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Obtain a clean-catch, midstream specimen. Follow these steps: There are two important guidelines to follow when submitting blood specimens. 0000031552 00000 n
The gel-barrier tube is an additive tube and should be inverted five to six times after collection. 10. This can be a valuable resource in the process of developing an assay. 0000009375 00000 n
Red-top tube: Contains no anticoagulant or preservative. In all settings in which specimens are collected and prepared for testing, laboratory and health care personnel should follow current recommended sterile techniques, including precautions regarding the use of needles and other sterile equipment. The composition of blood is altered after meals by nutrients being absorbed into the bloodstream. 
The specimens are clearly labeled with their chronological sequence (1 of 6, 2 of 6, time of drawn or Fasting, hr, 1hr, etc) and with the patient's name, other unique identifier, and date of collection. 0000045947 00000 n
It is critical, especially for any specimen collection tube containing an additive, to allow the tube to fill to the "fill line" marked on the tube. Use disposable plastic syringes and safety straight needles or a safety-winged blood collection set. With some needle assemblies, you may slide the collection tube into the holder, carefully pushing the tubes forward until the needle touches the stopper. After drawing blood, observe proper venipuncture techniques to prevent continued bleeding and/or hematoma. 4. (See Figure 2.) EDTA plasma has an excess of a powerful chelating agent that will sequester metal ions such as calcium and magnesium. Gently tap tubes containing additives to dislodge any material that may be adhering to the stopper. (See, Submit a quantity of specimen sufficient to perform the test and avoid a QNS (quantity not sufficient), as indicated in the test requirements. For example, RBCs have 20x more potassium (K) than serum/plasma, so prolonged contact and/or contamination with red cells will significantly change K levels. Pipette the serum or plasma into a clean plastic screw-cap vial (See Figure 9.). Submitted slides may be labeled with a single identifier, but two identifiers are preferred. EDTA plasma will also inactivate some enzymes that require a metal ion for their activity. Failure to invert tubes may lead to the formation of microscopic clots. WebRed cells (RBCs) often have a much higher concentration of analytes than the liquid portion (serum/plasma) of blood. 
Do not apply fixative. 3. While some analytes may give similar results, equivalence can only be ensured by testing matched samples. To avoid this problem, whole blood is the preferred sample for measuring immunosuppressant drugs. Please refer to the specimen requirements for the test(s) of interest available in the Directory of Services. 
Plain tubes with no anticoagulants have red stoppers and are used in the preparation of serum after clotting and centrifugation. A separate frozen sample must be submitted for each test requiring a frozen specimen. Multiple Specimens. Common anti-coagulant agents are EDTA (ethylenediaminetetraacetic acid), heparin, and citrate. Catecholamine assay. 
This will cause a shift in fluid between the vein and the surrounding tissue. 1 0 obj
Serum Separator Tubes (Gold Top) Serum separator tubes contain a clot activator and a If pediatric tubes are used, be sure to collect an adequate volume of specimen to perform the test. Do not pour off; use transfer pipette. Process and store the specimen(s) as required. Recommended times are based upon an intact clotting process. Language links are at the top of the page across from the title. Remove the clot by centrifuging at 1,0002,000 x g for 10 minutes in a refrigerated centrifuge. Collect in an appropriate collection tube. (See appendices or individual tests for specific information.). (See Quantity Not Sufficient.). Serum separation from blood centrifugation Collect whole blood in a covered test tube. Plasmas are also not interchangeable. 0000017572 00000 n
When the blood clots, a serum sample is taken from the test tube. Push the spreader slide rapidly over the entire length of the slide, pulling a thin smear of blood behind it. Hemolysis occurs when the red cells rupture and hemoglobin and other intracellular components spill into the serum. 
The BD PPT should be at room temperature and properly labeled for patient identification. (See Figure 10.) Following centrifugation, it is important to immediately transfer the liquid component (plasma) into a clean polypropylene tube using a Pasteur pipette. Platelets are small fragments of special cells that aid in blood clotting. endobj
For after-hours pickup, follow the steps under Frozen Serum above. This clotted blood is then centrifuged, yielding serum, which contains two types of protein: albumin and globulin. Fasting plasma glucose alone or in conjunction with a random glucose determination, as recommended by the American Diabetes Association, to diagnose diabetes. Premature removal of the tube causes a rush of air to enter the tube, which may result in damage to the red cells. Materials provided by the laboratory for specimen collection can maintain the quality of the specimen only when they are used in strict accordance with the instructions provided. When using vacuum tubes containing no additives: In general, grossly or even moderately hemolyzed blood specimens may not be acceptable for testing. Yellow-top tube: Contains acid citrate dextrose (ACD) solution. Blood cultures should be collected directly into the blood culture bottles provided by LabCorp. Correct diagnostic and therapeutic decisions rely, in part, on the accuracy of test results. Note: LabCorp works with health care providers to minimize the total volume collected from pediatric and geriatric patients. All Rights Reserved. The other is for a test that may require multiple blood specimens to be collected at several specific times. After allowing clot to form, insert the tube in the centrifuge, stopper end up. (1992) Measuring cytokine levels in blood. The chemical has been chosen to preserve some feature of the specimen and to work with the method used to perform the test. Open the single or multiple sample needle package in front of the patient; do not tear the paper seal for the needle's cap, and do not remove the needle's cap (sterile shield) at this point. Blood samples should be centrifuged within 45 minutes to two hours depending on the test(s). For all those who are involved in specimen collection and preparation, the responsibility to adhere to current recommendations designed to maintain the safety of both patients and health care workers does not end when the patient is dismissed. This can cause discomfort to the patient and may also cause hemolysis. Also, a clot tube (eg, red-top tube or gel-barrier) that does not clot should be brought to the attention of the physician. 113 0 obj
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7 Agustus 2021 0. After mixing, store the BD PPT upright at room temperature until centrifugation. If you have after-hours pickup for frozen specimens, label the tube with a permanent marker. To allow for adequate mixing of blood with the anticoagulant or preservative, use a slow rolling wrist motion to invert the tube gently four to eight times. Rouleaux of the red cells (stacking like piles of coins) and platelet clumping will also occur. Serum is the fluid portion of the blood that DOES NOT contain the clotting factors. When there is difficulty accessing a vein or when a vacuum tube fills too slowly due to a difficult venipuncture, damage to the red blood cells may result. The samples should be maintained at 28C while handling. Prepare the second film in the same manner. The most common timed procedure is a glucose tolerance test. It is obtained when a clotting-prevention agent is added to whole blood and then placed in a centrifuge to separate the cellular material from the lighter liquid layer. %PDF-1.6
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The laboratory sends out a report marked QNS (quantity not sufficient), and the patient has to be called back for a repeat collection at an inconvenience to the patient and to the physician. You can also go the test description for Blood Culture, Routine [008300] in LabCorp's online directory and refer to the Microbiology Specimen Collection and Transport Guide attached in the Related Documents field for additional information on blood culture specimen collection. Samples which are hemolyzed, icteric or lipemic can invalidate certain tests. Prior to each collection, review the appropriate test description, including the specimen type indicated, the volume, the procedure, the collection materials, patient preparation, and storage and handling instructions. Purple or lavender top tubes contain EDTA, and green top tubes have heparin in them. Recommended times are based upon an intact clotting process. Preparing the Puncture Site. endstream
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Pull the safety shield on the needle back over the holder before removing the needle shield. This usually takes 1530 minutes. The gel barrier prevents the remixing of the plasma with the cellular elements of the blood. 2. The blood does not clot in the plasma tube. Permit the vacuum tube to fill completely. 11. Do not remove the tube stopper. <>
It can interfere in assays once released from RBCs. Serum or plasma may be cloudy due to bacterial contamination or chronic or transient high lipid levels in the patient's blood. 
Permit the tube to fill completely to ensure the proper ratio of blood to additive. The drop of blood should be in the center line, approximately inch from the frosted end. When frozen serum is required, place the plastic transport tube(s) (prepared above) immediately in the freezer compartment of the refrigerator. There are other commercially available tubes for blood sample collection. As the blood is separated, the heavier reds cells sink to the bottom and are given back to you. This prevents the blood from clotting and enables the blood to separate into 3 distinct layers during the centrifugation process. Webred serum after centrifugation. It is important to separate the cellular and liquid portions of a blood specimen as soon as possible when the test requires a sample of serum or plasma. Adhere to the following steps when using a gel-barrier tube. After centrifugation, the gel forms a barrier SST tube 30 minutes. These are available from Becton Dickinson (BD). Treat all biological material as material that is potentially hazardous as well as contaminated specimen collection supplies. This usually takes 1530 minutes. Carefully tighten specimen container lids to avoid leakage of specimen. This applies to both the last tube collected during a routine venipuncture and to tubes collected during a difficult procedure. 0000012690 00000 n
Repeat for the second collection slide. WebSerum Preparation. 1. Use: EDTA plasma for molecular diagnostic tests (eg, polymerase chain reaction (PCR) and/or branched DNA amplification (bDNA) techniques). One of the very effective ways for carrying out this process is the addition of alcohol to the plasma membrane pool while simultaneously cooling the pool. Remove the tube carefully without disturbing the contents. Labs usually have time limits on how long serum or plasma can remain in touch with the red blood cells before being physically separatedusually by pouring off into another tubewhile maintaining the identity of the patient from whom the blood was taken. WebIf it turned red colour, we could be explain the hemolysis will occur when animal test. Do not disturb the cell layer or carry any cells over into the pipette. Place the tube(s) in a designated freezer. In general, specimens for determining the concentration of body constituents should be collected when the patient is in a basal state (ie, in the early morning after awakening and about 12 to 14 hours after the last ingestion of food). The resulting supernatant is designated serum. 
Plasma is produced when whole blood is collected in tubes that are treated with an anticoagulant. 
Prepare the silver gel packs that fit into the Frozen Specimen Keeper by making sure that they also are frozen. Other examples include such tests as occult blood, ova and parasites, and blood cultures. Preparing the Specimen. xYKoH,7 %Q>v3SUUU>/|G~>>|C b 3/G>>[?frL-LXODK",l\j7tp7S{xq7Sqc6[]Bg^z-Jr/^ehdAHSv~q7Sn/gv?-=jr$Z_y]kQVvR1j%Zu3E^KYAu@rzt7
S7m 8uMb?]R$|!|H.-CjBDI6f6^TtR;R8Lw]l+nw7>=wq_#[rL/1jSth=21CSt\BeX:@obNZPm)sxdOdRojwQ}j%=in R8FKma!nIyfNAN"y9b[tYM"uOo"O'hu=)d All sequential specimens are from the same patient and are sent to the laboratory at the same time. When multiple specimens are required, remove the first collection tube from the holder as soon as blood flow ceases, invert the first tube to prevent clotting, and gently insert the second tube into the holder. Hold the spreader by the frosted end between the right thumb and the index finger. It is quick and easy to get excellent separation of centrifuged blood with the aid of a high-quality blood separation centrifuge such as the CAPPRondo Advanced Clinical Centrifuge CRC-416X. WebAfter collection of the whole blood, allow the blood to clot by leaving it undisturbed at room temperature. %
Depending on the need of the patient, either the RBCs, the plasma, or both can be transfused. Place the collection tube in the upright position in the rack, and allow the blood to clot at room temperature for 30 to 60 minutes. Do. To avoid clotting, gently mix the blood with the anticoagulant immediately after drawing each sample. Because additives are not interchangeable, it is necessary to consult the specimen requirement field of individual test descriptions to determine the appropriate collection requirements for the test ordered. Add the preservative (as specified in the test requirements) to the urine collection container prior to collection of the specimen if the preservative is not already in the container. Perfect for everyone from startups to academicians to large companies. Put on laboratory personal protective equipment. Patients who consume these foods within the 24-hour period immediately preceding collection of a blood specimen may have temporarily elevated lipid levels, which may be manifested by cloudy or lipemic serum. Serum separation from blood centrifugation Collect whole blood in a covered test tube. WebRed top tubes must be allowed to clot completely (30-60 minutes) prior to centrifugation. 0000017996 00000 n
Frozen Gel Packs. Serum is recovered from whole blood after allowing the blood to clot. Do not use gel-barrier tubes to submit specimens for therapeutic drug monitoring, direct Coombs', blood group, and blood types. For some tests, such as chemistry procedures, fasting samples are often the specimen of choice. If the patient cannot be taken off the medication in question, its presence should be noted on the test request form. Also, print on the label the type of plasma submitted (eg, Plasma, Sodium Citrate, Plasma, EDTA, etc). Whole blood contains the liquid fraction of blood (i.e., plasma) as well as the cellular elements that lead to clotting under certain circumstances. 6. For clients whose specimen lockboxes must be placed outdoors, adding a frozen gel pack to the lockbox during warmer weather will help provide a moderate temperature inside the lockbox until specimens are collected by your LabCorp service representative. Store unpreserved specimens refrigerated or in a cool place until ready for transport. Labcorp also offers a different lockbox for use at locations that experience extreme temperatures. Clotting Clotting instructions: non-additive tube (red stopper) 60 minutes. 0000016260 00000 n
It DOES NOT contain the red or white blood cells or platelets. 
0000037681 00000 n
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NOTE: All drug levels must be drawn in red top tubes only. Rapid wrist motion or vigorous shaking may contribute to hemolysis. After collection of the whole blood, allow the blood to clot by leaving it undisturbed at room temperature. It is important to separate the cellular and liquid portions of a blood specimen as soon as possible when the test requires a sample of serum or plasma. 5. All Rights Reserved. WebSerum separation tubes (SSTs) are tubes used in phlebotomy containing a silicone gel; when centrifuged the silicone gel forms a layer on top of the buffy coat, allowing the blood serum to be removed more effectively for testing and related purposes. Please refer to the specimen requirements for the test(s) of interest available in the Directory of Services. Centrifuge Time Clotting Clotting instructions: non-additive tube (red stopper) 60 minutes. Small amounts of moisture can cause hemolysis. Spreader slide pushed across the slide in a jerky manner. Blood films may be prepared from venous blood (venipuncture) or capillary puncture blood. Be sure to use only tubes with a 3.2% sodium citrate concentration. Inevitably, due to a need to have enough blood on hand to meet unexpected demand, some of the blood cannot be transfused because it has been stored too long. When all samples have been drawn, remove the entire assembly from the arm. Use: EDTA whole blood or plasma. 5. 0000014613 00000 n
It is important to avoid freeze-thaw cycles. No portion of the film should extend to the edges of the slide. Let the specimen stand for 30 to 60 minutes and (preferably) not longer than 60 minutes prior to centrifugation. Invitrogen has not evaluated some of these tubes for compatibility with our ELISA kits. endobj
Heparinized tubes (green tops) are indicated for some applications; however, heparin can often be contaminated with endotoxin, which can stimulate white blood cells to release cytokines. Fasting or diet restrictions, such as low-fat diets, should be explained in detail, particularly to aged or overanxious patients or their caregivers. Hemolyzed serum or plasma is pink or red, rather than the normal clear straw or pale yellow color. Pipette the serum or plasma into a clean plastic screw-cap vial 7. Why do we need to separate the serum from the red blood cells after centrifugation? Remove and invert each successive tube after it is filled. Both anticoagulants and preservatives may be required for plasma specimens. Centrifuge for at least 15 minutes at 2200-2500 RPM. Recommended times are based upon an intact clotting process. 0000017471 00000 n
Following centrifugation, it is important to immediately transfer the liquid component (serum) into a clean polypropylene tube using a Pasteur pipette. After collection of the whole blood, allow the blood to clot by leaving it undisturbed at room temperature. The essential difference between plasma and serum is that plasma retains fibrinogen (the clotting component), which is removed from serum. Permit the vacuum tube to fill completely. 5. Remove the clot by centrifuging at 1,0002,000 x g for 10 minutes in a refrigerated centrifuge. If commercially available tubes are to be used, the researcher should use the red topped tubes. 0000010908 00000 n
Troponin I values measured in heparinized plasma are often lower than when measured in EDTA plasma or serum from the same patient taken at the same time. Many common prescription and nonprescription (over-the-counter) medications can interfere with chemical determinations or alter levels of substances measured. If you have after-hours pickup, follow the steps under frozen serum.... Been drawn, remove the entire length of the slide in a cool place until for. Over into the serum or plasma into a clean polypropylene tube using gel-barrier... Fasting samples are often the specimen requirements for the test ( s ) interest... Or white blood cells after centrifugation, such as calcium and magnesium for. Red colour, we could be explain the hemolysis will occur when animal test centrifugation! And magnesium clear straw or pale yellow color diagnosis of a viral infection when culturing is not.! Problem, whole blood in a refrigerated centrifuge then centrifuged, yielding serum, which Contains types. To aid in blood clotting occult blood, allow the blood from clotting and enables the blood clots, serum. Diagnose Diabetes the top of the patient, either the RBCs, the gel barrier prevents the of. To enter the tube Causes a rush of air to enter the tube with a random determination! Immediately after drawing blood, allow the blood clots, a serum sample is taken from the title contaminated!: //www.youtube.com/embed/G9_u_YVqPOs '' title= '' serum or plasma not contain the red blood cells after centrifugation, the gel prevents. Experience extreme temperatures a difficult procedure leaving it undisturbed at room temperature as the blood is altered meals. Plasma glucose alone or in conjunction with a single identifier, but two identifiers are preferred is separated, heavier. Provided by LabCorp available tubes are to be collected at several specific times of special that! Anticoagulant or preservative and geriatric patients chelating agent that will sequester metal such., the researcher should use the red cells rupture and hemoglobin and other intracellular components spill into the blood the! With a random glucose determination, as recommended by the American Diabetes Association, diagnose. Avoid leakage of specimen '' 560 '' height= '' 315 '' src= '' https: //www.youtube.com/embed/G9_u_YVqPOs '' title= '' or. And should be maintained at 28C while handling not disturb the cell layer or carry any cells over into serum! Give similar results, equivalence can only be ensured by testing matched samples '' src= '' https: ''. Required for plasma specimens rapidly over the entire length of the whole blood in a covered test tube Directory Services. Ppt upright at room temperature 30 to 60 minutes plasma, or both can a... To clot is filled patient can not be acceptable for testing after allowing clot to form, insert tube... Clot by centrifuging at 1,0002,000 x g for 10 minutes in a cool place until for... Coombs ', blood group, and citrate a separate frozen sample must be submitted for each requiring! To immediately transfer the liquid component ( plasma ) into a clean plastic screw-cap (. A 3.2 % sodium citrate concentration blood culture bottles provided by LabCorp test that may be required for specimens! Coombs ', blood group, and green top tubes have heparin in them of an acute and convalescent to... Upon an intact clotting process at room temperature until centrifugation label the tube ( )... Blood DOES not clot in the Directory of Services potentially hazardous as well contaminated! The most common timed procedure is a glucose tolerance test or even moderately hemolyzed blood.... Due to bacterial contamination or chronic or transient high lipid levels in the centrifuge, stopper end up interfere chemical. Drawn, remove the entire assembly from the red blood cells after,! 60 minutes the diagnosis of a viral infection when culturing is not feasible //www.youtube.com/embed/G9_u_YVqPOs '' ''. 0000017572 00000 n Red-top tube: Contains no anticoagulant or preservative are given back to you infection when culturing not. Different lockbox for use at locations that experience extreme temperatures Contains acid citrate dextrose ( )... Last tube collected during a difficult procedure gently tap tubes containing no additives: general! Applies to both the last tube collected during a routine venipuncture and to work with anticoagulant. Are at the top of the blood is the preferred sample for measuring immunosuppressant drugs the bottom and given. Across the slide, pulling a thin smear of blood should be the! Patient and may also cause hemolysis and preservatives may be required for plasma specimens webred cells ( )! And magnesium even moderately hemolyzed blood specimens to be collected directly into the serum or plasma is pink or,. Liquid portion ( serum/plasma ) of interest available in the centrifuge, end... Enables the blood is separated, the plasma tube in a covered tube. Need of the page across from the test tube being absorbed into serum! < > endobj 7 Agustus 2021 0 blood to clot by leaving it at! Association, to diagnose Diabetes a clean plastic screw-cap vial ( See Figure 9. ) to preserve feature... Process of developing an assay your lockbox for use at locations that experience extreme temperatures well. May give similar results, equivalence can only be ensured by testing matched samples to! Specimen requirements for the test request form shaking may contribute to hemolysis using vacuum tubes containing no additives in. The other is for a test that may require multiple blood specimens a tolerance... The cell layer or carry any cells over into the pipette LabCorp works with health care providers to the! Sink to the red cells ( stacking like piles of coins ) and platelet clumping will also.... Occult blood, allow the blood to separate into 3 distinct layers the. Tubes to submit specimens for therapeutic drug monitoring, direct Coombs ', red serum after centrifugation group, and cultures! Concentration of analytes than the liquid component ( plasma ) into a clean polypropylene tube using a gel-barrier tube within... Be adhering to the stopper, and citrate of Services be in the center line, inch. Viral infection when culturing is not feasible, ova and parasites, and blood cultures should be on... To be collected at several specific times patient, either the RBCs, the heavier cells. Plasma tube for reuse the plasma tube and green top tubes have heparin in them acute and convalescent serum aid., or both can be transfused, insert the tube Causes a rush of to. Small fragments of special cells that aid in the Directory of Services all biological material as material that potentially. Some enzymes that require a metal ion for their activity recovered from whole blood, allow the red serum after centrifugation to completely! A serum sample is taken from the title tighten specimen container lids to freeze-thaw... Be maintained at 28C while handling, whole blood in a covered test tube when blood! Culturing is not feasible hemolyzed, icteric or lipemic can invalidate certain tests blood then. Stand for 30 to 60 minutes ) not longer than 60 minutes prior to centrifugation are back! Rapid wrist motion or vigorous shaking may contribute to hemolysis clear straw or pale yellow color be at. Contaminated specimen collection supplies hemolyzed, icteric or lipemic can invalidate certain tests potentially hazardous as well as contaminated collection! Plasma will also occur often the specimen requirements for the test tube biological material material... Invitrogen has not evaluated some of these tubes for blood sample collection 315 '' ''... Tube is an additive tube and should be noted on the test form... Medication in question, its presence should be collected directly into the serum or into. Therapeutic drug monitoring, direct Coombs ', blood group, and green top tubes contain EDTA and. Gel forms a barrier SST tube 30 minutes bottom and are given back to you it! Clotting instructions: non-additive tube ( s ) in a refrigerated centrifuge due to bacterial contamination or chronic or high... Chemical determinations or alter levels of substances measured containing additives to dislodge any material that may require blood! Higher concentration of analytes than the normal clear straw or pale yellow color be collected at several specific.... Sodium citrate concentration important to avoid this problem, whole blood, ova and parasites, and top! Released from RBCs webif it turned red colour, we could be explain the hemolysis will when!: non-additive tube ( red stopper ) 60 minutes and ( preferably ) longer. Your lockbox for reuse in a jerky manner a thin smear of blood it!, gently mix the blood with the anticoagulant immediately after drawing blood, allow the to. Layer or carry any cells over into the blood is then centrifuged, yielding,! Of choice using a Pasteur pipette tests, such as chemistry procedures, fasting samples are often specimen. Chemical has been chosen to preserve some feature of the slide, pulling a smear! Blood DOES not clot in the center line, approximately inch from the red cells rupture and and..., ova and parasites, and blood cultures should be in the Directory of.! Of specimen, ova and parasites, and citrate use gel-barrier tubes to submit specimens for drug! Contamination or chronic or transient high lipid levels in the patient 's.! Or plasma may be labeled with a single identifier, but two identifiers are preferred entire length the... Is separated, the heavier reds cells sink to the red or white blood cells after centrifugation, heavier. Container lids to avoid freeze-thaw cycles random glucose determination, as recommended by the Diabetes., icteric or lipemic can invalidate certain tests portion of the blood culture bottles provided by LabCorp for... Anticoagulants and preservatives may be required for plasma specimens ( ethylenediaminetetraacetic acid ), heparin, and blood cultures of! Be collected at several specific times n when the red cells general, grossly or even moderately hemolyzed specimens. At 28C while handling for specific information. ) and therapeutic decisions,... White blood cells or platelets lavender top tubes have heparin in them BD ) clot.
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