Order of Draw Phlebotomy

To be a successful phlebotomist, you will need to know how to draw blood consistently without causing pain or discomfort while also knowing the order of draw phlebotomy uses. It is important to draw blood in a specific order because not doing so can cause cross-contamination of additives between vials, which can alter test results and how the patient is treated. Following this model is part of the best practices of phlebotomy. So today, we’ll be talking about the order of draw phlebotomy uses, which can be confusing at first but will become ingrained in your memory as you continue to practice and apply your clinical skills.

The Order of Draw Phlebotomy Uses

The order of draw phlebotomy uses can differ slightly depending on where you work and also changes over time when new research indicates that different additives can interfere with the accuracy of test results. The main indicator of where a tube should be placed in the order of draw is finding out what additive is used. This information can be found on the tube label itself. However, the general order of draw phlebotomy uses is as follows:

  1. Blood cultures
  2. Coagulation tubes
  3. Serum tube (with or without clot activator/gel)
  4. Heparin tube (with or without gel plasma separator)
  5. EDTA tube (with or without gel separator)
  6. Glycolytic inhibitor

order of draw phlebotomy tubes
The order of draw phlebotomy specifies should always be followed regardless of equipment used and for all venipuncture blood collections. This procedure is followed for all outpatients, inpatients, home care, and for all ages.

Order of Draw Phlebotomy Chart

Order of Draw Bottle/Vial/Stopper Additive
1  Culture Bottles
Blood Cultures - Order of Draw
 SEE BOTTLE LABEL
2 Light Blue
light-blues - Order of Draw
Sodium Citrate
3 Red
red - Order of Draw
No gel, serum
4 Gold or Red/Black/Gray
gold-red/black - Order of Draw
Gel, serum
5 Light Green
light green - Order of Draw
Lithium Heparin
6 Dark or Dull Green
dark-green-dull-green - Order of Draw
 Heparin
7 Lavender, Pink, Royal Blue
lavender-pink-dark-blue - Order of Draw
EDTA
8 Gray
gray - Order of Draw
Sodium Fluoride (Glucose)
9 Yellow
yellow - Order of Draw
Citrate ACD