What Is the Purpose of a Royalblue Topped Tube
Specimen Requirements/Containers
Laboratory test results are dependent on the quality of the specimen submitted. If there is any doubt or question regarding the type of specimen that should be collected, it is imperative that the laboratory is called to clarify the order and specimen requirements.
Most laboratory tests are performed on serum, anticoagulated plasma or whole blood. Please see the individual test directory listings for specific requirements.
Plasma: Plasma: Draw a sufficient amount of blood with the indicated anticoagulant to yield the necessary plasma volume. Gently mix the blood collection tube by inverting 8-10 times immediately after collection. The majority of samples require separation of plasma from cells within two hours of collection. However, there are few tests that require separation within 15-30 minutes. Please refer to our laboratory test directory for additional information. All specimens must be delivered to the laboratory within 4 hours of collection.
Serum: Draw a sufficient amount of blood to yield the necessary serum volume. Invert tube 5-10 times to activate clotting. Allow blood to clot at room temperature for 30 minutes. NOTE: Avoid hemolysis.
Whole Blood: Draw a sufficient amount of blood with the indicated anticoagulant. Gently mix the blood collection tube by inverting 8-10 times immediately after collection. NOTE: Tubes intended for whole blood analyses are not to be centrifuged and separated.
All patient specimens must be place in biohazard bags for transport to the laboratory.
Specimen Collection Tubes
- Gold-top serum separator tube (SST)
This tube contains a clot activator and serum gel separator – used for various chemistry, serology, and immunology tests. If the specimen requirement for a test is red-top tube(s), do not use gold-top/SST tube(s).
NOTE: Invert the tube to activate the clotting; let stand for 20-30 minutes before centrifuging for 10 minutes. If frozen serum is required, pour off serum into plastic vial and freeze. Do not freeze Vacutainer® tubes.
- Red-top tube, plastic
This tube is a plastic Vacutainer containing a clot activator but no anticoagulants, preservatives, or separator material. It is used for collection of serum for selected laboratory tests as indicated. If the specimen requirement for a test is red-top tube(s), do not use gold-top/SST® tube(s), as the gel separator may interfere with analysis.
- Red-top tube, glass
This tube is a plain glass Vacutainer® containing no clot activators, anticoagulants, preservatives or separator material. These tubes can be used for Blood Bank tests.
- Pink-top tube (EDTA)
This tube contains EDTA as an anticoagulant. These tubes are preferred for blood bank tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
- Light green-top tube (lithium heparin)
This tube contains lithium heparin and gel separator used for the collection of heparinized plasma for routine chemistry tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
- Dark green-top tube (sodium heparin)
This tube contains sodium heparin used for the collection of heparinized plasma or whole blood for special tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
- Grey-top tube (potassium oxalate/sodium fluoride)
This tube contains potassium oxalate as an anticoagulant and sodium fluoride as a preservative – used to preserve glucose in whole blood and for some special chemistry tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
- Lavender-top tube (EDTA)
This tube contains EDTA as an anticoagulant - used for most hematological procedures. These tubes are preferred for molecular tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.To avoid RBC shrinkage due to excess EDTA (with resulting changes in HCT and RBC indices values) and possible dilutional effect, the tubes should be filled with the proper amount of blood for the size of tube used. Tubes with various draw volumes are available (2.0 mL, 3.0 mL, 5.0 mL and 0.75 mL microvettes); to assure proper ratio of EDTA to blood, it is recommended that the tubes contain no less than one-half of the stated volume.
- Royal blue-top tube
There are two types of royal blue-top Monoject® tubes – one with the anticoagulant EDTA and the other plain. These are used in the collection of whole blood or serum for trace element analysis. Refer to the individual metals in the individual test listing to determine the tube type necessary.
- Yellow-top tube (ACD)
This tube contains ACD, which is used for the collection of whole blood for special tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
- Pearl white-top tube plasma preparation tube (PPT)
This tube contains EDTA and a special polyester material - used for the collection of plasma for molecular (PCR) tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure adequate anticoagulation of the specimen.
Special Collection Tubes:Some tests require specific tubes for proper analysis. Please contact the laboratory prior to patient draw to obtain the correct tubes for metal analysis or other tests as identified in the individual test listings.
Microtainer® tubes (pediatric bullet tubes)*
| Microtainer® tube |  |  |  |  |  |
| Color | Gold | Red | Light Green (amber or clear) | Lavender | Light Green (without gel barrier) |
| Additive | No additive w/ gel barrier | No additive | Lithium Heparin w/ gel barrier | K2EDTA | Lithium Heparin without gel barrier |
| Volume | 0.5 mL | 0.5 mL | 0.5 mL | 0.5 mL | .04 mL |
*Microtainer is a registered trademark of Becton, Dickinson and Company
Microbiological Collection Containers
Anaerobic Transport Media: Tube with soft agar and reducing agents designed to maintain viability of anaerobic organisms. Fluid can be injected through the diaphragm cap into the tube. To transport swab specimens or tissue, remove the cap, place the specimen into the tube (break off the swab stem if needed) and replace and tighten cap.
Blood Culture Media: Draw 20 mL of blood and aseptically inoculate 10 mL into each of the 2 bottles: BACTEC PLUS (blue label) and BACTEC LYTIC (purple label). Use an alcohol prep to clean the top of each bottle before and after inoculation.
Charcoal Amies Medium With Swab: This swab is used for the collection and transport of specimens for Bordetella isolation. The specimen of choice is secretions collected from the posterior nasopharynx. Culture Swab™ must be submitted for direct examination.
Chlamydia Culture Transport Medium: Use the swab provided to collect the specimen and inoculate the transport medium. If specimen transport is delayed, refrigerate after inoculation.
Chlamydia trachomatis, MicroTrak® Direct Stain Specimen Collection Kit: This is used in the collection of specimens for analysis by the MicroTrak C trachomatis direct specimen test. The kit contains slide, swabs, cytology brush, and fixative. The directions for use are on the package.
HSV 1, HSV 2, VZV MicroTrak Direct Stain Specimen Collection Kit: For use in the collection of specimens for analysis by the HSV1/HSV2 and VZV direct specimen typing test. This test is for external lesions only. The kit contains slides, swabs, fixative and directions for use. Collection kits are available in microbiology.
Isolator Microbial Tube (adult and pediatric): These tubes are used for the collection of blood specimens for the isolation of fungi and mycobacteria. Transport to the laboratory at ambient temperature.
Viral Culturette®:This sterile swab is used for the collection and transport of herpes and viral specimens. Transport to the laboratory on wet ice.
Urine Collection
Random Collection: For routine and microscopic evaluation, a clean catch or midstream specimen is preferred.
Inpatients: The patient should void a small amount of urine, which is discarded. Collect urine in a clean container before voiding is completed. The container should be capped, labeled and refrigerated.
Outpatients and Referral Patients: After collection, the transfer of urine into preservative tubes should happen at the collection site. Mix the urine and peel back the protective sticker on the blue cap to expose the cannula. Fill the tubes in this order: gray for culture & sensitivity, yellow-red marble top for urinalysis and non-additive red top . The tube is filled by pushing the tube stopper side down onto the exposed cannula. Each tube has a line indicating the "minimum draw."
Urine Collection for Chlamydia/Gonorrhea PCR: Patient must not have voided for at least 2 hours. The first stream of urine is collected and submitted for testing.
24-hour Urine Collection: UCI Pathology Services provides 24-hour urine collection containers.
Use the following procedure for the correct specimen collection and preparation:
- Warn the patient of the presence of potentially hazardous preservatives in the collection container. Instruct the patient to discard the first morning specimen and to record the time of voiding.
- The patient should collect all subsequent voided urine for the remainder of the day and night. The first-morning specimen on day two should be collected at the same time as noted on day one.
- Mix well before aliquoting and provide the total volume of the 24-hour urine collection or send the complete 24-hour collection to the laboratory.
For more information call us toll free at 1-888-UCI-LABS
Source: http://www.pathology.uci.edu/services/specimen-containers.asp
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