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Phlebotomy: Coagulation and Times Inversions

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Phlebotomy: Coagulation and Times Inversions
January 6-14 marked my date of assignment as an intern phlebotomist in the premises of our hospital. This was my most awaited section throughout the whole internship thing. I have been looking forward to be assigned in this section since the beginning of internship. Being able to extract blood from different kind of patients such as the geriatric, paediatric and obese is very rewarding because this is the hallmark of being a skilled phlebotomist.
At the start of the rotation, I felt a little nervous and excited at the same time. Good thing that I was already oriented with the dos and don’ts in phlebotomy during my afternoon and night shifts more so, made me feel a little bit confident.
Before doing any blood extraction, it is essential to know first the tubes, order of draw and inversions, sites to avoid and select and of course most importantly the patient identification. The commonly used tubes in the laboratory are gold, black , light blue, red, light green and lavender. The mentioned tubes also are in their correct order of draw when evacuated tube method is used. Gold top tubes contain Serum Separator Gel which are used for chemistry, immunology and serology tests and requires 5-6 inversions. Light blue tubes contain sodium citrate which are used for coagulation tests and only requires 3-4 inversions. Black top tubes on the other hand contain buffered sodium citrate which are used for erythrocyte sedimentation rate and requires 8-10 times inversions. Red plastic tubes which contain silica enhances clot formation and are used also for chemistry, immunology and serology and blood bank and also requires 5-6 times inversions. Light green tubes contain lithium heparin which are used for troponin t and donor screening tests and requires 8-10 inversions. Lastly, the lavender tubes contain EDTA whose action forms calcium salts to remove Ca and prevent clotting and are used in CBC determination and donor screening and crossmatching and also requires 8-10 times

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