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Order of Draw – and Why it is so Important

Prior to performing your procedure, you need to make sure you have all of the necessary equipment. This includes the collection tubes, needles of the proper gauge, a holder for the tubes, a tourniquet, both iodine and alcohol wipes, adhesive bandages and tape, gauze sponges, a proper unit for disposing of needles, syringes, and gloves.

The purpose of the Order of Draw is to prevent cross-contamination between the tubes. During your phlebotomy training, you have learned the tops of the tubes are color-coded for these procedures. The first draw is for the blood culture tube. The top of this tube is yellow. The top of the second tube is light blue. This second draw tube is the coagulation tube. The third draw tube has a red top, and is non-additive. The last draw involves additive tubes. The tops of these tubes are color-coded to indicate the additive used in the particular tube. A gold or red/gray top indicates SST. Deep green tops indicate heparin. Light green-topped tubes are for PST. Lavender tops indicate EDTA. ACDB or ACDA is indicated by a light yellow-topped tube. Light gray denotes oxalate/fluoride.

Accurate test results require strictly adhering to the Order of Draw. If it is not followed, numerous problems can occur. One is the blood in a tube can become contaminated. Another problem is the additives can mix. Either of these problems can result in affecting the blood in the tube so it cannot be tested properly. This can mean a considerable amount of difficulty for everyone concerned. The phlebotomist will need to perform the entire procedure all over again. This can cause a great deal of stress to a patient. If the phlebotomist tries to cover up this kind of mistake, sending contaminated blood to the laboratory, the test results will not be accurate. In instances where blood is used for diagnostic testing, it should be easy to understand why this process is so important.

The Order of Draw is one of the many skills you will learn in your phlebotomy training. You may begin by reading about the procedure and memorizing the details. Having the opportunity to practice it in person is something you must take very seriously.

When you are studying for your exam, flash cards are an excellent resource to help you learn and memorize the Order of Draw. You should choose a good set of flash cards that includes both terminology and color-coding information. In addition to learning these essentials, you should also know what each of the additives do when mixed with blood.

If you are taking your phlebotomist training online, be sure this is covered in your coursework. An additional point to keep in mind regarding this topic is some health facilities use different equipment. When you get your first job, be sure you are familiar with the equipment they use. If they have a different system, this is something you must know before you begin working. The Order of Draw is one of the most important factors in guaranteeing accuracy. Get your first job off to the right start by making sure you learn and remember it.

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