Phlebotomy Order of Draw Study (NHCO
July 2023). Updated 2024/5.
Lab responsible for blood cultures?
Microbiology
Additive in blood cultures?
Sodium polyanethole sulfonate- SPS (Nutrient Broth)
How and what do you clean for blood culture?
ChloraPrep (not alc) at injection site and wipe down the tops of collection bottles
What order do you fill blood culture bottles?
Aerobic first and then anaerobic (butterfly tubing contains air, hence why aerobic is first)
What does STAT mean?
Test must be carried out immediately
T/F) Blood cultures are usually ordered STAT or as timed specimens
True
What is the purpose of sodium polyanethole sulfonate (SPS)?
To promote rapid growth of pathogenic/infectious microorganisms in a blood sample (for identification)-
blood culture bottles
What tubes come before and after blood cultures?
No tubes before, discard tube after (clear or glass red top).
What needle should you use for a blood culture?
Use a winged infusion set (butterfly) to prevent nutrient broth introduction to blood stream (may differ
by employer)
Which red top tube (glass/plastic) do you use as a discard?
Glass (glass red tops contain no additives)
What is a discard tube used for?
Used to prevent thrombin and other cells from polluting the samples drawn in following tubes.
What tubes come before and after a discard tube?
Blood culture bottles before, light blue top tube after
, What tubes come before and after a light blue top?
Discard tube before (clear, red glass), royal blue with red stripe after
T/F) the royal blue with red stripe tube has no additives
True
Does the royal blue red stripe tube yield serum or plasma?
Serum
What is the difference between a glass red top tube (no additive) and a royal blue red stripe tube?
The royal blue red stripe tube contains no nickel
What is the difference between a purple top tube and a royal blue lavender/blue stripe tube?
The royal blue lavender/blue stripe tube contains no nickel
What 2 tests are royal blue tubes used for? (Red stripe or lavender/blue stripe)
Lead (Pb) poisoning, Heavy metal toxicology
Lab responsible for royal blue tubes? (Red stripe or lavender/blue stripe)
Toxicology
How many times should you invert royal blue tube? (Red stripe or lavender/blue stripe)
8 times (but you will invert all tubes 8-10 times)
What tubes come before and after royal blue red stripe tube?
Light blue before, plastic red top after
What tubes come before and after royal blue lavender/blue stripe tube?
Lavender before, grey after
Lab responsible for light blue top tube?
Coagulation (or Hematology if a smaller facility)
Additive in light blue tube? What does it do?
Sodium citrate- anticoagulant (prevents blood from coagulating and using up coagulation factors before
reaching the lab)
How does sodium citrate work?
Sodium citrate prevents coagulation by binding to the calcium in a specimen. This preserves the
specimens coagulation factors.
How much should you fill the light blue tube top? And why?
July 2023). Updated 2024/5.
Lab responsible for blood cultures?
Microbiology
Additive in blood cultures?
Sodium polyanethole sulfonate- SPS (Nutrient Broth)
How and what do you clean for blood culture?
ChloraPrep (not alc) at injection site and wipe down the tops of collection bottles
What order do you fill blood culture bottles?
Aerobic first and then anaerobic (butterfly tubing contains air, hence why aerobic is first)
What does STAT mean?
Test must be carried out immediately
T/F) Blood cultures are usually ordered STAT or as timed specimens
True
What is the purpose of sodium polyanethole sulfonate (SPS)?
To promote rapid growth of pathogenic/infectious microorganisms in a blood sample (for identification)-
blood culture bottles
What tubes come before and after blood cultures?
No tubes before, discard tube after (clear or glass red top).
What needle should you use for a blood culture?
Use a winged infusion set (butterfly) to prevent nutrient broth introduction to blood stream (may differ
by employer)
Which red top tube (glass/plastic) do you use as a discard?
Glass (glass red tops contain no additives)
What is a discard tube used for?
Used to prevent thrombin and other cells from polluting the samples drawn in following tubes.
What tubes come before and after a discard tube?
Blood culture bottles before, light blue top tube after
, What tubes come before and after a light blue top?
Discard tube before (clear, red glass), royal blue with red stripe after
T/F) the royal blue with red stripe tube has no additives
True
Does the royal blue red stripe tube yield serum or plasma?
Serum
What is the difference between a glass red top tube (no additive) and a royal blue red stripe tube?
The royal blue red stripe tube contains no nickel
What is the difference between a purple top tube and a royal blue lavender/blue stripe tube?
The royal blue lavender/blue stripe tube contains no nickel
What 2 tests are royal blue tubes used for? (Red stripe or lavender/blue stripe)
Lead (Pb) poisoning, Heavy metal toxicology
Lab responsible for royal blue tubes? (Red stripe or lavender/blue stripe)
Toxicology
How many times should you invert royal blue tube? (Red stripe or lavender/blue stripe)
8 times (but you will invert all tubes 8-10 times)
What tubes come before and after royal blue red stripe tube?
Light blue before, plastic red top after
What tubes come before and after royal blue lavender/blue stripe tube?
Lavender before, grey after
Lab responsible for light blue top tube?
Coagulation (or Hematology if a smaller facility)
Additive in light blue tube? What does it do?
Sodium citrate- anticoagulant (prevents blood from coagulating and using up coagulation factors before
reaching the lab)
How does sodium citrate work?
Sodium citrate prevents coagulation by binding to the calcium in a specimen. This preserves the
specimens coagulation factors.
How much should you fill the light blue tube top? And why?
