The most current Clinical and Laboratory Standards Institute (CLSI) guidelines recommends a single "Order of Draw", whether using a multi sample, evacuated tube system or drawing with a syringe.

The "Order of Draw" is designed to eliminate the possibility of cross contamination that may result in erroneous results.

It is based on CLSI Procedures for Collection of Diagnostic Blood Specimens by Venipuncture Approved Standard Sixth Edition, October 2007.

It appears that the only exception to this rule is in drawing micro-containers from finger or heel punctures.

Order of Draw (Syringe or Evacuated Tube Method):

1. Blood Culture tubes

2. Coagulation tubes (lt. blue)

3. Serum tube with or without clot activator and with or without gel

4. Additive tubes

• Heparin (green) with or without plasma separator

• EDTA (lavender) with or without plasma separator

• Oxalate/fluoride (gray)

If a blue top (citrate) is the only tube being drawn a discard tube is necessary when using a butterfly. The discard tube is drawn to eliminate the dead space (air) in the line of the butterfly which may act to reduce the volume of blood drawn, thereby resulting in an under-filled tube.

First

Last