Patient Preparation

Common tubes
Additives &/or anticoagulants
Mode of action
Uses

 Red Top
ADDITIVE: None (glass); Clot Activator (plastic)
MODE OF ACTION:

Blood clots, and the serum is separated by

centrifugation

USES:
Chemistries,
Immunology and Serology,
Blood Bank (Crossmatch)

 Gold Top
ADDITIVE: Gel and Clot Activator
MODE OF ACTION:
Serum separator tube (SST) contains a gel at
the bottom to separate blood from serum
during centrifugation

USES:
Serum Chemistries

 Green Top
ADDITIVE:

heparin

Sodium heparin/lithium

MODE OF ACTION:
Inactivates thrombin and thromboplastin

 Green Top
ADDITIVE:

heparin

Sodium heparin/lithium

MODE OF ACTION:
Inactivates thrombin and thromboplastin

USES:
lithium level (use sodium heparin)
ammonia level (use sodium/lithium heparin)
Plasma chemistries

 Light Green Top (PST)

ADDITIVE: Gel & Lithium heparin
MODE OF ACTION:
Anticoagulates with lithium heparin;
Plasma is separated with Plasma Separator
Tube gel at the bottom of the tube

USES:
Chemistries (blood gas analysis)

HEPARIN
Acts as anti-thromboplastin
and anti-thrombin
Best anticoagulant
Anticoagulant of choice for
minimal hemolysis

 Royal Blue Top

ADDITIVE: Sodium EDTA (glass)
MODE OF ACTION:
designed to contain non contaminating metals

USES:
Trace element testing

zinc, copper, lead, mercury

Toxicology

 Lavender Top
ADDITIVE: Liquid Tripotassium EDTA (glass);
Dipotassium EDTA (plastic)
MODE OF ACTION:
Chelates calcium

USES:
Hematology (CBC)
Blood Bank (Crossmatch);
requires full draw - invert 8 times to prevent clotting and platelet
clumping

EDTA

Prevents clotting by chelation

EDTA
Prevents Calcium from ionizing

SOURCES:

Di-Na+ salt of EDTA (powder)

Versene or Versenate
Di-K+ salt of EDTA (liquid)
Sequestrene

 SPECIAL CONSIDERATIONS:
Blood smear should be
performed no more than 4
hours
(cause red cell shrinkage)

 Light Blue Top

ADDITIVE: Buffered 3.2% (0.105M)
Sodium citrate (glass)
MODE OF ACTION:
Forms calcium salts, in a non-ionized form
or soluble complex

USES:
Coagulation tests (PT and PTT);
full draw required

 Yellow Top
ADDITIVE: sodium polyanethol sulfonate (SPS);
ACD
MODE OF ACTION:
Complement inactivation

USES:
Blood culture
HLA tissue typing, paternity testing, DNA studies

 Light Gray Top

ADDITIVE: Na+ fluoride; K Oxalate
MODE OF ACTION:
Antiglycolytic agent which preserves glucose up to 5
days

USES:
Glucoses, requires full draw (may cause hemolysis if
short draw)

FLUORIDE
Form a weakly dissociated
Ca++ component
w/ preservative action
Interferes glycolysis

 Orange Top
ADDITIVE: Thrombin
MODE OF ACTION:
Quickly clots blood
Activates fibrinogen to fibrin

USES:
STAT serum chemistries

ORDER OF DRAW FOR

MULTPLE COLLECTION
OF SPECIMENS..
WHO, WHAT, WHEN AND
WHY?

The order of draw is followed for every

venipuncture blood collection. It used for
outpatients, inpatients, home care, and all
ages. The same order of draw is followed
regardless of what equipment is used
syringe or evacuated tubes.

Is the order of
draw so important?