Tube
GRAY TOP
PLASMA
RED TOP
SERUM
ORANGE TOP
SERUM
GOLD TOP
Additive and
Clotting Time
Sodium Fluoride
NO CT
REQUIRED
Lithium
Iodoacetate
NO CT
REQUIRED
Glass tube
(Silicon coated)
or Silica Particles
CT: 60 MINUTES
Thrombin
CT: 5 MINUTES
TUBE COLLECTION REFERENCE GUIDE
Notes
✓
✓
✓
✓
ANTIGLYCOLYTIC AGENTS
Number of Inversions: 8
Preserves glucose for up to 3 days
Antiglycolytic agent: K Oxalate
Number of Inversions: 8
Preserves glucose for up to 24 hours
Antiglycolytic agent: K Heparin
Tests Commonly
Associated
Requires
FULL DRAW
(may cause
hemolysis if
short draw)
Blood glucose and alcohol
level determinations
CLOT ACTIVATORS
Number of Inversions: 5
MOA: blood clots, serum is separated by centrifugation
✓
Glass: NO additive (0); glass is considered as a clot
activator
✓ Plastic: Clot activator (5)
Number of Inversions: 5
MOA: cleaves fibrinogen into fibrin
Thixothropic gel
+
Silica particles
CT: 30 MINUTES
STAT serum determinations
(CHEMISTRY)
Number of Inversions: 5
SERUM
Separator gel – inert material that undergoes a temporary change in viscosity during the centrifugation process
ANTICOAGULANTS
LAVENDER TOP
Ethylenediamine
Number of Inversions: 8
tetraacetic acid
MOA: chelates calcium
Optimal anticoagulant conc: 1.5-2.2 mg/mL of blood
WHOLE
BLOOD/PLASMA
✓
Most commonly used anticoagulant for hemotological
testing
Important considerations:
•
K2EDTA (most preferred), K3EDTA, LiEDTA, or
Na2EDTA can be used but NEVER USE Na3EDTA
Insufficient EDTA
(overfilled tube)
presence of clots or
microclots
Excessive EDTA
(underfilled tube)
falsely (↓) HCT and ESR,
degenerative changes in
WBC, false (↑) MCHC and
platelet count
Routine Hematological
studies - CBC, Reticulocyte
Count, modified Westergren
of ESR
•
GREEN TOP
Heparin
when platelet clumping (platelet aggregation) is
encountered when examining the smear, recollect a
blood sample using 3.2% sodium citrate and repeat
the platelet count
Number of Inversions: 8
MOA: inhibits thrombin
Optimal anticoagulant conc: 15-20 units/mL of blood
PLASMA
LIGHT BLUE TOP
PLASMA
3.2% Sodium
Citrate
Three formulations:
1) Ammonium Heparin = NOT used for ammonia level
determinations
2) Sodium Heparin = NOT used for sodium
determinations or electrolyte panel
3) Lithium Heparin = NOT used for lithium determinations
o
causes the LEAST INTERFERENCE in chemistry
testing
o
most commonly used anticoagulant for plasma
and whole blood chemistry assays
✓ Heparin induces cellular clumping (specially of
platelets), causing a false increase in WBC count, and
falsely decreased platelet count
✓ NOT to be used for:
▪
blood smear preparation = causes morphologic
distortion of platelets and WBCs + background
staining with Romanowsky stains (Wright’s and
Giemsa)
▪
coagulation studies because it inhibits thrombin
Number of Inversions: 3-4
MOA: binds to calcium in an unionized form
Critical ratio of blood to anticoagulant: 9:1
Important consideration:
✓ Forceful mixing and excessive inversions can activate
platelets and shorten clotting times
Osmotic Fragility Testing and
Blood Gas Analysis
STAT Chemistry
determinations
Coagulation tests
(PT, PTT/APTT)
YELLOW TOP
WHOLE BLOOD
TAN TOP
Sodium
Polyanethol
Sulfonate
(SPS)
Acid Citrate
Dextrose
(ACD)
K2EDTA
OTHER BLOOD COLLECTION TUBES
Number of Inversions: 3-4
✓
For blood culture specimen collections in microbiology
✓
Complement inactivation
K2EDTA
K2EDTA with gel
separator
3.8% Buffered
Sodium citrate
K2EDTA
Forms calcium salts
Forms calcium salts to remove calcium
Number of Inversions: 8
✓
WHOLE
BLOOD/PLASMA
YELLO-BLACK TOP
Contains very low levels of trace elements
Trace Elements
Molecular (PCR and DNA)
Tests
Number of Inversions: 8
✓
PLASMA
PINK TOP
Lead determination
Number of Inversions: 8
✓
PLASMA
BLACK TOP
Certified to contain <0.01 ug/mL of Lead
Number of Inversions: 8
✓
PLASMA
WHITE TOP
Blood bank tests, paternity
testing, HLA (tissue typing)
testing, DNA testing
Number of Inversions: 8
✓
PLASMA
ROYAL BLUE TOP
Blood Culture
Forms calcium salts
Westergren method of ESR
determination
Blood Bank Test
(Crossmatching)
Immunohematology
Broth Mixture
✓
Preserves viability of microorganisms
Microbiology – aerobes,
anaerobes, fungi