This document discusses the order of draw for blood collection tubes. It provides information on the different types of blood collection tubes used in phlebotomy, including their purposes, components, and order of collection. The recommended order is: 1) Blood culture bottles, 2) Citrate tubes, 3) Clot activator tubes, 4) Serum separator tubes, 5) Heparin tubes, 6) EDTA tubes, 7) Fluoride tubes. Following the correct order of draw is important to prevent errors and cross-contamination between tubes.

1. ORDER OF DRAW
Jan Martin M. Justo, RMT

2. OBJECTIVES
• Know the importance and functions of various blood tubes
used in the laboratory including its specific components
• Understand and learn different tubes used in phlebotomy
particularly the ‘Order of Draw’
• Review basic information on Laboratory procedures and
instructions involving Phlebotomy.

3. VENIPUNCTURE
Also known as Phlebotomy, Extraction
or Blood Draw
EVACUATED TUBE SYSTEM
Tubes are filled with chemical substances (additives)
together with air vacuum and sealed.
They vary in shapes, sizes, and colors.
Different colors correspond to various additives and
specific functions in the laboratory.
PATIENT IDENTIFICATION
UNIVERSAL PRECAUTION

4. SERUM
PLASMA
Has Anticoagulant
Has clotting factors
Has Fibrinogen
Platelets and WBCs are present.
No anticoagulant
No clotting factors
No Fibrinogen
Could be hemolyzed, icteric,
or chylous

5. BLOOD TUBES

6. 1. Mainly used for Microbiology studies.
2. Volume is from 3-5 ml
3. Anticoagulant is SPS (Sodium Polyanethole
Sulfonate)
4. Sterile and perform aseptic technique
5. Mix inversion 8- 10x
BLOOD CULTURE
BOTTLES
01
ORDER OF DRAW

7. 02
COAGULATION /
CITRATE TUBES
1. Mainly used for Coagulation and Hematology
studies.
2. Volume is 1-2 ml ONLY.
3. Anticoagulant is 3.2% Sodium Citrate
4. Mix inversion 3-4x
ORDER OF DRAW

8. 03 CLOT ACTIVATOR
TUBES
1. Mainly used for Blood banking, sometimes
Chemistry.
2. Volume is from 3-5 ml
3. No additive/ plain.
4. Mix inversion 5-10x
ORDER OF DRAW
NOT USED FOR ELECTROLYTES and LIVER ENZYMES

9. 04
SERUM SEPARATOR
TUBES
1. Mainly used for Chemistry, Serology studies.
2. Volume is from 3-5 ml
3. Used to set apart serum from red blood cells.
4. Thixotropic Gel separator combined with
silica and ACD (acid citrate dextrose).
5. Mix inversion 5-10x
ORDER OF DRAW

10. 05
HEPARIN TUBES 1. Mainly used for Chemistry studies.
2. Volume is from 3-5 ml
3. Anticoagulant is Sodium Heparin or Lithium
Heparin
4. Mix inversion 8-10x
Used for Troponin, Ammonia, ABG
ORDER OF DRAW

11. 06
EDTA TUBES 1. Mainly used for Hematology, Blood Banking.
2. Varies from 3-5 ml
3. Anticoagulant is EDTA (Ethylene Diamine
Tetra acetic acid). Sometimes K2 or K3
4. Mix inversion 8-10x
Used for HBAIC and ESR
ORDER OF DRAW

12. 07
GLUCOSE STUDIES
TUBES
1. Mainly used for Chemistry studies.
2. Volume is from 3-5 ml
3. Anticoagulant is Sodium Fluoride
4. Mix inversion 8-10x
Fasting blood
specimens
ORDER OF DRAW

13. Other Blood tubes
GOLD BLACK
Special
Chemistry
tests
ESR tube
1. Mainly used for Chemistry studies.
2. Volume is from 3-5 ml.
3. Anticoagulant is Potassium Oxalate
4. Mix inversion 8-10x
Erythrocyte
Sedimentation Rate
(Westergren method)
TB Quantiferon

14. IMPORTANCE
PREVENT CROSS CONTAMINATION AND CARRY-OVER PHENOMENON.
REDUCE ERRORS SUCH AS HEMOLYSIS, CLOTTING, SHORT DRAW, ETC.
ORDER OF DRAW

15. ORDER OF DRAW

16. ORDER OF DRAW

17. EXERCISES
ORDER OF DRAW
1. Lab tests of Patient include HBAIC, ESR, Blood culture, Blood
typing, Serum Electrolytes, Serum Pregnancy test, and CBC.
What is the correct order of draw?
2. An elderly patient had a series of blood tests consisting of Troponin
I, Fasting Blood Sugar, HBAIC, Serum Creatinine, Coagulation tests,
and Serum Ferritin. What is the correct order of draw?
BLOOD CS SERUM PT /
ELECTROLYTES
CBC/ BT/
HBAIC
ESR
BLUE YELLOW
RED GREEN EDTA GRAY

18. • Basic Principles and Practice of Clinical Chemistry (Bishop)
• Clinical and Laboratory Standards Institute Guidelines for
Phlebotomy
• BD Vacutainer ‘Order of Draw’
REFERENCES

19. THANK YOU