Blood Collection Tubes comes with various sizes, with color coded tops indicating tube contents. Most blood collection tubes contain an additive that either accelerates clotting of the blood (clot activator) or prevents the blood from clotting (anticoagulant).
A tube that contains a clot activator will produce a serum sample when the blood is separated by centrifugation.
A tube that contains an anticoagulant will produce a plasma sample after centrifugation.
Some tests require the use of serum, some require plasma, and other tests require anticoagulated whole blood.
Red
The red bottle is less common. It is used for biochemistry tests requiring serum which might be adversely affected by the separator gel used in the yellow bottle.
Additive: None or contains silica particles which act as clot activators.
Role of Additive: Clot activator promotes blood clotting with glass or silica particles.
Laboratory Uses: Serum testing (glucose, cholesterol, triglycerides, HDL, potassium, amylase, alkaline phosphatase, BUN, CK, liver enzymes), blood bank, serology (RH Typing, Antibody screening, Red Cell Phototyping, DAT, RPR, monospot, rheumatoid factor, ANA)
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Yellow
Additive: anticoagulant SPS (Sodium Polyanetholsulfonate) & ACD (acid citrate dextrose)
Role of Additive: Prevents the blood from clotting and stabilizes bacterial growth.
Laboratory Uses: Blood and bodily fluid cultures (HLA, DNA, Paternity)
Tubes with SPS (Sodium Polyanetholsulfonate) : For Blood and bodily fluid cultures (HLA, DNA, Paternity). The SPS aids in the recovery of microorganisms by slowing down/ stopping the actions of complement, phagocytes, and certain antibiotics.
Tubes with ACD (Acid Citrate Dextrose) are for cellular studies, HLA typing, paternity testing.
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Light Blue
The blue bottle is used for haematology tests involving the clotting system, which require inactivated whole blood for analysis.
Additive: Sodium Citrate
Role of Additive: Binds and remove calcium to prevent blood from clotting
Laboratory uses: Coagulation (clotting process - Prothrombin Time)
PT (Prothrombin Time, evaluates the extrinsic system of the coagulation cascade & monitors coumadin therapy)
APTT/ PTT (Activated Partial Thromboplastin Time – evaluates the intrinsic system of the coagulation cascade & monitors heparin therapy)
FDP (Fibrinogen Degradation Products)
TT (Thrombin Time)
Factor assays
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Green
This less commonly used bottle is for biochemistry tests which require heparinised plasma or whole blood for analysis.
Additive: Heparin (Sodium/Lithium/Ammonium)
Role of Additive: Inhibits thrombin formation to prevent clotting
Laboratory uses: Chemistry Testing (Plasma determinations in chemistry) : ammonia, carboxyhemoglobin & STAT electrolytes, chromosome screening, insulin, renin and aldosterone
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Lavender
These bottles are generally used for haematology tests where whole blood is required for analysis.
Additive: EDTA (Ethylenediaminetetraacetic Acid)
Role of Additive: Removes calcium preventing clotting of blood
Laboratory uses: Hematology testing (ESR, CBC w/diff., HgBA1c)
blood film for abnormal cells or malaria parasites, reticulocytes, red cell folate, Monospot test for EBV, parathyroid hormone (PTH)
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Grey
Additive: Potassium oxalate and Sodium fluoride
Role of Additive: Sodium fluoride acts as an antiglycolytic agent to ensure that no further glucose breakdown occurs within the sample after it is taken. Potassium oxalate removes calcium and acts as an anticoagulant.
Laboratory uses: Chemistry testing, especially glucose(sugar) and lactate, Glucose tolerance test (GTT)
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Royal Blue
Additive: Sodium Heparin also Sodium EDTA
Role of Additive: Inhibits Thrombin formation to prevent
Laboratory uses: Chemistry trace elements (such as Zinc, Copper, Lead and Mercury), toxicology, and nutritional chemistry testing
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Black
Additive: Sodium Citrate
Role of Additive: Forms calcium salts to remove calcium
Laboratory uses: paediatric ESR
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