Specimen Collection and Preparation.fm



Specimen Collection and PreparationLaboratory test results are dependent on the quality of the specimen submitted to the laboratory. It is important that all specimens and request forms be properly labeled with the name of patient, collection date & time, and the origin (source) of specimen, when applicable.If there is any doubt or question regarding the type of specimen that should be collected, it is imperative that the laboratory be called (Tel # 508-539-6100 or 800-750-8378) in order to clarify the order and specimen requirements.Blood CollectionMost laboratory tests are performed on anticoagulated whole blood, plasma, or serum. In general, specimens should be refrigerated, unless otherwise specified, until placed in the courier box for transport to the laboratory. Please see our individual test directory section for specific requirements.? Plasma: Draw a sufficient amount of blood with indicated anticoagulant to yield necessary plasma volume. Gently mix blood collection tube by inverting immediately after the draw. If required, separate the plasma from cells by centrifugation within 20 to 30 minutes.? Serum: Draw a sufficient amount of blood to yield necessary serum volume. Gently mix blood collection tube by inverting immediately after the draw. Allow the blood to clot in a vertical position at an ambient temperature for 30 minutes and then separate the serum from the clot by centrifugation within 20 to 30 minutes. Caution: avoid hemolysis.? Whole Blood: Draw a sufficient amount of blood with the indicated anticoagulant. Gently mix blood collection tube by inverting the blood collection tube immediately after the draw.Specimen Collection Tubes AvailableThe following is a list of blood collection tubes referred to in the test listings for specimen requirements:? Gold-Top Serum Gel Tube: This tube contains a clot activator and serum gel separator—used for the analysis of various chemistry tests.Note: Immediately invert the tube 5X gently in order to activate clotting; let stand in a vertical position for 30 minutes before centrifuging for 10 minutes. If frozen serum is required, pour off serum into a plastic vial and freeze. Do not freeze VACUTAINER? tubes.? Green-Top Tube: This tube contains either lithium or sodium heparin—used for drawing heparinized plasma or whole blood for special tests. Note: After the tube has been filled with blood,immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Dark Green-Top (Sodium Heparin) Tube: This tube contains sodium heparin—used for drawing heparinized plasma or whole blood for special tests. Note: After the tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Gray-Top Tube (Potassium Oxalate/Sodium Fluoride): This tube contains potassium oxalate as an anticoagulant and sodium fluoride as a preservative—used to preserve glucose in whole blood and for some special chemistry tests.Note: After the tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Lavender-Top Tube (EDTA): This tube contains EDTA as an anticoagulant—used for most hematological procedures.Note: After tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Light Blue-Top Tube (Sodium Citrate): This tube contains sodium citrate as an anticoagulant—used for drawing blood for coagulation studies.Note: It is imperative that the tube be completely filled.The ratio of blood to anticoagulant is critical for valid prothrombin time results. Immediately after the draw, gently invert the tube 3 – 4 times in order to activate the anticoagulant.? Light Green-Top (Lithium Heparin Gel) Tube: This tube contains lithium heparin and a plasma gel separator— used for the analysis of various chemistry tests.Note: After the tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to mix the blood with the anticoagulant.? Pink-Top Tube (K2 EDTA): This tube contains K2 EDTA as an anticoagulant—used for Blood Bank procedures.Note: After tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Red-Top Tube: This tube contains a clot activator and is used for drawing serum for selected chemistry tests.Note: Immediately invert the tube 5X gently in order to activate clotting.? Royal Dark Blue-Top Tube: There are 2 types of royal dark blue- top VACUTAINER? tubes—1 with the anticoagulant EDTA and the other with a clot activator. These tubes are used in drawing whole blood or serum for trace element (i.e. metals and minerals, respectively) analysis. Refer to the individual metals and minerals in the test listings in order to determine the specific collection tube needed.Note: After tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Yellow-Top Tube (ACD): This tube contains an ACD solution, either Solution A or B—it is used for drawing whole blood for special tests, such as Factor V Leiden.Note: After tube has been filled with blood, immediately invert the tube 8 – 10 times gently in order to prevent coagulation.? Special Collection Tubes: Some tests, such as lead, require a specific tube for proper analysis. Please contact CCHC Laboratory Services (Tel # 508-539-6100 or 800-750-8378) prior to the patient being drawn in order to obtain the correct tubes for metal analysis or other tests as identified in the test listings.Order of Draw:Blood CulturesCitrate [Light Blue]Serum [Red or Gold]Heparin [Light or Dark Green]EDTA [Lavender, Pink, or Tan]Oxalate [Gray]Other collection tubes, such as ACD [yellow]Exceptions:Royal Dark Blue-Top tubes:[1]Serum: Placed after the citrate tube and before other serum tubes. However, a plain discard tube should be used between the citrate tube and this tube during the order of draw in order. This is due to the potential of metal contamination associated with additive carryover. [2]EDTA: Placed after the heparin tube and before other EDTA tubes. However, a plain discard tube should be used between the heparin tube and this tube during the order of draw in order. This is due to the potential of metal contamination associated with additive carryover. ................
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