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Kylie Selassie
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Do you take blood in a certain order?
Does anyone have any UK info on the order of blood bottles you should follow when you take blood?
When I first learned venepuncture in the UK I was never taught that you place bottles in a certain order. I've never thought it mattered. However, there's discussion on the French nurses' site about the order of the bottles:
http://www.infirmiers.com/frm/ftopic57362.php
Some are saying do the plain bottles first to reduce the risk of contamination with preservative, leaving the EDTA bottle (for FBC) until last, since EDTA is the most likely contaminant of other blood bottles. Yet others are saying that since the tourniquet gives some degree of venous compression, the longer you leave it to take the biochem sample, the more chance you have of haemolysis giving faulty results (notably potassium) hence you should do the biochem bottle first. I have also heard that a clotting sample should never be taken first as the initial puncture gives a false clotting time. Hence, in some French hospitals now, if you're taking a clotting sample only, you take a plain bottle first and chuck it so that your clotting bottle hasn't been the first sample.
Is there any foundation to all this? If so, which is right, plain bottle first or biochem bottle first? Is it right about the clotting bottle and the EDTA bottle? Or is this all just crap?
Last edited by Kylie Selassie, 7/May/07, 14:16
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7/May/07, 14:10
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Kylie Selassie
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Re: Do you take blood in a certain order?
I think you're referring to vacutainer, which we use here. It isn't about external spillage (which should be impossible) but cross contamination (and human coagulation in the case of the cloting bottle argument). The above arguments could reasonably apply, I'm just interested to know if anybody has any solid proof for any of them.
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8/May/07, 19:02
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oaktree2
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Re: Do you take blood in a certain order?
There are recommendations for this - if you google 'order of draw' you will find lots of information on this. I often find the reps from the companies don't give sufficient info on this when they are teaching but lab staff and phlebotomy will certainly have an opinion on this.
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8/May/07, 19:07
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goalie
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Re: Do you take blood in a certain order?
The company that manufactures vacutainer used to produce a chart about order of sampling. a bit like this one
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8/May/07, 19:16
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Kylie Selassie
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Re: Do you take blood in a certain order?
Thanks both. I found this one really clear
http://www.calgarylabservices.com/files/HealthcareProfessionals/BloodCollectionTubes.pdf
Last edited by Kylie Selassie, 8/May/07, 20:05
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8/May/07, 20:05
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Chestnut6
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Re: Do you take blood in a certain order?
we use vacutainers. I was only taught to pull the red one first as it's smaller so easier to pull. the others can be drawn back before changing over.
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24/May/07, 19:46
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Kylie Selassie
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Re: Do you take blood in a certain order?
I do remember once, and only once, a sample in the UK years ago coming back as invalid as it was "contaminated with EDTA"
Given that many of us have been oblivious to this running order and it's seemingly rarely had any negative effect on the samples we take, are the risks of contamination miniscule? I remain intrigued about the clotting theory.
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11/Jun/07, 13:13
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