This document discusses the uses of anticoagulant vials in pathological laboratories. It describes the three sources of blood that can be collected: capillary, venous, and arterial. It then explains the different types of anticoagulants used including EDTA, citrate, heparin, fluoride/oxalate and their purposes. EDTA is used for complete blood counts and coagulation profiles. Citrate and heparin are used to prevent clotting for coagulation studies. Fluoride/oxalate is used specifically for blood glucose testing. The document provides details on collection methods, tube colors and the mechanisms by which different anticoagulants prevent clotting.

1. III Doctoral Seminar I (BCBE 980)
on
Uses of anticoagulants vials in pathological laboratories
Divya Singh
UGC-SRF
Department of Biochemistry & Biochemical Engineering JSBB
Sam Higginbottom University of Agriculture, Technology & Sciences
Prayagraj, U.P., India
2021

2. Contents
Sources
Methods of blood collection
Venous blood vs arterial blood vs capillary blood
Types of anticoagulants used (color coding)

3. Blood can be collected from 3 different sources:
1. Capillary blood.
2. Venous blood.
3. Arterial blood.
CAPILLARY BLOOD – METHOD OF COLLECTION :
Select the least used finger.
Cleanse the site with alcohol swab.
Puncture across the grain of the skin
 And transfer blood to a strip or small container.

5. Indications:
To draw a small amount of blood
In a microtube or strip for blood sugar and
bleeding time tests.
 For infants and young children.

7. Radial artery and brachial artery
femoral artery

8. Blood collection for venous blood:
Equipment required: •Tourniquet. •Vacutainer and syringe. •Alcohol swab. •Bandage
Most common
Majority of routine tests are performed on venous blood.
Blood can be taken directly from the vein.
The best site - deep veins of the ante-cubital fossa.

9. Fore arm vein:
other sites are: Dorsum of hand
Femoral vein

11. SERUM:
Liquid remaining after blood has clotted naturally in a plain tube.
It’s the most common specimen required for chemical and serological test.
PLASMA:
 A fluid obtained from anticoagulated and centrifuged blood
Plasma is required for Coagulation Profile and Fibrinogen Assay.

12. ANTICOAGULANT TUBE/ VACUTAINER
EDTA (Ethylene Diamine Tetra-Acetate) liquid:
 Types: Na and K2 EDTA (2.0mg /ml,
Mechanism: forming Ca salts to remove Ca.
 Uses: CBC, PCR, PS and HbA1c.
Requires full draw (invert 8 times).
EDTAAvailable as:
 Disodium EDTA
 Dipotassium EDTA
Uses: 1. cell counts 2. smears & 3. platelet counts

13. RED (PLAINTUBE):
 No preservative/anticoagulant.
 Uses: usually for toxicology and serology

14. SST (SERUM SEPARATOR TUBE)
 No additives.
 Clotting accelerator and separation gel.
 Uses: Chemistry, Immunology, and Serology.

15. Sodium citrate :
 (1:9 ratio).
Anticoagulant: 3.2%
Mechanism: Calcium chelation.
Use: Coagulation studies and
platelet function.
BLACK:
 Na citrate 1:4.
 3.8% of sodium citrate
 Action: Remove calcium.
Uses: Westergren – Erythrocyte Sedimentation Rate (ESR).

16. • Citrate •Action: - Binds Ca in a non-ionsed but soluble complex. •Disadvantage: - It is a liquid - not acceptable for
blood cell counts & Hb estimation.
HEPARIN:
Sodium Heparin or Lithium Heparin (Green)
0.5 to 1.0mg per 5ml of blood
Mechanism: inactivation of thrombin and thromboplastin.
Uses: - For Lithium level - Na Heparin anticoagulant. - For Ammonia level - Na or Lithium Heparin
Heparin • Uses: -naturally occuring biological anti-coagulant -Used in hematological special tests, biochemistry for
electrolytes For blood gases -Transfusions

17. GREY:
Sodium fluoride + Potassium oxalate
MOA: inhibits red cell glycolytic pathway
Used: blood glucose
Oxalate
Potasium oxalate: - concentration is 2mg/ml blood - shrinkage of RBC’s, so 8% shrinkage in PCV - used for
chemical analysis -Not used for PCV, ESR, cell morphology
Ammonium oxalate: - concentration 2mg/ml blood - Adr: swelling of RBC - Not used for PCV, ESR

18. References
• WHO-World Health Organization(2018)-Use of anticoagulants in diagnostic laboratory
investigations, WHO/DIL/LAB/00.1 Rev.2.