This document provides information about different colored blood collection tubes and their uses. It discusses the purposes and additives of purple, pink, blue, yellow, grey, and red tubes. The purple, pink, and blue tubes contain anticoagulants and are used for hematology and coagulation tests. The yellow, grey, and red tubes are used for biochemical and other serum-based tests. It provides examples of common tests performed using each tube type and tips for proper sample collection and handling.
YouTube video is attached. In this high-yield, concise presentation, you will learn about the various blood collection tubes, color coding and the order of draw.
Collecting blood samples and other biological specimens is crucial to the understanding, prevention, and treatment of disease. However, from the patient’s perspective, it can also be painful, unnerving, frightening, and inconvenient.
Bone marrow aspiration & trephine biopsySanjeev Kumar
Bone marrow aspiration & trephine biopsy, Complication of BM Aspiration, Clinical significance, Indication of Bone Marrow Aspiration and Biopsy, Types Of Needles, Site for Bone Marrow Biopsy And Aspiration, types Of Smear for Bone Marrow, Advantages of Bone Marrow Trephine Biopsy
YouTube video is attached. In this high-yield, concise presentation, you will learn about the various blood collection tubes, color coding and the order of draw.
Collecting blood samples and other biological specimens is crucial to the understanding, prevention, and treatment of disease. However, from the patient’s perspective, it can also be painful, unnerving, frightening, and inconvenient.
Bone marrow aspiration & trephine biopsySanjeev Kumar
Bone marrow aspiration & trephine biopsy, Complication of BM Aspiration, Clinical significance, Indication of Bone Marrow Aspiration and Biopsy, Types Of Needles, Site for Bone Marrow Biopsy And Aspiration, types Of Smear for Bone Marrow, Advantages of Bone Marrow Trephine Biopsy
Common Diagnostic pitfalls with coagulation disorders lies in addressing challenges in preanalytical processes & implementation of algorithms as per newer guidelines.
Blood products:Collection, Processing and Storage of whole human blood, dried...Steffi Thomas
blood and its components, conditions for being a donor, anti-coagulants, whole human blood, changes in composition during storage, red blood cells, concentrated platelets, plasma, dried human plasma, fresh frozen plasma, dried human serum, plasma substitutes, ideal properties of plasma substitute, dextran, gum saline, polyvinylpyrrolidone
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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2. INTRODUCTION.
The colours of the Vacutainer bottles are standardized, but
depending which hospital you end up working in there
may be some variation in preferences between individual
laboratories, especially when it comes to tests which are
performed less commonly. I have used as many sources as
possible to compile the information below, so hopefully it
is as accurate as possible, but obviously I cannot
guarantee it will be applicable to all hospitals. Always
check local guidelines if you’re not sure.
3. PURPLE
These bottles are generally used for haematology
tests where whole blood is required for analysis.
ADDITIVE: contains EDTA (ethylenediaminetetraacetic
acid), which acts as a potent anticoagulant by binding to
calcium in the blood. EDTA also binds metal ions in the
blood and is used in chelation therapy to treat iron, lead or
mercury poisoning. Its blood-binding capacity also means it
can be labelled with radioisotopes and used as an EDTA
scan to test renal glomerular filtration rate.
4. COMMON TESTS:
full blood count (FBC)
erythrocyte sedimentation rate (ESR)
blood film for abnormal cells or malaria parasites
reticulocytes
red cell folate
Monospot test for EBV
HbA1C for diabetic control
parathyroid hormone (PTH)
5. TIPS FOR USE:
the purple tube needs inverting about 8 times to
mix the sample with the EDTA. About 1ml of
blood is sufficient to do a full blood count, but to
get an ESR you need a full purple bottle.
6. PINK
The pink bottles work in the same way as the
purple ones, but are specifically used only for
whole blood samples being sent to the
transfusion lab.
ADDITIVE: this tube also contains the
anticoagulant EDTA.
7. COMMON TESTS:
group and save (G&S) - this simply means the patient’s blood is typed and
tested for antibodies, then saved in the lab in case it is required; it DOES
NOT get you blood products for transfusion. If you need blood products
you have to request a crossmatch.
crossmatch (XM) – this means that the patient’s blood is typed and tested
as above, then matched to specific units of blood, platelets or other
products for transfusion. You need to specify on the form how many units
you need, why you need them and when they are required. A full
crossmatch takes about 45-60 minutes in the lab – if you have an unstable
bleeding patient and think you’ll need blood products sooner than this, you
still need to send a crossmatch sample, but you can ask the lab for units of
type-specific blood (which take 10-20 minutes), or in a genuine emergency
you can use their stocks of O negative blood from the fridge.
direct Coomb’s test (aka direct antiglobulin test) for autoimmune
haemolytic anaemia
8. TIPS FOR USE
the pink tube needs inverting about 8 times to mix
the sample with the EDTA. It should contain at least
1ml of blood, but more is preferred by the labs if at
all possible. It has a special label which needs to be
carefully filled in by hand at the bedside to ensure
the correct patient details are used and prevent
potentially catastrophic mismatched blood
transfusions. If you need blood for a patient
urgently, or have any unusual or complicated
requests, you must ring the transfusion lab and let
them know, or you risk invoking their terrifying
wrath.
9. BLUE
The blue bottle is used for haematology tests
involving the clotting system, which require
inactivated whole blood for analysis.
ADDITIVE: contains buffered sodium citrate, which
acts as a reversible anticoagulant by binding to
calcium ions in the blood and subsequently disrupting
the clotting cascade. Sodium citrate is also added to
blood products for transfusion, and acts as a
preservative by stopping them from clotting in the bag.
10. COMMON TESTS:
coagulation screen including bleeding time for platelet
function, prothrombin time (PT) for extrinsic pathway, activated
partial thromboplastin time (APTT) for intrinsic pathway,
and thrombin time (TT) or fibrinogen assay for the final common
pathway
D-dimer for thrombosis e.g. due to DVT or PE
INR for monitoring patients on warfarin (this is calculated from the
prothrombin time)
activated partial thromboplastin ratio (APTR) for monitoring
patients on IV heparin infusions (this is calculated from the APTT)
anti-Xa assay for monitoring patients on high-dose low molecular
weight heparins like tinzaparin
11. TIPS FOR USE:
the blue bottle needs to be inverted 3-4 times to mix the
sample with the anticoagulant. The sodium citrate liquid
in the bottle dilutes the blood sample, and the machines in
the lab are specifically calibrated to interpret results based
on a set ratio of blood to anticoagulant. It is therefore
essential that the bottle is filled to the line marked around
its edge to ensure the tests are interpreted accurately –
otherwise the samples may be over-anticoagulated. Some
clotting tests need to be taken at specific times; INRs
should ideally be done in the morning, and anti-Xa assays
must be taken 3-4 hours after tinzaparin is given. APTR
timings are often indicated on the prescription algorithm.
12. YELLOW
These bottles are used for a huge variety of tests requiring
separated serum for analysis, including biochemistry,
endocrinology, oncology, toxicology, microbiology and
immunology.
ADDITIVE: this tube is known in the lab as the SST (serum
separating tube). It contains two agents; silica particles and a
serum separating gel. The silica particles work to activate clotting
and cause the blood cells to clump together. The serum separator
consists of an inert polymer gel which floats as a layer between
the blood cells and plasma to form a physical barrier between
them. This means that the sample can be centrifuged (spun) in the
lab and the separated serum easily removed.
13. COMMON TESTS:
biochemistry tests are the ones you will encounter most commonly:
urea and electrolytes (U+E) – this includes urea, creatinine, sodium and
potassium
C-reactive protein (CRP)
liver function tests (LFTs) – this includes bilirubin, ALP, AST/ALT, GGT,
total protein and albumin
amylase assay
bone profile - this includes calcium, phosphate, ALP and albumin
magnesium assay
iron studies - this includes serum iron, ferritin, transferrin saturation and
total iron binding capacity
lipid profile – this includes cholesterol, LDL, HDL and triglycerides
thyroid function tests (TFTs) – this includes TSH, free T4 +/- free T3
14. COMMON TESTS:
vitamins e.g. vitamin B12
troponins – this requires 2 samples to be taken at different times to assess
the acute trend
creatine kinase (CK)
urate
serum osmolality – this requires a urine sample to be taken at the same
time
endocrinology: beta-hCG, calcitonin*, cortisol, EPO, sex hormones,
growth hormone, IGF-1
tumour markers: PSA, CEA, CA-125, CA19-9, AFP, lactate dehydrogenase
(LDH)
toxicology: ethanol, cannabis, opiates, benzodiazepines, other drugs e.g.
cocaine, amphetamines
15. COMMON TESTS:
drug levels: paracetamol, salicylates (aspirin),
digoxin, lithium, gentamicin, carbamazepine
microbiology/virology: serology for a wide
variety of bacterial, viral, fungal and parasitic
infections including HIV and viral hepatitis
immunology: immunoglobulins, complement,
autoantibody screen, rheumatoid factor, thyroid
antibodies, α1AT, ACE
16. TIPS FOR USE:
the yellow bottle needs to be inverted about 5 times
to mix the sample with the silica and separator.
Don’t panic if the blood starts to clot or separate in
the bottle, it’s supposed to! The amount of blood
required will depend on how many tests you’re
doing, but at least 1ml is ideal. You can usually get
about 12 tests from one full yellow bottle.
Remember that different labs may be located in
different areas and technicians don’t like sharing –
this means you’ll need to put your biochemistry and
microbiology samples in separate yellow bottles to
go to their respective laboratories.
17. GREY
The grey bottle is only used for two tests, so
compared to the yellow one it’s fairly easy to
remember! It is used for biochemistry tests
requiring whole blood for analysis.
ADDITIVE: contains two main agents. Sodium fluoride
acts as an antiglycolytic agent to ensure that no further
glucose breakdown occurs within the sample after it is
taken. Potassium oxalate acts as an anticoagulant. Some
variants of the grey bottle use EDTA as the anticoagulant
instead.
18. COMMON TESTS:
glucose - this can be fasting or non-fasting, or
part of a glucose tolerance test (GTT)
lactate
19. TIPS FOR USE:
the grey bottle needs to be inverted about 8 times to mix
the sample with the fluoride and oxalate. Only a tiny
amount of blood is required for a glucose, but for a lactate
the bottle should ideally contain at least 1ml of blood.
Venous glucose results are generally more accurate than
fingerprick BM tests, especially in hyperglycaemic
patients, but can take a while to come back from the lab.
If you need a blood glucose urgently then ask one of the
nurses to do a BM for you on the ward. Samples for
venous lactate need to be sent to the lab immediately.
Again, the results tend to take a while to come back, so if
you’re desparate for a lactate see if you can get access to
an ABG machine that does arterial lactates – these are
often available in A+E or ITU, and take about 2 minutes
to process.
20. RED
The red bottle is less common – it is used for
biochemistry tests requiring serum which might
be adversely affected by the separator gel used in
the yellow bottle.
ADDITIVE: contains silica particles which act as clot
activators.
21. COMMON TESTS:
the use of this bottle varies greatly – some
hospitals use it for many sensitive tests, including
hormones, toxicology, drug levels, bacterial and
viral serology and antibodies, whereas others
seem to only use it for a few very specific
purposes and use the yellow bottle for most
things.
my hospital definitely uses it for ionised calcium,
but not much else
22. TIPS FOR USE:
the red bottle needs inverting 5 times to mix the
sample with the clot activator. There is also
another version of the red bottle made out of
glass, which contains no additives whatsoever.
23. DARK GREEN
This less commonly used bottle is for
biochemistry tests which require
heparinised plasma or whole blood for
analysis.
ADDITIVE: contains sodium heparin, which acts as
an anticoagulant.
25. TIPS FOR USE:
the green bottle needs to be inverted about 8
times to mix the sample with the heparin. This
bottle cannot be reliably used to assess sodium
levels.
26. LIGHT GREEN
This rare species of bottle is used for biochemistry
tests requiring separated heparinised plasma. I
have never actually used one but have seen them on
the dermatology ward.
ADDITIVE: this bottle is known as the plasma separator
tube (PST). It contains lithium heparin, which acts as an
anticoagulant, and a plasma separator gel similar to that
used in the yellow bottle, which acts to separate out the
plasma layer.
27. COMMON TESTS:
it can be used for routine biochemistry, but most
hospitals seem to use the yellow bottle for this. It
can also be used for blood ethanol provided the
sample is not for legal purposes.
28. TIPS FOR USE:
the light green bottle needs inverting about 8
times to mix the sample with the heparin and
separator. This bottle cannot be reliably used to
assess lithium levels.
29. OTHERS
dark blue – used for toxicology and trace elements such as zinc, selenium
and copper (however, the ever-versatile yellow bottle can also be used for
these)
tan – used to test for lead
orange – contains a thrombin-based clot activator which allows stat serum
testing
light yellow – used for HLA phenotyping, tissue typing, DNA analysis and
paternity testing
white – used for molecular diagnostics such as PCR and DNA amplification
studies
black - for paediatric ESR
clear lid – used as a discard tube, for example when taking bloods from a
central line