Vacutainer Tubes

Vacutainer Tubes for Blood Collection

Vacutainer tubes are specialized blood collection tubes used in many kinds of laboratory testing; the type of additive they contain determines the color of the tube, which is important for some examinations. These tubes are essential for handling, preservation, and separation of blood samples for various types of tests. They are color-coded based on the additive type, which is essential for specific tests. The different types of Vacutainer tubes provide a comprehensive solution for handling, troubleshooting, and special considerations in laboratory tests.

1. Types of Vacutainer Tubes

1.1. Red-Top Tubes

Additive: No additive (simple tube) can include a clot activator; the additive, like silica gel, is not thought to be a clot activator.

Purpose: The material known as clot activator is utilized in blood assays for hormones and antibodies in clinical chemistry, immunology, and serology. It facilitates the faster separation of serum from blood cells by hastening the production of clots. This is particularly useful in chemistry panels, serology, and blood bank tests. Clot activator promotes clot formation, facilitating the efficient separation of serum from cells. It is essential for chemistry panels, serology, and blood bank tests. This statement advises against using this product for tests that require anticoagulated blood.

Special Considerations

Mixing Protocol: Invert 5 times if a clot activator is present.

Clot Activation: To ensure proper centrifugation, tubes with clot activators should be fully clotted, which can take 30 minutes to an hour, and this process is crucial for accurate results.

Handling & Storage: The blood should clot for 30-60 minutes at room temperature, then centrifuge for serum separation, and either store it at room temperature or refrigerate.

1.2. Blue-Top Tubes

Additive: Sodium citrate, a chemical substance found in sodium salt, is mentioned many times in the book.

Purpose: Activated Partial Thromboplastin Time (aPTT), Prothrombin Time (PT), and D-dimer assays are coagulation tests that employ sodium citrate as a material. It is essential in avoiding blood clotting because it binds calcium. Studies on coagulation, including PT, APTT, and fibrinogen levels, also include sodium citrate. The main application for it is in coagulation tests to evaluate blood clotting.

Special Considerations

Fill Levels: Fill the tube to the designated amount and make sure it is thoroughly mixed to avoid clumping in order to guarantee appropriate anticoagulation. Proper test findings depend on maintaining a precise volume and a 9:1 blood to sodium citrate ratio, and proper filling is also necessary.

Mixing Protocol: To prevent interfering with coagulation investigations, gently flip the sample three to four times after collection. Do not shake vigorously.

Handling & Storage: The sample has to be brought to the lab in less than two hours, filled to the proper ratio (9 parts blood to 1 part additive), and kept at room temperature.

1.3.  Light Green Top (PST - Plasma Separator Tube)

Additive: Heparin, a substance composed of sodium, lithium, or ammonium, is used for plasma separation. It can be mixed with gel for further processing and be either lithium or sodium heparin.

Purpose: Clinical chemistry procedures that measure electrolytes, troponin, ammonia, and other fast-processing analytes require heparin as a critical component. It is used for chemistry tests and some cytogenetic analyses. Heparin inhibits thrombin and other clotting factors to prevent clot formation. It is also used in plasma tests for chemistry panels, cytogenetic analyses, and some hormone tests. Heparin is also used in plasma-based tests in clinical chemistry, such as potassium, calcium, and liver function tests. The gel acts as a barrier after centrifugation.

Special Considerations

Type of Heparin: While lithium heparin is favored for several chemical tests due to less interference, sodium heparin is frequently used for plasma. Depending on the particular test or analysis, several forms of heparin may be utilized; lithium heparin is recommended since it interferes less.

Mixing: To ensure complete mixing with the heparin, gently invert the tube 8-10 times.

Handling & Storage: The plasma can be separated by centrifuging immediately after collection, stored at room temperature or refrigerated, and can be stored at either room temperature or refrigerated.

1.4. Lavender or Purple Top

Additive: A chemical substance called ethylenediaminetetraacetic acid, or EDTA, is utilized in many different ways to make adhesives that are strong and long-lasting.

Purpose: Hematology assays include blood type, hemoglobin A1c, and complete blood counts (CBC) employ EDTA as a component. It preserves cellular morphology by preventing clotting, preserving blood cells for analysis. EDTA binds calcium to prevent blood clotting, ensuring accurate results in CBC, blood smears, and certain DNA tests. It is essential for hematology tests such as CBC, blood smears, and certain DNA tests.

Special Considerations

Mixing: To ensure even EDTA distribution, invert the tube immediately after collection and mix thoroughly, inverting 8-10 times to prevent clumping and skewed results.

Processing: Inaccurate findings or cellular artifacts may arise from processing delays.

Handling & Storage: Within 24 to 48 hours, the EDTA whole blood samples should be tested and kept at room temperature or in the refrigerator.

1.5. Yellow-Top Tubes

Additive: A substance called acid citrate dextrose (ACD) or sodium polyanethol sulfonate (SPS) is used to make acid citrate solutions.

Purpose: This material is used in blood cultures and other microbiology tests to identify microbial illnesses such as bacterial or fungal diseases. In addition, it is utilized in blood cultures, DNA testing, transfusion medicine applications, HLA phenotyping, and other specialist procedures requiring cell preservation.

ACD (Acid Citrate Dextrose) Tubes: This document describes the use of a specific chemical substance for blood cultures, transfusion tests, DNA testing, and certain types of transfusion medicine. It also mentions its use for cell preservation and certain tests like DNA analysis. It also mentions its use in blood culture and transfusion studies.

SPS (Sodium Polyanethol Sulfonate) Tubes: The use of blood cultures to identify illnesses and promote bacterial growth is described in this text. It highlights the significance of correctly filling tubes to avoid false negatives in blood cultures and states that sufficient tube filling is necessary to guarantee reliable findings.

Special Considerations

Mixing Protocol: The text instructs to gently invert 8-10 times.

Processing: Processing may be done in two hours, and it can be chilled or kept at room temperature for storage.

Handling & Storage: To avoid contamination, cultures should be brought to the lab as soon as possible and kept at room temperature.

1.6. Gray-Top Tubes

Additive: Sodium fluoride and potassium oxalate are commonly used as a glycolytic inhibitor, combining their properties to create a potent and effective solution.

Purpose: Measurements of ethanol, lactate, and glucose all depend on sodium fluoride. It inhibits glycolysis, preventing glucose breakdown after blood draw. Potassium oxalate acts as an anticoagulant, preventing clotting and aiding in glucose testing, lactate measurements, and some drug testing.

Special Considerations

Glucose Preservation: Sodium fluoride prevents glycolysis, preserving glucose levels. It's crucial to process or cool it immediately if needed, as glucose levels can change rapidly.

Mixing Protocol: To prevent glucose degradation, it is recommended to invert the tube 8-10 times immediately after collection.

Handling & Storage: Store at room temperature and refrigerate for extended storage, ensuring glucose stability for up to 24-48 hours.

1.7. Black-Top Tubes

Additive: Sodium citrate is a chemical compound with varying concentrations compared to blue-top tubes, which are used in various applications. It is present in different concentrations than light blue tubes and is used in various applications to maintain a consistent color.

Purpose: According to this paper, erythrocyte sedimentation rate (ESR) tests are the main means by which the quantity of erythrocytes in the blood is determined.

Special Considerations

Mixing Protocols: To avoid sedimentation artifacts and false results, it's essential to mix thoroughly and invert 3-4 times.

Processing Time: ESR tests should be conducted within 4 hours of collection for accurate results.

Handling & Storage: The light blue top is similar to the light blue handle but is specifically designed for ESR testing and should be stored at room temperature.

1.8. Gold or Red-Gray (SST - Serum Separator Tube)

Additive: Clot activator and a gel for serum separation.

Mixing Protocol: Invert 5-6 times.

Purpose: Used for the same purposes as the red-top tube but with a gel barrier for easier serum separation. Mostly utilized for clinical chemistry (lipid, glucose, and electrolyte panels, for example).

Handling & Storage: After letting the blood coagulate for half an hour, separate the serum using a centrifuge. Extended room temperature or refrigerated storage is made possible by the gel's ability to provide a barrier between the cells and serum.

Vacutainer Tubes Usage and Procedure

Tube Selection and Preparation

• Choose the right tube based on the test required.
• Verify specific requirements for each test, including the required tube type and volume.
• Check expiry dates and inspect tubes for damage or clumping of additives.

Tube Preparation

• Always use tubes within their validity period.
• Inspect tubes for signs of damage.

Blood Collection

• Attach the appropriate tube to the needle holder before venipuncture.
• Follow the correct order of draw to avoid cross-contamination.

Post-Collection

• Gently invert each tube to mix with additives.
• Label vials immediately after collection with patient information and collection details.

Storage and Handling

• Store tubes according to test requirements.
• Process samples according to specific guidelines for each test.

Handling Tips

• Avoid contamination and prevent clotting.
• Use sterile techniques and ensure patient comfort.
• Document collection and handling details for proper testing.

Special Considerations

• Use pediatric tubes for smaller volumes to avoid vein damage.

Emergency Situations

• Prioritize rapid processing and proper handling in critical situations.

Troubleshooting Blood Collection Issues

• Adjust needle angle or try different vein.
• Check tube mixing and expiration date.
• Use dedicated tubes for specific tests.

Regulatory and Best Practices in Blood Collection

• Adhere to all blood collection and handling regulations.
• Consistently inspect and adjust tools and supplies.

 

Conclusion

Using tubes with certain additives, the Vacutainer system is a color-coded method that makes blood collection and diagnostic testing easier. These tubes are intended for use with particular blood test types, and handling, mixing, and storage must be done correctly to guarantee accurate and trustworthy results. The guide provides a comprehensive overview of the different types of Vacutainer tubes, their additives, mixing protocols, intended purposes, and appropriate handling and storage conditions. Mixing is essential for ensuring accurate results, as vigorous shaking can cause hemolysis, which may compromise test results. Storage guidelines for each tube include room temperature for most samples, refrigeration for some tests, and prompt centrifugation for tubes with serum or plasma separation additives to maintain sample integrity.

In conclusion, understanding the different types of Vacutainer tubes and their specific uses is essential for accurate and effective blood specimen collection for various diagnostic tests. Proper handling of specimens and tube selection are necessary for high-quality laboratory diagnosis. Blood specimens obtained with the Vacutainer system may be handled with the utmost precision and efficiency by following these instructions, which will produce trustworthy laboratory findings.