Phlebotomy - Blood Tests: with Tube Colors
Blood Group & Rh Type
- ABO and Rh - LAV - Immunohematology/ Blood Bank - Invert gently 8 times immediately - Dedicated ("Lav") top or pink top - Special ID Procedure Detection of ABO and Rh antigens on the red blood cells.
Alkaline Phosphatase
- ALP - Gold Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Centrifuge for complete separation as soon as possible - Fasting 8-12 hrs is required This blood test determines liver function
Alanine Transferase
- ALT - Gold-Top or Red/Gray - Chemistry - Invert gently 5 times immediately - Centrifuge for complete separation as soon as possible and refrigerate Evaluate hepatic disease
Aspartate Transferase
- AST - Red/Gray or Gold Tube - Chemistry - Invert gently 5 times immediately - Centrifuge for complete separation and refrigerate Acute and chronic liver disease
CHEMISTRY BLOOD TESTS: Acid Phosphatase
- Acid P'tase - Gold-Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Centrifuge, Separate, and Freeze serum immediately - Transport Frozen Cancer of the Prostate
Basic Metabolic Panel
- BMP - Red Top - Chemistry - Invert gently 8 times immediately - Separate within 45 mins of venipuncture - Fasting 8-12 hrs is required A designated number of tests covering certain body systems
(Blood) Urea Nitrogen
- BUN - Red/Gray - Chemistry - Invert gently 5 times immediately - Centrifuge for complete separation and Refrigerate Kidney Function
Bilirubin, Total & Direct
- Bili - Pink - Chemistry - Invert gently 8 times immediately - Spin and separate within 45 mins - Wrap in foil to protect from light - Refrigerate Increased with type of jaundice (hepatic or hemolytic)
Order Of Draw - ETS/Syringe with Transfer Device
- Blood Culture Tube - Sodium Citrate Tube (e.g., Light Blue Top: Coagulation). - Serum Tube with/without Clot Activator, with/without gel (e.g., Red, Red/Grey-mottled, or Gold Stopper). - Heparin Tube with/without Gel Plasma Separator (e.g., Green Top). - EDTA Tube with/without Gel Separator (e.g., Lavender, Purple, or White/Pearl Top). - Sodium Fluoride/Potassium Oxalate Glycolytic inhibitor (e.g., Grey Top).
HEMATOLOGY TESTS: Complete Blood Count
- CBC - LAV - Hematology - Invert gently 6-8 times immediately - Includes WBC, RBC, Hgb, Hct, Indices, Platelets and Differential This blood test determines blood disease
Creatine Kinase
- CK - Gold Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Refrigerated Serum Muscular dystrophy and trauma to skeletal muscle
Creatine Kinase MB
- CK/MB - Gold Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Refrigerated Serum Organ differentiation and to rule out myocardial infarction
Chromium (no additive)
- CR level - Royal Blue - Chemistry - Metal free, separate and refrigerate immediately Associated with diabetes and aspartame toxicity
Phenobarbitol
- Can be taken during pregnancy - Red Top Tube (non-additive) - Chemistry
Cholesterol, HDL
- Chol - Red/Gray Tube or Gold Tube - Chemistry - Invert gently 5 times immediately - Separate as soon as possible; refrigerate serum Evaluates risk of coronary heart disease
Creatinine
- Creat - Gold Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Separate as soon as possible; refrigerate serum Kidney Function
Copper (no additive)
- Cu level - Royal Blue - Chemistry - Metal free, separate and transfer to a plastic transport tube immediately Wilson disease or nephritic syndrome
COAGULATION TESTS: D-Dimer
- D-D1 - Light Blue - Coagulation - Invert 3 to 4 times - 1ml frozen citrated plasma from a completely filled Lt Blue tube. - Separate and freeze Plasma immediately in plastic vials. - Transport Frozen DIC and Therombic episodes such as Pulmonary emboli.
Differential
- Diff - LAV - Hematology - Invert gently 8 times immediately - Blood smear stained with Wright Stain Classifying Types of Leukocytes
Erythrocyte Sedimentation Rate
- ESR - LAV - Hematology - Invert gently 6-8 times immediately After drawing
Alcohol
- ETOH - Gray - Chemistry - Invert gently 8 times immediately - Use non-alcohol germicidal solution to cleanse skin - Chain of custody required if for legal purposes Intoxication
Glucose
- FBS - Gray - Chemistry - Invert gently 8 times immediately - Separate from the cells within 1 hr or use gray-top tube Diabetes, Hypoglycemia
Blood Culture Collection Procedure
- Follow normal Identification Protocol; explain collection Procedure. - Identify venipuncture site and release Tourniquet. - Aseptically select and assemble equipment. - Perform friction scrub. - Allow the site to dry. - Remove the flip-off cap and inspect the bottle for visible defects. - Cleanse the Culture Bottle Stoppers while the site is drying. - Mark the minimum and maximum fill on the Culture Bottles. - Reapply the Tourniquet and perform the venipuncture without touching or repalpating the site. - Inoculate the medium as required. - Invert the bottle Several Times. - Clean the Patient's Skin if applicable. - Label the Specimen containers with required Identification Information, including the site of blood - collection. - Dispose of used and contaminated materials. - Thank the Patient, remove Gloves, and Sanitize Hands. - Transport Specimen to the lab as quickly as possible.
Thyroid
- T3, T4, TSH - Red Tube - Chemistry - Invert gently 5 times immediately - Must Be Separated To Plastic Transfer Tubes Hyper - or hypothyroid conditions
Iron & Total Iron Binding Capacity
- TIBC & FE - Pink - Chemistry - Invert gently 8 times immediately - Refrigerated Serum - Separate from cells within 1 hr of collection - Fasting morning specimen is preferred Assist in differential diagnosis of anemia
White Cell Count
- WBC - LAV - Hematology - Invert gently 6 to 8 times immediately after drawing. Infection (viral or bacterial)
Zinc (serum)
- Zn - Royal Blue (no additive) - Chemistry - If serum should be separated within 45 mins and transferred to the plastic transport tube Liver Dysfunction
Calcium
- iCatt - Red/Gray Tube - Chemistry - Invert gently 5 times immediately - Centrifuge with a cap on; do not pour over - Refrigerate - Place a piece of tape over the top of the tube, write "do not open" Bone cancer, nephritis, multiple myeloma
Acid-Fast Bacillus
-AFB -Green - Microbiology - Invert gently 8 times immediately - ("Green") top tube, Isolator tube, or Gel-Barrier tube. - Special Cleaning for site and tube stopper. Isolate and Identify Mycobacteria
IMMUNOLOGY/SEROLOGY TESTS: Antinuclear Antibodies
-ANA -Red -Immunology/Serology - Gel-Barrier tube. - Refrigerated Serum. - Avoid hemolysis and upemia This test determines systemic lupus erythematesus and other. Autoimmune Connective Disease
Antistreptolysin O Test
-ASO -Red - Immunology/Serology - Refrigerate or Freeze Serum if not performed immediately. This blood test determines streptococcul infection.
MICROBIOLOGY TESTS: Blood Culture
-BC -Yellow - Microbiology - Invert gently 8 times immediately - Whole Blood inoculated into two blood culture bottles: "Anaerobic" and "one aerobic" from two different sites or ("yellow") tube. - Do Not Refrigerate Isolate and identify potentially Pathogenic organism causing bacteremia or septicemia.
Anti-Rh Antibody Prep
-CMV -Red - Immunohematology/Blood Bank - Invert gently 5 times immediately - Special ID Procedure Administered to Rh-negative mothers to prevent Rh immunization.
Direct Antiglobulin Test
-Coombs Test/Direct -LAV - Immunohematology/Blood Bank - Invert gently 8 times immediately - Dedicated ("Lav") top - Special ID Procedure Detects antibodies attached to the patient's red blood cells.
Antibody Screen
-Coombs Test/Indirect -LAV - Immunohematology/Blood Bank - Invert gently 8 times immediately - Collect whole blood ("Lav") - Special ID Procedure Identifies any atypical antibodies present.
Epstein-Barr virus
-EBV -Red -Immunology/Serology - Gel-Barrier tube. - Store Serum at 2 to 8 degrees This test determines mononucleosis.
Fibrin Split/Degradation Products
-FSP/FDP - Light Blue - Coagulation - Invert 6 times immediately - Centrifuge for 15 mins, separate and freeze. - Transport Frozen. DIC and Thrombotic episodes, sign of increased rate of fibrin deposition.
Hepatitis B Surface Antibody
-HBsAb -Red -Immunology/Serology - Gel-Barrier tine, refrigerated serum This test determines of previous infection and immunity by hepatitis B.
Hepatitis B Surface Antigen
-HBsAg -Red -Immunology/Serology - Gel-Barrier tube, refrigerated serum This test determines acute or same chronic stage of infection and carrier status of hepatitis B.
Human Immunodeficiency virus
-HIV -Red -Immunology/Serology - Gel-Barrier tube, refrigerated serum -Do Not ship in glass tube Protect Patient's confidentiality by using a code number in place of patient's name.
Fibrinogen
-Light Blue - Coagulation - Invert 3 to 4 times - Centrifuge 15 mins, separate and freeze immediately. - Place in plastic vial and transport frozen. To investigate suspected bleeding disorder.
Platelet Count
-PLT. Ct - LAV -Hematology - Invert gently 6 to 8 times immediately after drawing. Bleeding disorders
Prothrombin Time
-PT - Light Blue - Coagulation - Invert 3 to 4 times immediately after draw. - Do Not Centrifuge or Freeze if the sample needs to be transported. Clotting factor deficiency, Monitoring warfarin therapy.
Partial Thromboplastin Time
-PTT - Light Blue - Coagulation - Invert 3 to 4 times immediately after draw. - Do Not Centrifuge or Freeze if the sample needs to be transported. Clotting factor deficiency, Monitoring heparin therapy.
Rheumatoid Factor
-RF -Red -Immunology/Serology - Gel-Barrier yuve, refrigerated serum - Overnight resting is preferred This blood test determines Arthritic Conditions.
Rapid Plasma Reagin
-RPR -Red -Immunology/Serology - Gel-Barrier tube - Refrigerated Serum
Cytomegalovirus
-Red - Immunohematology/Blood Bank - Invert gently 5 times immediately - Gel-Barrier tube -Separate As Soon As Possible; Refrigerate Serum. Screens donors and blood products for transplant programs.
Cord Blood
-Red - Immunohematology/Blood Bank - Invert gently 5 times immediately - Refrigerate Serum Group and type baby's blood to detect the presence of incompatibilities, or mother for possible Rh immune globulin.
Cold Agglutinins
-Red - Immunology/Serology - Gel-Barrier tube. Must be kept warm. - Incubate at 37 C and allow it to clot at 37 C before separation store and ship at room temperature. This blood test determines to diagnose viral and a typical pneumonia caused by mycoplusma pneumonia.
Febrile Agglutins
-Red -Immunology/Serology - Gel-Barrier rube - Random Serum Specimen - Avoid gross hemolysis and lipemia This test determines screens for Salmonella, Tularemia, Rickettsial, and Brucellosis organism antibodies.
Chlamydia Antibodies
-Red -Immunology/Serology - Gel-Barrier tube. - Refrigerate serum. - Collected using aseptic technique - Centrifuge and Separate serum from clot within 4 hrs of collection. This blood test for trachoma, psittacosis, LGV, and pneumonia.
IMMUNOHEMATOLOGY(Blood Bank) TESTS: Human Leukocyte Antigen
-Typing A&B - HLA-B27 - Yellow - Immunohematology/Blood Bank - Invert gently 8 times immediately - ACD("yellow top") tube; Unopened tube required. - Do Not Freeze or Refrigerate - Ethnic origin must be included. Tested for disease association, matching prior to organ transplantation, platelet transfusion, paternity and forensic evaluation.
Mononucleosis Screen
-monospot -Red -Immunology/Serology - Gel-Barrier tube, refrigerated serum This test determines infections mononucleosis.
Serum Protein Electrophoresis
- SPEP - Pink - Chemistry - Invert gently 8 times immediately - Refrigerated Serum Abnormal Protein Detection
OTHER CARDS: Glucose Tolerance Test Procedure
- Follow normal Identification protocol, explain collection procedure, and advice patient that water is allowed but drinking other beverages, eating food, smoking, or chewing gum is not allowed through- out the test period. -Draw fasting specimen and check for Glucose. - Ask the patient to collect a fasting urine specimen if urine testing has been requested. - Give patient the determined dose of Glucose Beverage. - Remind the patient to finish the Beverage within 5 Minutes. - Note the Time that the patient finishes the Beverage, start the timing for the test and Calculate the Collection Times for the rest of the Specimens based on this time. - Give a copy of the Collection Times to the patient. - Collect Blood and Urine Specimens (if applicable) as close to the Comp- uted Times as possible. - Label All Specimens with the Exact Time collected and the Time Interval of the test (1/2 hrs, 1hr, etc) in addition to patient Identification Information. - Deliver or send Specimens to the Lab As Soon As Possible (ASAP).
Amylase and Lipase
- Gold Tube or Red/Gray - Chemistry - Invert gently 5 times immediately - Centrifuge, and refrigerate serum - Avoid hemolysis and lipemia Acute Pancreatitis
Human Chorionic Gonadotropin
- HCG - Pink - Chemistry - Invert gently 8 times immediately - Refrigerated Serum Pregnancy, Testicular Cancer
Lipoproteins (high and low density)
- HDL & LDL - Pink - Chemistry - Invert gently 8 times immediately - Must Be Fasting a minimum of 12 hrs Evaluate lipid disorders and coronary artery disease risk
C-Reactive Protein
- HS-CRP - Red - Immunology/Serology - Gel-Barrier to be refrigerated Serum. This test determines Chronic Inflammation.
Glycosylated Hemoglobin
- HbA1c - LAV - Chemistry - Invert gently 8 times immediately Monitoring diabetes mellitus
Hematocrit, Hemoglobin & Red Cell Count
- Hct, Hgb, RBC - LAV - Hematology - Invert gently 6-8 times immediately - After drawing Anemia
Homocysteine
- Hcy - Pink - Chemistry - Invert gently 8 times immediately - Specimens must be centrifuged and separated within 2 hrs of draw Elevated levels indicate increased risk of atherosclerosis
Hemoglobin Electrophoresis
- LAV - Hematology - Invert 6 to 8 times immediately after drawing. Hemoglobinopathies and Thalassemia
Lactic Dehydrogenase
- LD - Pink - Chemistry - Invert gently 8 times immediately - Avoid hemolysis ="do not freeze or refrigerate" Cardiac Injury and other Muscle Damage
Digoxin
- Lanoxin - Red Top Tube (non-additive) - Chemistry Heart Stimulant
Indices
- MCV - LAV -Hematology - Invert gently 6 to 8 times immediately after drawing. Indicates mean cell hemoglobin (MCH), hemoglobin concentration (MCHC), and volume (MCV)
Magnesium & Phosphorus
- Mg - Pink - Chemistry - Invert gently 8 times immediately - Separate from cells within 45 mins - Maintain specimen at room temperature Mineral Metabolism, Kidney Function
Electrolytes (STAT)
- NA -Green - Chemistry - Invert gently 8 times immediately - "Avoid Hemolysis" Fluid balance, cardiotoxicity, heart failure, edema
Ammonia
- NH3 - LAV - Chemistry - Invert 8 times immediately - Centrifuge within 15 mins without removing stopper - Separate plasma and freeze in a plastic vial Evaluates liver function. High levels in the blood lead to a problem known as hepatic encephalopathy
Prostate Specific Antigen
- PSA - Pink - Chemistry - Invert gently 8 times immediately - Separate and freeze serum immediately in a plastic vial. - Transport frozen Screen for the presence of Prostate Cancer
Lead
- Pb - Royal Blue - Chemistry - Invert gently 8 times immediately - Use of other evacuated tubes or transfer tubes may produce falsely elevated results due to contamination. Lead Toxicity. Can lead to Neurologic Dysfunction and possible Permanent Brain Damage
Dilantin
- Phenytoin - Red Top Tube (non-additive) - Chemistry Treatment of epilepsy
Ferritin
- Pink - Chemistry - Invert 8 times immediately - Refrigerated Serum Hemochromatosis, Iron deficiency
Vitamin B12 and Folate
- Pink - Chemistry - Invert gently 8 times immediately - Centrifuge, separate, and refrigerate - Protect from light Macrocytic anemia
CHEMISTRY TESTS (Drug Monitoring): Amikacin, Gentamycin, Tobramycin & Vancomycin
- Red Top Tube (non-additive) - Chemistry
Carbamazepine (Tegretol)
- Red Top Tube (non-additive) - Chemistry
Lithium
- Red Top Tube (non-additive) - Chemistry
Theophylline
- Red Top Tube (non-additive) - Chemistry
Cryoglobulin
- Red Tubes - Chemistry - Invert gently 5 times immediately - Draw and process at room temperature - Separate from cells immediately Associated with the immunological disease (i.e., multiple myeloma or rheumatoid arthritis)
Uric Acid
- Red/Gray - Chemistry - Invert gently 5 times immediately - Must Be Separated Within 45 mins - Maintain specimen at room temperature Gout
Carotene
- Red/Gray Tube or Gold Tube - Chemistry - Invert gently 5 times immediately - Transport in amber plastic tube with amber stopper(if available). Warp in aluminum foil - To protect from Light. Freeze Carotenemia
Cortisol
- Red/Gray or Gold Tube - Chemistry - Invert gently 5 times immediately - Refrigerated system - Clearly noted time drawn Cushing Syndrome