order of draw cheat sheet

Lemon

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31-01-2025

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Accurate blood collection is paramount in healthcare, and understanding the order of draw is fundamental to ensuring the integrity of laboratory results. A seemingly small error in the sequence can compromise sample quality, leading to inaccurate diagnoses and potentially impacting patient care. This cheat sheet provides a clear, concise guide to mastering the order of draw, helping you avoid common pitfalls and maintain best practices.

Why is the Order of Draw Important?

The order of draw is crucial because different additive tubes can contaminate each other. For example, transferring anticoagulants or additives from one tube to another can alter test results significantly. Following the correct order minimizes the risk of cross-contamination and ensures accurate and reliable laboratory results.

The Standard Order of Draw (Most Common):

This order of draw is generally accepted as standard, but always refer to your institution's specific guidelines. Variations may exist depending on the specific tests being performed.

1. Blood Culture Bottles (Aerobic and Anaerobic): These are drawn first to minimize the risk of contamination from other tubes. The bottles should be meticulously cleaned and disinfected before venipuncture.

2. Sodium Citrate (Light Blue Top): This tube contains sodium citrate, an anticoagulant used for coagulation studies (PT, PTT, INR). Drawing it second prevents contamination with other additives.

3. Serum Tubes (Red Top or Gold Top): These tubes contain no additives (or a clot activator in gold-top tubes). They're used for serum-based tests. Drawing it after citrate tubes prevents anticoagulants from interfering.

4. Heparin Tubes (Green Top): These tubes contain heparin, an anticoagulant used for various tests that require plasma. Heparin acts differently than citrate, so it's vital to draw it after the citrate tube.

5. EDTA Tubes (Lavender Top): These tubes contain EDTA, an anticoagulant used for hematology tests (CBC, blood counts). It prevents platelet clumping and is crucial for accurate hematological analysis.

6. Glycolytic Inhibitors (Gray Top): These tubes contain additives like sodium fluoride and potassium oxalate, which preserve glucose levels in the blood. They are used for glucose testing and other specific metabolic analyses.

Visualizing the Order:

To remember the order of draw, many healthcare professionals use a simple mnemonic device. While many exist, a helpful and commonly used one is "BC, B, R, G, L, G," representing Blood Culture, Light Blue (citrate), Red (serum), Green (heparin), Lavender (EDTA), and Gray (glycolytic inhibitors) tubes.

Beyond the Basics:

• Always check your institution's policy: Specific procedures and tube orders may vary slightly based on local regulations and laboratory protocols.
• Proper labeling: Each tube must be meticulously labeled immediately following blood collection, including patient identification and date/time.
• Tube inversion: Proper inversion of the tubes after collection is essential to fully mix additives with the blood sample.
• Maintaining aseptic technique: Strict adherence to aseptic technique throughout the entire process is paramount to avoid contamination.

Conclusion:

Mastering the order of draw is a cornerstone of accurate and reliable blood collection. By consistently following these guidelines, healthcare professionals can significantly contribute to accurate diagnosis and improved patient care. Remember that continuous education and adhering to established protocols are crucial for maintaining proficiency and accuracy. This cheat sheet serves as a helpful reference but should be supplemented with thorough training and practical experience.