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Vials with blue, purple and pink top contain enriched soybean-casin broth with CO2. Aside from bacterial, they are used in fungal blood cultures. As an anticoagulant, citrate binds the calcium in blood that is needed for clotting.
Since the additive still results in a whole blood sample — plasma and red blood cells, the coagulation tubes also contain buffered tri-sodium citrate solution. Tubes with red-colored stoppers are used for serology and immunohematology.
Plastic tubes need to be inverted to mix the blood with the coagulant. It usually takes 30 minutes for clotting to occur. Serology is done to check infectious mononucleosis, rheumatoid arthritis, syphilis, rubella titer, strep testing, pregnancy test, cold agglutinins, haptoglobin and C-reactive protein.
Some of the requested components include packed red blood cells, platelets, cryoprecipitate and fresh frozen plasma. Phlebotomy tubes with green top contain sodium herapin, lithium herapin and ammonium herapin, all of which are coated in the inside of the tube. The herapin anticoagulant activates antithrombins that block the coagulation cascade and produce a plasma sample or whole blood.
The same tubes are used for clinical chemistry and STAT chemistry tests. They contain a gel that separates plasma from the cells when centrifuged, and are used for a wide range of testing. Serum separator tubes make an acceptable substitute for PST.
Tubes with purple or lavender-colored stoppers contain EDTA ethylenediaminetetraacetic acid additive that binds calcium ions, effectively blocking coagulation cascade. Clinical laboratories use these to test for whole blood. The former is used to test whole blood in molecular diagnostics. EDTA tubes are used in direct sampling analyzers without the need to open them. For up to 24 hours, erythrocytes, white blood cells and platelets remain stable in blood anticoagulated with EDTA, but blood smears must be prepared 3 hours after specimen is collected.
Routine hematology tests that use EDTA tubes include hemoglobin, hematocrit, white blood cell, red blood cell, and platelet count, reticulocyte count, eosinophil count, body fluid counts, sickle cell test, and erythrocyte sedimentation rate.
These are often used for laboratory procedures where glycolytic inhibition of specimen is needed. Although red top tube can be used for a similar procedure, gray top tubes are preferred when there is a delay in having the glucose level tested. For adequate mixing of blood and additive, the tube must be inverted 4 to 5 times after specimen is collected.
Generally, phlebotomy tubes with gray stoppers are used to test glucose levels, lactate, bicarbonate and blood alcohol levels. In clinical chemistry, however, it is used for a wide range of specialized and routine procedures.
These include tests for the following:. Aside from these, there are blood collection tubes with slight variations in color. Tubes with pink stoppers, for example, are used in blood banks for different procedures, such as cross-matching, screening of anti-bodies or blood typing.
In total, there are different blood collection tubes for different tests. The tubes have different top color, additives and purposes. Disclaimer: The brand of blood tubes pictured below is BD.
We are not paid nor sponsored by BD for this post. We are not in the position to recommend BD as well. The picture taken and featured below are for educational purposes only. Purpose of Additive: Acts as an anticoagulant by binding to calcium in blood to prevent clotting. Purpose of Additive: After centrifugation, the separating gel serves as a barrier between the serum and the clot. Purpose of Additive: Inhibits coagulation by inactivating thrombin and thromboplastin to produce a plasma or whole blood sample.
Purpose of Additive: Forms calcium salts to prevent coagulation. Tube is designed to prevent risk of trace metal contamination. Common Tests: Toxicology, drug level and trace element testing lead, copper, mercury and zinc. Practice your skills in doing blood draws with this useful kit for students. Check it out here.
Considering the most common tubes used by nurses for venipuncture, here is the proper order of blood draw:. It is important to take the blood cultures first to prevent contamination from the additives of the other blood tubes. The aerobic bottle should also be drawn first to prevent air contamination in the anaerobic bottle if you are using a butterfly needle. Following the proper order of blood draw is essential in ensuring accurate blood test results. If it will not be followed, some tests may produce false-positive result.
For example, drawing lavender tube before gold or SST tube will spike potassium levels in the SST tube, thereby producing false hyperkalemia result.
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