E-3
Sample Collection Order
In order to prevent coagulation and contamination, blood should be drawn into the collection tubes
in a specific order.
Note
: While the following orders are recommended by the various tube manufacturers, always
follow your clinic’s protocol for order of draw.
Order for Evacuated Collection Tubes
The following is the recommended order of draw when using evacuated tubes:
1. Blood cultures
2. Citrate
Note
: If drawing citrate first, it is important to draw and discard a small volume of blood
before dispensing the sample into a citrate tube.
3. Serum (with or without gel)
4. Plasma/lithium heparin (with or without gel)
5. EDTA
6. Fluoride
Order for Nonevacuated/Micro Collection Tubes
The following is the recommended order of draw when using nonevacuated/micro collection tubes:
1. Blood cultures
2. Citrate
Note
: If drawing citrate first, it is important to draw and discard a small volume of blood
before dispensing the sample into a citrate tube.
3. EDTA
4. Plasma/lithium heparin (with or without gel)
5. Fluoride
6. Serum (with or without gel)
Centrifuged Sample Inspection
It is good practice to examine the sample carefully following centrifugation. If fibrin strands can be
seen in the sample, they may interfere with sample pipetting. It may be necessary to rim the serum/
plasma with a wooden stick, respin the sample, and proceed.
Various conditions, such as hemolysis, may affect results. You also want to modify your test panel
based on the following visual observations.
Hemolysis
Visual
:
Sample has a transparent reddish hue ranging from pale pink to deep red.
Indications
:
Damage to red cells during sample preparation or intravascular hemolysis.
Icterus
Visual
:
Plasma has a transparent yellow to opaque brown color.
Indications
:
Obstructive or toxic liver disease, intravascular hemolysis.
Sample Preparation and Storage
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