (order) and samples labels, if applicable, have the same identifiers.

Patient Identification

Check inpatient's identification band to verify the name and hospital identification number match the order.

If the patient is not wearing an identification band, DO NOT perform the venipuncture.

Correct identification of patient is critical. Blood test results collected from a mis-identified patient will be linked to the wrong patient, and may put the health of two patients at risk.

Assemble Equipment

Prior to initiating venipuncture, gather all equipment needed.

Place the necessary evacuated tubes in the proper sequence for specimen collection.

A sharps container should be easily accessible for immediate needle disposal following completion of the venipuncture.

Position Patient Seated or lying The patient's arm should be firmly

supported and extended downward in a straight line from the shoulder to the wrist.

Ensure patient's hand is closed, which makes the veins more prominent.

Tie Tourniquet 3-4 inches above the intended venipuncture site, Apply and maintain tension. Without rolling or twisting the

tourniquet, bring the two sides together. Cross one side over the other and securely tuck a portion of

the upper side under the lower side. The loop should be below the tourniquet band and the free

ends (flaps) of the tourniquet are pointing away from the venipuncture site.

The flaps should be positioned so they can easily be grasped with one hand.

Site Selection Cubital vein

Cephalic vein

Basilic vein Avoid major nerves (can cause sharp and

immediate pain; involuntary reflex action) Avoid arteries which can be detected by a

pulse. Do not select a vein that overlies or is close to

an artery. Avoid excessive or blind probing while

performing a venipuncture

Cleanse site

Clean venipuncture site with antiseptic

Let the site air dry (30 - 60 seconds) prior to beginning the venipuncture.

Do not wipe, blow on, or fan

Needle Insertion

Fill Tube

Remove Needle

Dispose Needle

Proper Needle Disposal

Improper Needle Disposal

Label Tube

Transport Tube When transporting tubes through public

hallways, place them in a secondary container to minimize the risk of leakage and spillage.

The secondary container must be clearly labeled "BIOHAZARD.“

Once the tubes are in the container, seal it before transport.Securely attach paper requisition(s) to the secondary transport container.

Tube GuideVacutainer Tubes with HEMOGARD

Closure

Vacutainer Tubes

Additive # of Inver-sion

Laboratory Use

Gold

Clot activator and gel for serum separation

5 BD Vacutainer® SST™ Tube for serum determinations in chemistry. Tube inversions ensure mixing of clot activator with blood and clotting within 30 minutes.

Light Green

Lithium heparin and gel for plasma separation

8 BD Vacutainer® PST™ Tube for plasma determinations in chemistry. Tube inversions prevent clotting

Vacutainer Tubes with HEMOGARD Closure

Vacutainer Tubes

Additive # of Inve

r-sion

Laboratory Use

Red

- None (glass). - Clot activator (plastic tube with Hemogard closure)

0

5

For serum determinations in chemistry and serology. Glass serum tubes are recommended for blood banking. Plastic tubes contain clot activator and are not recommended for blood banking. Tube inversions ensure mixing of clot activator with blood and clotting within 60 minutes.

Orange

Thrombin 8 For stat serum determinations in chemistry. Tube inversions ensure complete clotting, usually in less than 5 minutes.

Royal Blue

- Sodium heparin- Na2EDTA- None (serum tube)

880

For trace element, toxicology and nutritional-chemistry determination. Special stopper formulation provides low levels of trace elements (see package insert).

LABOPN1

Vacutainer Tubes with

HEMOGARD Closure

Vacutainer Tubes


Laboratory Use

Green

- Sodium heparin- Lithium heparin

88

For plasma determinations in chemistry. Tube inversions prevent clotting.

Grey

- Potassium oxalate/Sodium fluoride- Sodium fluoride /Na2EDTA- Sodium fluoride (serum tube)

8

8

8

For glucose determinations. Oxalate and EDTA, anticoagulant will give plasma samples. Sodium fluoride is the antiglycolytic agent. Tube inversions ensure proper mixing of additive and blood.

Tan

- Sodium heparin (glass)- K2EDTA (plastic)

8

8

For lead determinations. This tube is certified to contain less than 0.1 ug/mL (ppm) lead. Tube inversions prevent clotting

LABOPN1

Vacutainer Tubes with

HEMOGARD Closure

Vacutainer Tubes


Laboratory Use

Yellow

- Sodium polyanetho- sulfonate (SPS)- Acid citrate dextrose (ACD): Solution A-22.0g/L tri- sodium citrate 8.0g/L citric acid, 24.5 g/l dextrose Solution B- 13.2g/L tri- sodium citrate, 4.8g/L citric acid, 14.7 g/L dextrose

8

SPS for blood culture specimen collections in microbiology. Tube inversions prevent clotting.ACD for use in blood bank studies, HLA phenotyping, DNA and paternity testing

Lavender

- Liquid K3EDTA (Glass)- Spray-dried K2EDTA (plastic)

8

8

K3EDTA for whole blood hematology determinations. K2EDTA for whole blood hematology determinations and immuno-hematology testing (ABO- grouping, Rh-typing, antibody screening). Tube inversions prevent clotting

LABOPN1

Partial-draw Tubes (2 ml and

3 ml: 13x75 mm).

Small-volume Pediatric

Tubes (2ml: 10.25 x 47 mm; 3ml:

10.25 x 64 mm)


Laboratory Use

Red

None 0 For serum determinations in chemistry and serology. Glass serum tubes are recommended for blood banking. Plastic tubes contain clot activator and are not recommended for blood banking. Tube inversions ensure mixing of clot activator with blood and clotting within 60 minutes.

Green

- Sodium heparin- Lithium Heparin

8

8

For plasma determinations in chemistry. Tube inversions prevent clotting.

LABOPN1

Partial-draw Tubes (2 ml

and 3 ml: 13x75 mm).

Small-volume Pediatric Tubes (2ml: 10.25 x 47 mm; 3ml: 10.25

x 64 mm)


Laboratory Use

Lavender

- Liquid K3EDTA (glass)- Spray-dried K2EDTA (plastic)

8

8

K3EDTA for whole blood hematology determinations. K2EDTA for whole blood hematology determinations and immuno-hematology testing (ABO grouping, Rh typing, antibody screening). Tube inversions prevent clotting.

Light Blue- .105M Sodium citrate (=3.2%)- .129M Sodium citrate (3.8%

3-4 For coagulation determinations. Tube inversions prevent clotting. NOTE: Certain tests may require chilled specimens. Follow your institution's recommended procedure for collection and transport of specimen.

Order of DrawClosure color Collection Tube Mix by Inverting

Yellow Blood Cultures 8 to 10 times

Red Serum (Glass Tube) 0

Light Blue Citrate 3-4 times

Red/Black Gold Red

BD SST™ Gel Separator Tube

BD SST™ Gel Separator Tube

Serum (Plastic Tube)

5 times

Green Light Green

Heparin

BD PST™ Gel Separator Tube with Heparin

8 to 10 times

Lavender EDTA 8 to 10 times

Business

Specimen collection cc