TUBE COLLECTION REFERENCE GUIDE

Tube Additive and Notes Tests Commonly

Clotting Time Associated
ANTIGLYCOLYTIC AGENTS
Sodium Fluoride Number of Inversions: 8
Requires
GRAY TOP NO CT ✓ Preserves glucose for up to 3 days
FULL DRAW
REQUIRED ✓ Antiglycolytic agent: K Oxalate
(may cause Blood glucose and alcohol
Lithium Number of Inversions: 8
hemolysis if level determinations
Iodoacetate ✓ Preserves glucose for up to 24 hours
PLASMA short draw)
NO CT ✓ Antiglycolytic agent: K Heparin
REQUIRED
CLOT ACTIVATORS
RED TOP Glass tube Number of Inversions: 5
(Silicon coated) MOA: blood clots, serum is separated by centrifugation
or Silica Particles
SERUM CT: 60 MINUTES ✓ Glass: NO additive (0); glass is considered as a clot
activator
✓ Plastic: Clot activator (5)
ORANGE TOP Thrombin Number of Inversions: 5 STAT serum determinations
CT: 5 MINUTES MOA: cleaves fibrinogen into fibrin (CHEMISTRY)

SERUM
GOLD TOP Thixothropic gel Number of Inversions: 5
+
Silica particles
SERUM CT: 30 MINUTES
Separator gel – inert material that undergoes a temporary change in viscosity during the centrifugation process
ANTICOAGULANTS
LAVENDER TOP Ethylenediamine Number of Inversions: 8
tetraacetic acid MOA: chelates calcium
Optimal anticoagulant conc: 1.5-2.2 mg/mL of blood
WHOLE
✓ Most commonly used anticoagulant for hemotological
BLOOD/PLASMA
testing
Important considerations:
• K2EDTA (most preferred), K3EDTA, LiEDTA, or
Na2EDTA can be used but NEVER USE Na3EDTA
Routine Hematological
studies - CBC, Reticulocyte
Insufficient EDTA Excessive EDTA
Count, modified Westergren
(overfilled tube) (underfilled tube)
of ESR
presence of clots or falsely (↓) HCT and ESR,
microclots degenerative changes in
WBC, false (↑) MCHC and
platelet count

• when platelet clumping (platelet aggregation) is

encountered when examining the smear, recollect a
blood sample using 3.2% sodium citrate and repeat
the platelet count
GREEN TOP Heparin Number of Inversions: 8
MOA: inhibits thrombin
Optimal anticoagulant conc: 15-20 units/mL of blood
PLASMA
Three formulations:
1) Ammonium Heparin = NOT used for ammonia level
determinations
2) Sodium Heparin = NOT used for sodium
determinations or electrolyte panel
Osmotic Fragility Testing and
3) Lithium Heparin = NOT used for lithium determinations
Blood Gas Analysis
o causes the LEAST INTERFERENCE in chemistry
testing
STAT Chemistry
o most commonly used anticoagulant for plasma
determinations
and whole blood chemistry assays
✓ Heparin induces cellular clumping (specially of
platelets), causing a false increase in WBC count, and
falsely decreased platelet count
✓ NOT to be used for:
▪ blood smear preparation = causes morphologic
distortion of platelets and WBCs + background
staining with Romanowsky stains (Wright’s and
Giemsa)
▪ coagulation studies because it inhibits thrombin
LIGHT BLUE TOP 3.2% Sodium Number of Inversions: 3-4
Citrate MOA: binds to calcium in an unionized form
Critical ratio of blood to anticoagulant: 9:1
PLASMA Coagulation tests
Important consideration:
(PT, PTT/APTT)
✓ Forceful mixing and excessive inversions can activate
platelets and shorten clotting times
 OTHER BLOOD COLLECTION TUBES
YELLOW TOP Sodium Number of Inversions: 3-4
Blood Culture
Polyanethol
Sulfonate ✓ For blood culture specimen collections in microbiology
WHOLE BLOOD (SPS)
Acid Citrate ✓ Complement inactivation Blood bank tests, paternity
Dextrose testing, HLA (tissue typing)
(ACD) testing, DNA testing
TAN TOP K2EDTA Number of Inversions: 8

✓ Certified to contain <0.01 ug/mL of Lead Lead determination

PLASMA
ROYAL BLUE TOP K2EDTA Number of Inversions: 8

✓ Contains very low levels of trace elements Trace Elements

PLASMA
WHITE TOP K2EDTA with gel Number of Inversions: 8
separator Molecular (PCR and DNA)
✓ Forms calcium salts Tests
PLASMA
BLACK TOP 3.8% Buffered Number of Inversions: 8
Sodium citrate Westergren method of ESR
✓ Forms calcium salts to remove calcium determination
PLASMA
PINK TOP K2EDTA Number of Inversions: 8
Blood Bank Test
✓ Forms calcium salts (Crossmatching)
WHOLE Immunohematology
BLOOD/PLASMA
YELLO-BLACK TOP Broth Mixture ✓ Preserves viability of microorganisms
Microbiology – aerobes,
anaerobes, fungi