Allied Health · Phlebotomy

Phlebotomy: Order of Draw and Additives

Blood collection tube colors, their additives, and the correct order of draw tested on phlebotomy certification exams.

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What is the correct first tube to draw in the standard order of draw?
Blood culture tube (yellow top, SPS)
What does SPS stand for in a blood culture tube?
Sodium polyanetholesulfonate
Which tube color is drawn second in the order of draw, right after blood cultures?
Light blue top
Light blue top tube additive
Sodium citrate
What test is the light blue (sodium citrate) tube used for?
Coagulation studies such as PT and PTT
Why must a light blue coagulation tube be filled to its exact draw volume?
To keep the correct blood-to-citrate ratio for accurate results
What color is a plain serum tube with no additive and no gel?
Red top
What is the common abbreviation for a gold or tiger-top serum tube?
SST (serum separator tube)
What does the gel in an SST (gold top) tube do?
Separates serum from blood cells during centrifugation
What additive is in a gold/tiger top (SST) tube besides the separator gel?
Clot activator
In the order of draw, do serum tubes (red/SST) come before or after coagulation tubes?
After
What additive is found in a green top tube?
Heparin (sodium or lithium)
What is a green top (heparin) tube commonly used for?
Plasma chemistry tests, such as stat electrolytes or ammonia
How does heparin prevent blood from clotting?
It inhibits thrombin formation
Lavender (purple) top tube additive
EDTA

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