Order of Draw and Additives | Blood Collection
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- เผยแพร่เมื่อ 24 พ.ค. 2024
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This lesson covers the correct order of draw for blood collection. We also explain the additives in each tube as well as some of the tests that you would look to run with each tube.
We break down the phlebotomy order of draw and explain why it is that the proper order really matters to ensure that your patients are not misdiagnosed and get the proper treatment that they need.
We also include a helpful mnemonic and acronym to help you to be able to memorize this order of draw so that you can always get it right.
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#OrderOfDraw #BloodTubes #ICUAdvantage
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NOTE: I did forget to mention, but typically the grey top tube tests will need to end up on ice immediately just like those select green top tube tests, in order to help preserve the values from when it was drawn from the patient!
ICU Advantage
Thankyou very much for this presentation.
May i suggest you something???
Wouldn’t it be great,if you could provide PDFs (via., links) for all the presentations, so ppl can download those & use them for revision and long-term retention(just a suggestion).
Thank you.
ICU Advantage yes each tube have had to be treat after in diferent ways an the invention and preparation to lab need to be different but this video is only about the color
For capillary draws, order is OPPOSITE. With capillary draws the blood is dropped in microtainers. Lavender microtainer is FIRST because of potential clots and fibrin formation. However, as with order of draw with vacutainers, I continue to draw green microtainer before lavender because of cross contamination risk (of k-edta contaminant) and never had clotting problems. What are your thoughts?
I really like t way how do you explain on the video
The question is what do you do if you inadvertently screw this up and obviously don't want to pull the needle?
Easy way to remember the order is
You- Yellow
Better- Blue
Remember - Red tiger top gold
Gods - Green
Loving - Lavender
Grace -Gray
Thanks for sharing!
THIS JUST HELPED ME SO MUCH THANK YOU!
Wow, thank you
Amen! Thank you
You’re so wicked good! Thanks! I love it! Don’t need it, but I love it! Cheers!🇨🇦❤️🙏🏽
I got by the acronym Boys Should Stay Home Every Summer. B for blood culture tube, S for sodium citrate, S for serum tube, H for heparin, E for EDTA, and S for sodium fluoride/ potassium oxalate.
Ooo that's a good one! Thanks for sharing!
Just took my NH exam and passed with a score of 420. Thank you for this detailed video, could not have done it without your help.
Congrats! Way to go! Glad to have been able to help some
Congratulations.. I was going to start my phlebotomy class and just want to know on the test what are the main things that they ask for .. I know everything is important I was told the order of draw it is very important I got a phlebotomy book to see what I getting myself into but the book that I bought seem to be really difficult to understand any suggestions??
@@jennelllyons6622 You should definitely get you tubes/bottles and additives in line!
I learned the basic order from the acronym “bunny rabbits get pregnant” so blue red green purple.
Hahaha this is great! I LOVE it!
I love this, I’m going to forever use this to remember 🥰
How come the gold tube is not added in this?
Thank you
@@lauraspeegle gold is same as red
I had these mnemonic for the proper order of draw. It is BCNHES (pronounced as benches)
B- blood culture (yellow)
C- citrate (blue)
N- no additives (red)
H- heparin (green)
E - EDTA (lavender)
S- sodium fluoride ( black or gray)
Nice! I like it!
Taking this with me thank you!! I just made this up for colors: (Y)ou (B)elong (R)eading (G)reat (L)ove (B)efore (G)od
Thats not a mnemonic that is an acronym. Plus, Cultures aren't uniformly colored.
@@Harlem55 it's for me to associate with bcnches
I've been taught Be Careful (Blood culture) Stop (SPS) Light (Light blue) Red, Stay (SST) Put (PST) Green, Let's (Lavender) Go! (Gray)
As a medical lab tech, the emphasis of how important the lab draws are is crucial for accurate lab testing. Integrity is everything. Loved this break down
Awesome! Glad you liked it and thanks for taking the time to leave a comment!
I'm transitioning from phlebotomy in a plasma center to phlebotomy in a lab or Dr office. We only take two samples. I need to know all this for my interview to get hired at a lab or Dr office. This really really helped me. Thank you so much 😊
I'm here because I'm thinking of taking a Phlebotomy course. This was very informative. Thanks so much. (I'm a retired Respiratory Therapist).
I’m in a new phlebotomists course and this video was amazing not only was it informative but it boosted my confidence. I plan to share this with my students. Thank you! The speaker was very clear and educational 🙏🏽
Thank you so much for this comment and feedback! I'm glad that you enjoyed the video and found it helpful. Absolutely would love the shares! :)
You're saving my life, sir! Ok, not literally, but you are DEFINITELY helping me through phlebotomy training! THANK YOU SO MUCH!!!💯💯💯
Yaaaas! So happy to be able to help! :)
This was so useful! I have my certification exam in a couple of weeks, and I was worried I wouldn't have a way to remember the order. This was so simple to understand, and I like the acronym. It's very easy to remember.
My top tip:
If you use a butterfly needle with a sodium citrate tube, you must take 2 tubes and discard the first one as it will be underfilled due to air in the line. It's the number 1 cause of underfilled citrate tubes in my lab.
The sodium citrate is best thought of as an actual reagent in the actual clotting tests. It differs from EDTA etc. because it's reversible with the addition of calcium, so as part of the clotting time tests a fixed amount of calcium is added to start the clotting and that's when the timer starts. This assumes a fixed concentration of citrate. If the tube is underfilled the concentration of citrate will be too high and the clotting times will be extended.
100% agree. Also: The first sample when using a butterfly needle MAY be contaminated with skin/tissue particles from the puncture, which may effect blood clot formation and therefore your coagulation parameters down the line!
Thanks for this video. I've been drawing blood since 2006 and got my associate degree in medical assisting since 2010, and your video took me back to my classroom days. You explain like a professor. I also learn by understanding the WHY of the issue, not just memorizing colors since some tubes are interchangeable and also different Labs use different colors for different tests. This was very informative, thank you.
literally the only reason I understand any of these tubes is all thanks to you. thank you thank you thank you!!!!!!!!!
Oh wow Ashley! This is so cool! I'm so happy to hear that I was able to help you. This is awesome :) You are more than welcome.
Ahhhh I hope it works for me too!!!
I first want to thank God and say thank you for your time on doing this video. I pass my NHA exam today. I never really had time to study the order of draw or test to the tubes. It’s a lot of information. This acronym is so simple! I played the video until it was time to turn our phones off for testing. Yes! The why’s... is a must know for NHA! Thank you again! 🤗
Wow Maria this is so awesome to hear! Congratulations! I'm beyond happy to hear that this video was helpful for you in your studying and being able to pass your exam. Thats so great!
Congratulations! How'd you do Maria? Mine is next week! Did you study using NHA? (Not Pete. Using husbands acct- This is Kathleen
Congratulations 🎊, my Phlebotomy Certification test is coming soon. This video is helping to make it make sense.
Thank God I found it
Continue to grow.
Blessings for sharing.
I used to work in the coagulation lab and I cannot emphasize enough the importance of mixing those blue tops so that the citrate mixes with the blood to stop clotting. The number of times I had to reject clotted samples was quite sad. I also had to explain to one nurse why I couldn't run an aptt on a clotted sample.
I am currently a phlebotomy student. This was a very, very helpful video! Thank you so very much!
Awesome, glad you enjoyed it!
I am entering the workforce after quite a few years and I needed this brush up! Thanks!
This video is very helpful and it is very helpful when it comes to learning about all the different tubes and the purpose for each tube. It is also important to remember to make sure that the tubes are not mixed and the additives in the tubes do not contaminate each other.
I’m a year into my nursing career as a CTICU RN and watch your videos whenever I get a moment. I wish you made handouts that I could refer back to.
The ease of your voice and explanation in this lesson. Thank you!
😊 Appreciate that! Glad you enjoy!
I do not know how anyone can unlike this video. Made what could be complicated very simple. Thank you.
Haha thank you. I think the same thing sometimes when I get dislikes on videos lol
This was very well done, to the point with just enough details of additives. Thank you!
Very informative. I’ve been working in lab for a few years and it’s changed so much with new tubes.
I liked the way you taught & explained it in a way to understand. Thank you so much! Great job!
Thank you so much Jeannie! Glad you liked it!
In my phlebotomy program, instead of Grey being last, it's the Royal Blue sometimes with a red stripe, the Toxicology tube, used for testing for heavy metals in the blood
Having worked in an environment where all the blood tubes were completed by phlebotomy, usually while I started the IV, this is quite helpful to know the correct order and why. I worked in a ED last Winter and had to draw all my own labs. Great video. Thanks.
I can't thank you enough for this. I'm taking the class right now and my exam is coming up. This was beyond helpful. Super appreciated. Also, I saw from another youtuber that a great way to think of this is as a landscape portrait with a sunrise. White (clouds), Blue (sky), Red (beginning or top of sunrise), Gold/tiger top (bottom of sunrise or the shining part of it), Green (grass), Purple (flowers) same with pink, it would just be by and under the purple flowers, and grey (end of painting or your signature).
Very cool. Hadn't heard that one. Thanks for sharing that!
Love this
I’ve been struggling to understand the order of draw and now I fully understand thank you so much
So great to hear this!
Thank you so much! I have so struggled with additives and it finally all makes sense. Great video!
Awesome! Glad it was what you needed! :)
Ok so I start phlebotomy training on the 24th ! I’m nervous and excited! This video has helped me so much ! Plus I learned there’s a tube just for blood type 😅 that was interesting ! 🎉will be making little cards with all this info
I am currently in Phlebotomy and this was a part of my course work and it acutally helped, especially with the acronym at the end because thats how my brain best remembers things! you're awesome, keep doing what you're doing!
Very cool! Glad you liked the video and that the acronym helped.
Yellow tube- SPS
Light blue - Sodium Citrate
Red/Tiger Tip/ Gold- Gel Barrier / Clot Activator SST
Green- Heparin(lithium, ammonium, sodium)
Pink/ Lavender- EDTA
Grey- Potassium Oxalate( additive) Sodium Fluoride (preservative)
I am a certified phlebotomist since 2018 but i have a phlebotomy job that doesn’t require the typical tubes, so this helped me brush up on tube order since ill be job hunting for phlebotomy positions at regular labs soon :)
So glad to help! Best of luck on the new job search!
Thank you so much for this video. I took my preliminary test today and cried at how bad I did. This explained it all so much better. You are the best!
Very clear and detailed, and easy to remember. Thank you.
Really interesting to see the subtle difference between the US and the UK. Our order of draw is:
White, Blue, Gold, Green, Violet, Pink. We always take a VBG for patients in A&E (the ER). Then cultures.
The way I remember it is to start off with a blank canvas (white), paint the sky (blue), add the sun (gold), then paint the grass (green) and add some flowers (violet and pink).
White: Nothing gets tested. The sample gets disposed of but it stops the following samples haemolysing.
Blue: Clotting, D-Dimer, etc
Gold: Biochemistry (U&Es, LFTs, CRP, etc)
Green: Troponin
Violet: Haematology (FBC/CBC, etc)
Pink: Group & Save / Cross Match
Very helpful! Thank you.
I've graduated 4/16/21, and have a job offer with Davita dialysis...good luck to everyone
Congratulations!!!
Thanks again.. looking for work after graduation was a bit tedious but I was offered a position at DaVita Dialysis. Just to get some experience.....so I'm going for it.
@@anubianqueen79 congratulations girly. Happy to hear. How long was your schooling
@@Lydiaheart411 I did it fast paced in 12 weeks. But a lot of studying especially when it came to the heart function and order of draw test.. individually over 50 tests, additives and lab orders..but hey I did it and I'm continuously being blessed.
@@anubianqueen79 that's Amazing do you like it so far??
I starting training as soon as I find an online course. So glad I found this channel
This video was awesome! Best one out there. Very informative and straight to the point. Thank you very much!
Awesome to hear! Thank you Paula. Glad you liked it!
Very impressed with your explanation of order of draw. I'm a medical laboratory technician and I'll be sharing this with our phlebotomists and students!
Awesome, thank you Val!
I like how this whole video was made. It’s very nice and hey I’m a man with Aspergers so I appreciate your illustrations.
Awesome to hear that you found it helpful! Thank you for taking the time to leave a comment!
Fantastic way to explain the blood draw order. Thank you
Thank you for this awesome comment Daniela!
You are so good! I want to be able to go back to school in May with confidence with what I learned from you! You explained it so well! We had to stop school from the Coronavirus! So this was very helpful to brush up knowledge! Thanks again!
Thank you thank you Jeannie! I'm really glad to hear this! Best of luck to you once things resume!
Here's my Whatsapp +1)425)3697660
@@doctorbilly5357 hi
While browsing here in you tube found out that this video really inspired me to pursue my career as a blood taker, I am a newly licensed phlebotomist, sometimes disappointing to find job as a phleb. nobody hire u if your new :) I not give up :) lol. thank you for this video really helpful.
Thank you and I'm glad you enjoyed the video and found inspiration. It can be tough but stick with it and you will find the job you want and there will be no turning back! Best of luck to you!
Appreciated the contents of this video as it was organized, professionally presented, and provided a good explanation of the importance of the order of the draw. This is a good video for nursing students as well as phlebotomy students. Thank you!
This is so awesome! I'm happy to hear that you really enjoyed the video. I did my best to try and relay the right info in a way that explained why and made sense. Thank you for taking to time to stop by and leave this comment!
Med lab tech to
Perfect, very good explanation, many thanks! You're a gifted teacher, hope you use this gift with other nurses, patients or nursing students, etc, would be a shame not to!
I appreciate the kind words! I definitely try to help all when I can
i like the simplicity that you use i just got in to this field
Thank You for making ICU lecture!
You're very welcome! Glad you enjoyed it.
Thank you for this video! It's very helpful!
Awesome video! Super educational and so easily understanding!
Thank you!
Yay! So happy to hear this Rosa. You are very welcome.
I am so excited for class tomorrow I wanted to jump ahead just a little. An I love the ending helping us try to remember the order of draws!!!!!
Awesome, glad you liked it!
I really enjoy my my work as lab technicians! My co team members in India! I miss that! Thanks to all my staff to great support!
Thank you for sharing Naimisha!
Thank you this was so helpful as a refresher AWESOME VIDEO
This is a super educational video, thank you for your clear explaining and nice tips :D
Really helps with my upcoming blood science exam. Thank you! :)
Sweet! Hope you destroy that exam Jess! 🙂
Omg wonderful video I just start my phlebotomy class yesterday 11/11/19 and they dont give you the book they more like give you a sort of textbook on line smh so this video helps me so much because the class is so fast and it’s hard to catch up . Thank you is an understatement ❤️ 🙏
Awesome! Good luck with class and glad this was helpful for you!
This video has really helped me understand the order of draw! thank you so much.
You are very welcome Taylor! 😊
thank you!!! i start phlebotomy school soon, youre very helpful
I just stumbled across on this video and I
must say it has been very informative.
So happy to hear this! Thanks for taking the time to leave a comment.
It's been 6 years since I did draws and the old "use it or lose it" has kicked in. I have an interview tomorrow and need a refresher and am so glad and thankful for this video!
Awesome! I wish you all the best tomorrow and I'm glad that this video was helpful for you. Break a leg! 🙂
@@ICUAdvantage Thanks!
Thank you. Really got something out of this and really appreciate your having done this.
So happy to hear this Deborah. Happy to help!
Thanx a bunch for this Video.
I'm a CNA working in a Hospital where we draw blood on a regular. It's ran Digitally and when we print out the Ticket it has the color on it.
To night our System has been tripping all night. (THANX A LOT EPIC!!!!)
Got a Pt. with very difficult veins because of her condition,and we can't use the Doppler cause you have to be an RN so we have no choice but to do it the old fashion way.
So had an Order for a Fibrogen I didn't know what color the tube was and Long story short,Gotta re stick this poor lady and I hate doing resticks because people hate being restuck. Thanks to this video I can learn what all the colors are for what test and won't have to worry about this again.
Thanks a bunch
Glad these were helpful for you. Just know this video doesn't cover an exhaustive list of what tests are for what tubes and is more focused on the proper order in which to draw them.
Did your hospital give you blood drawing training without a phlebotomy certification?
Thanks for sharing. I'm currently studying for the NHA Phlebotomy certification and I have the order of draw down pretty good. However I'm still struggling with the department that tubes go to....like chemistry, coagulation, etc..
If anyone has any memory joggers please share.
Did you ever find any memory joggers for what tubes go to what department?
Thank You for making ICU lessons!! This is great for ICU newbie nurses :D
Thank you! Our goal is to make these topics and concepts easy to understand and grasp!
Thank you so very much for taking the time out of you day to make this awesome video. I really appreciate your help 🙏❤💪
Truly my pleasure to be able to help. Glad you enjoyed it!
Blood Culture, Blue, Red, SST, Green, Lavender, Pink, and Grey, Other tubes
Awesome video
One thing to note: If you are using a "butterfly" type needle and you are not drawing a bloodculture bottle. When you draw light blue first there is some air in the small flexible tubing running from the needle to the connector for the sample tubes. To make sure this air does not go into the lightblue tube and skew the ratio of Sodium Citrate to blood, fill the flexible tubing with blood by using a tube with no additives or another blue tube(that you then discard). At my workplace we use no additive tubes because the blue tubes are slightly more expensive
Thank you and thanks for the added info. You are absolutely correct about needing a waste tube to get the air out if not drawing in to a syringe!
So, Can I just use red tube first and then discard it, then Light blue and so on? (if I don't have blood coltures)
Came to the comments just to see if someone already mentioned this. Very important to use a red top to get the air out of the line first.
Very good tip. I will remember that
my favorite part is how easy you explain these kinds of things.
Thank you so much! So awesome to hear this!
Super appreciate your video! I will be watching your other vids to help with my classes!
Glad to hear you find these videos helpful!
Explaining the additives was simple and great. Thanks
Glad it helped!
STARTING SCHOOL IN TWO WEEKS AND I'M A BIT ANXIOUS.THANKS FOR THE INSIGHT
I will be finishing my phlebotomy class next week. Blessings on you class.
@@camilleoutten-lockhart249 CONGRATS
Ms. Dana Moultrie, CPS... thank you
Don’t be nervous you’ll do fine!!!
@@MizzNiah thank you so much for the encouragement
Loved it ! Taking my medical Assistant certification test!! Very helpful
yay! good luck! you'll have to let me know how you did!
ICU Advantage 👩💻 passed my test!! So happy 😁 thanks 🙏🏻
Congratulations
@@roxymami69 Amazing! Congrats!
Congratulations!!
Very informative and helpful thank you so much!!
Pretty helpful video!!! Very clear explanation. Thank you!!
You're welcome!
Blood tests always make me anxious because I’m scared of needles. I always apply EMLA cream (a kind of local anaesthetic) to my arm where the needle goes
Blood culture
Light blue
Serum
Rapid
Green
Lavender
Pink
Grey
Light yellow
Royale blue
Awesome!
Thank you for the video! I enjoy the informative content.
thanks for making the video. This actually helps me to understand better!
Absolutely my pleasure. I’ve always been the type to want to better understand the “what and why” behind things so I try to explain all that with my lessons. Glad you liked it! 😊
You should make a PDF of this video with the tubes. So good! Thanks :)
Good idea! ;) Glad you liked it!
Loved this video! I watched another video where she changed the order of draw because she was using a butterfly she did red top first then blue , gold and purple ….but she said if she was using a regular needle she would just toss the red top out and do blue, gold and then purple top. Why is this?
The only thing I can think is to eliminate the air thats initially in the butterfly tubing. The vacutainers have the vacuum set so they draw the proper amount of blood. Since the blue (coagulation studies) is very dependent on having the exact right mix of blood to citrate (hence why you must fill to the line.) That added air initially might decrease the amount of blood that you would end up in the tube.
Its pretty much been answered & im sure you don't still need the answer but - the blue top tube, which tests for clotting factors, that's 1 tube that MUST be filled to the top of the lab cannot/will not run it. So when using the butterfly needle, once you pop the tube in, it will first suck in all that air in the tubing of the butterfly thus not allowing all the blood to fill to the top. Whereas a straight needle, no tubing/air taking up space.
The reason they specifically used the red top tube, is because there's no additive in it. Your blue must always come first & you cannot cross contaminate it with another tubes additive (like edta in the lavender tube) or it'll give faulty results 😊 hope this helps!
The red top is the discard tube. But now you can use a lit blue tube for the discard tube.
because it is vital the blue top tube has the exact amount of blood as mentioned. butterfly needles will add a small amount of air (as mentioned with the culture bottles) into the first tube you fill. she chose the red top because it has no additives that will carry over in to the blue top and affect the results. this is how it always should be done! this allows the air to go into the red top tube to be discarded.
Because of the 'space' in the flexible tubings attached to the butterflyneedle, it will b sucked in into the Lt blue tube thereby causing underfilled tube.so you need a "'discard tube".
I absolutely loved this video! Thank you so much!
Woohoo!! 😊 Really glad you enjoyed it
Thank you for explaining so nicely. I have become your fan:)
Blood culture
Discard tube(depending in place)
Citrate
Serum
Heparin
EDTA
Oxalate
Video starts at 3:27
Good lookin out lol
It also ends at 22:56
Really help me to study the order of draw better thanks.
As a nurse thank you I work at a small hospital and any draws that are not scheduled at 5am or 11pm for night shift we get. And I always wanted to understand the reasoning
put the play back speed at 1.5 , trust me. love this video tho! thanks
Haha thats great! I keep trying to make the videos shorter but have not had success yet! Glad you liked the video.
ICU Advantage 😍😍😍😍 dont change for me lol!! Some people need things explained slower !
Watch it with the captions. Helped me retain the information easier
I use this as a mnemonic (Blue and Red Gives Purple) and I fill the rest in my mind.
Nice! I like it!
I love your videos. You are amazing. Thanks for all your efforts! ♥️
Wow, thank you so much Celia! I really appreciate your kind words!
Thank you so much... I’m a new grad ICU NURSE. Now I will feel confident in choosing.
SO great to hear this Renee! BTW, great last name ;)
Sterile bottles
Light blue
Red
Yellow
Mint green
Green
Lavender
Pink
Grey
Dark blue with red stripe
Dark blue with light blue stripe
Very inclusive! Great job!
S G The colors are standardized for the various additives or lack there of. I covered the additives in the video.
I remember it by Yolanda Loves Red Golden Grapes Like Gary
Awesome! Thanks for sharing this Richard.
Very great and informative video! I love your teaching style
Awesome! Glad you enjoyed it Sasha!
This is so informative. Nice presentation and soothing voice !!!
So glad to hear it! Thank you!
I was told by my preceptor Bring Your Good Liqour
Blue, Yellow, Green, Lavender
Love this!
Easiest to remember lo
Im looking at my order of draw sheet from the phleb class I started today and it showed "gold" before "red", would it matter if either or went first if both were required?
They are essentially interchangeable. Neither has anything that would impact the results down the order from them.
This was soo much help I thank you.
Thank you so much for this video. I am just getting started and I had no idea where to begin. Very good description of how and why. I was wondering if the sterile culture tubes, the ones to be drawn first, are usually white or yellow or both? I keep reading people saying yellow first so I was just wondering if they are the same tubes just might vary in color? thanks:)