1. Blood Collection Procedure
Jimmy Hall, RN, BSN

2. Objectives Identify phlebotomy process Identify common lab tests
Identify common tubes used

3. Steps in Lab Drawing Verify order/requisition for tests ordered
Identify any special requests (some lab tests may need to be sent on ice, etc.)
Gather supplies
Tourniquet
Alcohol
Needle/Syringe/butterfly
Tubes
Gauze
Band-aid

4. Steps in Lab Drawing Identify patient Select a site for venipuncture
Get patient to state name and social security number if possible
Select a site for venipuncture
Always best to stick distal
If receiving IV fluids, use opposite arm if possible
If not possible, stick below IV site or turn IV fluids off for at least 2 minutes before sticking above IV site
Place tourniquet – tourniquet should not remain on the arm longer than ONE MINUTE

5. Steps in Lab Drawing Sites to Avoid Arms in a cast Arms with IV
Edematous arm
Cannula
Fistula
Vascular graft
Areas of extensive scarring
Side of the body that a mastectomy was performed

6. Steps in Lab Drawing
Prepare equipment, the patient, and the puncture site.
Explain procedure to patient
Place supplies nearby
Clean site (Chloraprep, alcohol)
Cleanse site in a circular motion from the center outwards with a 70% isopropyl alcohol solution
Allow site to dry

7. Performing the venipuncture
Puncture vein with bevel edge up at a 15 degree angle
Release tourniquet once blood flow begins
Fill each tube until blood flow stops flowing into the tube
Place a gauze to over puncture site and remove needle.
Invert tubes 5-10 times when tube contains additive
Place bandage to site
***Place needles and all sharps in sharps container immediately.
DO NOT PLACE SHARPS ON BED!

8. Steps in Lab Drawing
Insert tubes into holder in the correct order of draw:
Blood culture tubes
Light blue top tubes
Red/Gold top tubes
Green top tubes
Lavender top tubes
Gray top tubes
**When using a butterfly collection set for venipuncture and a light blue top tube is first tube to be drawn, a discard tube should be drawn first**

9. Steps in Lab Drawing Specimen label should include:
Patient’s first and last name
Identification number (account # or medical record #)
Date and time of collection
Initials of person collecting the specimen

10. Which color tube do you use?

11. Which color tube do you use?
Light Blue
PT, PTT, Fibrinogen, Fibrin D-Dimer, other coagulation testing
Invert gently 3-4 times

12. Which color tube do you use?
Red top (red/black and red/gold)
For tests requiring serum; contains clot activator
Common tests:
Red/Black: type/cross match
Red/Gold: CMP, BMP, drug levels

13. Which color tube do you use?
Light Green (Lithium Heparin)
Troponin, Metabolic Panels, Lipid, Liver Panels, Ammonia (on ice), HIV Rapid Anti-body
Bright Green (Sodium Heparin)
Mycobacteriology (AFB) Blood Culture, HLA-B27, Chromosome Studies
Dark Green (Lithium Heparin)
Ammonia (on ice), Ionized Calcium

14. Which color tube do you use?
Lavender tube:
Hematology : CBC, Platelet, Sed. Rate
Chemistry: CD4, CD8, G6PD, Hemoglobin A1C, and Hemoglobin Variants

15. Which color tube do you use?
Gray
Lactate (Lactic Acid) on ice

16. References:
University of California, San Francisco. Plastic tube top color and order of draw. March, Retrieved April 2, 2010, from lastic%20Tube%20Top%20Color%20and%20 Order%20of%20Draw%20Chart.pdf
University of Mississippi Medical Center. October 20, Phlebotomy procedure. Retrieved April 2, 2010, from cedure.html