A patient may have to have blood samples collected into several different types of vacutainers from a single venipuncture. The presence of an additive in the vacutainer in theory could contaminate the next tube. Therefore, vacutainers should be drawn in a sequence that will minimize this effect.
In general, tubes with additives:
(1) are to be drawn last
(2) should be filled completely (the amount of additive assumes a full tube)
Sequence to follow in filling tubes:
(1) blood culture tubes (or other sterile containers without additives)
(2) plain serum tube without any additive (plain red top)
(3) coagulation tube with citrate (blue top)
(4) serum tube with gel separator (speckled top)
(5) heparinized tube (green or yellow top)
(6) tube with EDTA (lavender top)
(7) oxalate/fluoride (gray top)
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