Blood Collection Tubes Order of Draw

Order Color Invert Additive Comments and Common Tests

of
Draw
1 Clear discard tube Not required No additive Tube used ONLY as a discard tube.

2 Blood Culture Bottle Invert gently Bacterial growth When a culture is ordered along with any other
(aerobic, anaerobic and to mix medium and blood work, the Blood Cultures MUST be drawn
pediatric bottles have activated charcoal first.
different colors of label
and top)

3 Yellow with clear label 8 to 10 times Sodium polyanethol Tube used for Mycobacteria (AFB) blood culture.
sulfonate (SPS)

4 Royal Blue (with red Not required Glass tube with no Tube used for serum trace element tests.
band on label) additive Available from CLS Referrals

5 Red GLASS Not required Glass tube with no Tube used for serum tests, which CANNOT be
additive collected in SST tubes. NOTE: red PLASTIC tubes
are preferable for lab tests.
6 Light Blue 3 to 4 times 3.2% buffered Tube used mainly for PT (INR), PTT, and other
Sodium citrate coagulation studies.
anticoagulant
7 Black 3 to 4 times 3.2% Sodium Tube used for ESR ONLY.
citrate anticoagulant

8 Red 5 times Clot activator, and Tube used for serum tests, which CANNOT be
no anticoagulant collected in SST tubes.

9 Gold or Orange 5 times Gel separator and Gold top tubes are referred to as “SST” (serum
clot activator separator tube) and orange top tubes are
referred to as “RST” (rapid separator tube). After
centrifugation, the gel forms a barrier between
the clot and the serum.
10 Dark Green 8 to 10 times Sodium heparin Sodium heparin tube is used mainly for Amino
anticoagulant Acids and Cytogenetics tests.
OR
Lithium heparin Lithium heparin tube is used by Calgary Rural
anticoagulant (CRL Laboratories (CRL) for some Chemistry testing
sites only)
11 Light Green (mint) 8 to 10 times Lithium heparin Usually referred to as “PST” (plasma separator
anticoagulant and tube). After centrifugation, the gel forms a barrier
gel separator between the blood cells and the plasma.
Tube used mainly for Chemistry tests.
12 Royal Blue (with 8 to 10 times K2EDTA Tube used for plasma and red cell trace element
lavender band on label) anticoagulant tests. Available from CLS Referrals.

13 Royal Blue (with no band 8 to 10 times Na2EDTA Tube used for whole blood trace element tests.
on label) anticoagulant Available from CLS Referrals.

14 Lavender 8 to 10 times K2EDTA Tube used mainly for CBC, pretransfusion testing,
anticoagulant Hemoglobin A1C, and anti-rejection drugs. Note:
EDTA tubes specifically for Catecholamines also
include Sodium metabisulfite.
15 Clear PPT tube 8 to 10 times K2EDTA spray-dried Tube used for HIV Viral Load.
anticoagulant with
gel separator
16 Black and Brown (FMC 8 to 10 times K3EDTA and cellfree Streck Cell-Free DNA BCT CE tubes used at FMC
only) preservative in a only, for T790 EGFR.
liquid medium NOTE: If collecting immediately after heparin tube
collect a clear discard tube before collecting.
17 Yellow with yellow 8 to 10 times Acid citrate dextrose Tube used for Tissue Typing and some Flow
banded white label solution ‘A’ (ACDA) Cytometry testing.

18 Grey 8 to 10 times Sodium fluoride and Tube used for Lactate.

Potassium oxalate
anticoagulant
Blood collection tubes must be filled in a specific sequence to minimize contamination of sterile specimens, avoid possible
test result error caused by carryover of additives between tubes, and reduce the effect of microclot formation in tubes.
When collecting blood samples, allow the tube to fill completely to ensure the blood/additive ratio necessary for accurate
results. Gently invert each tube the required number of times immediately after collection to adequately mix the blood and
additive. Never pour blood from one tube into another tube.

,
Prepared By:

Sherwin P. Gammad, RMT, LPT, MSPHc

Instructor