PhlebBot
Order of Draw Chart
Venipuncture: cultures, light blue, red/gold, green, lavender/pink, gray. Each tube sits where the additives drawn before it cannot change its results.
| # | Tube | Additive | Invert | Common tests |
|---|---|---|---|---|
| 1 | Blood culture bottles (aerobic + anaerobic) | Culture media | Per bottle instructions | Blood cultures |
| 2 | Light blue | 3.2% sodium citrate | 3–4 times | PT/INR, aPTT, fibrinogen, D‑dimer |
| 3 | Gold / red-gray (SST) or red | Clot activator (SST also has gel) | 5 times | BMP/CMP, lipid panel, serology, drug levels |
| 4 | Green / light green (PST) | Lithium heparin (PST also has gel) | 8–10 times | STAT chemistry and electrolytes, ammonia (many labs) |
| 5 | Lavender (or pink) | K2EDTA | 8–10 times | CBC, hemoglobin A1c, type and screen (pink) |
| 6 | Gray | Sodium fluoride / potassium oxalate | 8–10 times | glucose, lactate, blood alcohol |
Remember
- Mnemonic: “Boys Can See How Every Game” — Blood cultures, Coagulation (citrate), Serum, Heparin, EDTA, Glycolytic inhibitor (gray).
- Why the order matters: additive carryover. EDTA carried into a chemistry tube falsely raises potassium and lowers calcium; clot activator carried into a citrate tube falsely shortens PT and aPTT.
- Butterfly + light blue first: draw a discard tube first (non-additive or another coagulation tube) so the citrate tube fills to its line and keeps the 9:1 ratio.
- Blood cultures with a butterfly: fill the aerobic bottle first, then the anaerobic bottle.
- Capillary order is different (CLSI GP42-Ed7): blood gases, EDTA (lavender), other additive tubes, then serum last.
- Invert gently, never shake. Glass red tubes have no additive and need no inversions.