The Correct Order of Draw Protocol In Phlebotomy: Importance and Guidelines

Summary

• The correct order of draw is crucial in phlebotomy to prevent sample Cross-Contamination.
• The order of draw is determined based on the types of additives in the blood collection tubes.
• Phlebotomists must follow the recommended order of draw protocol to ensure accurate Test Results.

Introduction

Phlebotomy is the process of drawing blood from patients for medical testing, transfusions, donations, or research purposes. One of the critical aspects of phlebotomy is ensuring the correct order of draw is followed when collecting blood samples. The order of draw refers to the sequence in which different blood collection tubes should be filled during a blood draw. This protocol is essential to prevent Cross-Contamination of samples and ensure accurate Test Results. In this article, we will explore how the correct order of draw is determined in phlebotomy.

Importance of the Correct Order of Draw

Following the correct order of draw is crucial in phlebotomy for several reasons:

1. Prevents Sample Cross-Contamination: Different blood collection tubes contain various additives to preserve the integrity of the blood samples and facilitate different tests. If the tubes are filled out of order, there is a risk of contaminating the samples with additives from the previous tubes, leading to inaccurate Test Results.
2. Ensures Accurate Test Results: Each blood collection tube is designed for specific types of tests, and the order of draw is determined to minimize the risk of sample contamination or interference. Following the recommended order ensures that the samples are collected in the right tubes, preserving their quality and integrity for accurate testing.
3. Promotes Patient Safety: By following the correct order of draw, phlebotomists can minimize the risk of complications for patients, such as inaccurate Test Results, misdiagnosis, or unnecessary retesting. This protocol is vital for patient safety and quality care.

Determining the Correct Order of Draw

The order of draw is determined based on the types of additives present in the blood collection tubes. Different additives are used to preserve the blood samples, prevent clotting, or facilitate specific tests. The most common order of draw recommended by clinical laboratories and phlebotomy organizations is as follows:

1. First Tube: Blood Culture tubes (yellow or yellow/black stoppers)
2. Second Tube: Coagulation tubes (light blue stoppers)
3. Third Tube: Serum tubes with or without gel (red or gold stoppers)
4. Fourth Tube: Heparin tubes (green stoppers)
5. Fifth Tube: EDTA tubes (lavender stoppers)
6. Sixth Tube: Glycolysis inhibitor tubes (gray stoppers)

Following the Order of Draw Protocol

Phlebotomists must adhere to the order of draw protocol during blood collection to ensure the accuracy and reliability of the Test Results. Here are some key points to remember when following the correct order of draw:

1. Verify the Patient's Identity: Confirm the patient's identity before starting the blood draw to prevent errors or mix-ups.
2. Use the Correct Collection Tubes: Select the appropriate blood collection tubes based on the tests being ordered and the order of draw protocol.
3. Properly Label the Tubes: Ensure that each tube is labeled correctly with the patient's information to avoid sample mix-ups or mislabeling.
4. Follow Standard Aseptic Techniques: Maintain proper hygiene, use clean equipment, and follow aseptic techniques to prevent contamination during the blood draw.
5. Discard the First Tube: When using evacuated tube systems, discard the first tube collected to clear the air from the tubing and prevent sample contamination.
6. Invert the Tubes Gently: After collection, invert the tubes gently to mix the blood with the additives without causing hemolysis or clotting.
7. Transport the Samples Properly: Store the blood samples in the recommended conditions and transport them to the laboratory promptly for processing.

Conclusion

Ensuring the correct order of draw is followed in phlebotomy is essential for maintaining the integrity of blood samples, preventing Cross-Contamination, and obtaining accurate Test Results. Phlebotomists play a crucial role in following the recommended order of draw protocol to promote patient safety and quality care. By understanding the importance of the order of draw and adhering to the prescribed sequence, healthcare professionals can ensure the reliability and accuracy of laboratory tests for diagnosing and treating patients.

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