Can I get a definitive statement as to the CORRECT order to teach Nurses to fill Blood Tubes ie I know Blood Cultures are first and Lavender is last......but happens in between.....Also if you are using a vacutainer system versus syringe do you filled the tubes in a different order? I thought someone had commented on this subject before but I searched and could not find the discussion--Thanks in advance of your responsesÂ
You have the right answer,
According to our Lab physician:
1.Blood Culture
2.Coags Blue top
last is purple / laveder CBC top
Everything else is after #2
Does not matter if syringe or vacutainer.
We use this The red gold green is a traffic stoplight as a reminder
YO yellow (blood cultures)
BEHOLD blue
the
RED red
GOLD gold
GREEN green
LIGHTS lavender
PRETTY pink
GIRL gray
The info can come from your clinical lab. They assume that nurses are drawing labs in this order. Most nurses are completely unaware of the "Order of the Draw." The reason is that blue must be first (after BC or waste) is that you cannot allow blood to sit in the catheter or tubing, nor can you allow any contamination of the vacutainer needle with any other anticoagulant, as these factors will affect the coag results. Next you draw the studies WITHOUT anticoagulants, eg, viral studies, serum studies---those go in your red top or gold top tubes (serum separator tubes). 3rd: Green or mint top tubes have heparin: these are for your chemistries. 4th: lavendar top: had EDTA which apparently has a high concentration of potassium in it. That is why it must be drawn last. Other tubes are drawn far less often; I encourage nurses to just call Clinical Lab to go over the "Order of the Draw" if you have to draw a navy, gray, or yellow top tube.
To help us out, one of the lab supervisors made a laminated poster stating the order of the draw with the colored tubes hot-glued to it. It's a clear reminder of how to do the "order."
Nadine Nakazawa, RN
PICC Nurse, Stanford Hospital
Nadine Nakazawa, RN, BS, VA-BC
Robin,
I have a color chart that lists the sequence, what's in the tubes and special handling (e.g. putting blood for ammonia on ice). We laminated this and have it in the areas where our nursing units have lab supplies. Send me your email address. [email protected]