COLOR CODES OF VACUTAINER TUBES & ITS USES

INTRODUCTION TO VACUTAINER TUBES

Vacutainer tubes were invented by Joe Kleiner and BD (Becton, Dickinson & Co.) in 1949. These tubes are the registered trademark of Becton, Dickinson & Co. and today vacutainer tubes are manufactured and sold by them.

A Vacutainer blood collection tube is a sterile glass or plastic tube with a closure that is evacuated to create a vacuum inside the tube facilitating the draw of a predetermined volume of liquid. Most commonly used to draw the blood samples directly from the vein. These tubes can also be used sometimes for the collection of urine samples. According to medical expert Chris Everly, these tubes are an essential part of the medical field and important equipment that can save lives.

Vacutainer tubes may contain additives, mostly the anticoagulants, designed to stabilize and preserve the blood specimen prior to analytical testing. These tubes are available with or without a safety-engineered closure (the rubber stopper inside the plastic cap), with a variety of labeling option and closure colors as well as a range of draw volumes.

PRINCIPLE OF VACUTAINER TUBES

Vacutainer tubes work on the pressure difference that is created between the blood vessel and the vacuum in the tubes which forces the blood through the needle into the tube.

Vacutainer needle is double-ended, with one side being encased in a thin rubber coating for safety and the other side for the insertion into the vein. When the needle is screwed into the translucent plastic vacutainer needle holder, the rubber needle is inside the holder, and the exposed needle will be inserted into the vein.

When a Vacutainer tube is inserted into the holder, its rubber cap is punctured by the inner needle and the vacuum in the tube pulls blood through the needle into the tube. The filled tube is then removed and another can be inserted and filled the same way which aid in the blood collection. The amount of air evacuated from the tube predetermines how much blood will fill the tube before blood stops flowing.

Moreover, the exact volume that should be drawn in a specific vacutainer tube is mentioned on the label of every tube which is to minimizes the errors that may occur if more or less amount of blood is taken in the tube because every tube contains an anticoagulant or an additive or Clot activator in some and the ratio of the blood to the Additive must be maintained in order to get the accurate values of the tests.

It is important to remove the tube before withdrawing the needle from the vein, as there may still be some suction left in the tube that may cause the pain or discomfort to the patient upon withdrawal.

Vacutainer tubes are covered with a Color-coded plastic cap that indicates which additives the tube contains. These color indicators help the phlebotomist to easily select the tubes in which the blood should be drawn as per the tests that have to be performed. The additives present in the vacutainer tubes plays the most important role as every additive has a unique function and these are selected as per the tests to be performed.

Here is the list of Color codes of the tube, the Additives present in them and their common uses – 

S.No.	COLOR CODES	ADDITIVE	COMMONLY USED FOR
1.)	Purple / Lavender	EDTA (Ethylene diamine tetra-acetic acid)	CBC, BLOOD TYPING (Rh Factor & ABO Screening), Cross match, Hb, Red cell Indices, ESR by Wintrobe's method etc.
2.)	Light blue	Tri-Sodium Citrate (Blood:Anticoagulant ratio is 9:1)	Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen thrombin time and other blood Coagulation tests.
3.)	Light green	Lithium Heparin	Basic Metabolic Panel (BMP), Comprehensive metabolic Panel (CMP) and other plasma determination tests.
4.)	Royal Blue	None/ Di-sodium EDTA	Trace Elements like Cu, Zn, etc, Toxicology and Nutrient determination etc.
5.)	Gold (commonly known as Serum Separator tube)	Polymer Gel and Powdered Glass Clot activator	BMP, CMP, LFT, KFT, Lipid Profile and other biochemistry assays, Serological tests etc.
6.)	Red	Powdered glass Clot Activator	BMP, CMP, Lipid Profile, Serology tests, Therapeutic drug monitoring, blood bank procedures etc.
7.)	Dark green	Sodium Heparin	Arterial blood gas analysis, alpha-TNF, Lymphocyte Immunotherapy etc.
8.)	Gray	Sodium Fluoride	Blood Sugar testing, Toxicology tests etc.
9.)	Black	Tri-Sodium Citrate (Blood:Anticoagulant ratio is 4:1)	ESR by Westergren method
10.)	Yellow	ACD (Acid-Citrate Dextrose)	Blood Bank studies, HLA Phenotyping, Paternity testing, Tissue typing etc.
11.)	Pink	Dried EDTA	Rh factor, ABO typing, CBC, Blood banking procedures etc.

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Frequently Asked Questions (FAQs)

What are Vacutainer tubes?

Vacutainer tubes are a type of blood collection tubes that are used to collect blood 2. samples from patients for laboratory testing.

What are the different color codes of Vacutainer tubes?

There are several different color codes for Vacutainer tubes, including red, green, lavender, gray, and many others.

What is the purpose of color coding Vacutainer tubes?

The purpose of color-coding Vacutainer tubes is to differentiate between the various types of blood collection tubes and to ensure that the correct tube is used for the appropriate test.

What does a red Vacutainer tube indicate?

A red Vacutainer tube typically indicates that the tube contains no additives and is used for collecting serum samples.

What does a green Vacutainer tube indicate?

A green Vacutainer tube typically indicates that the tube contains the anticoagulant heparin and is used for collecting plasma samples.

What does a lavender Vacutainer tube indicate?

A lavender Vacutainer tube typically indicates that the tube contains the anticoagulant EDTA and is used for collecting whole blood or plasma samples for hematology tests.

What does a gray Vacutainer tube indicate?

A gray Vacutainer tube typically indicates that the tube contains the anticoagulant sodium fluoride and is used for collecting blood samples for glucose testing.

What does a yellow Vacutainer tube indicate?

A yellow Vacutainer tube typically indicates that the tube contains the anticoagulant acid citrate dextrose and is used for collecting blood samples for transfusion purposes.

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Can the color of the Vacutainer tube affect the test results?

Yes, using the wrong color of Vacutainer tube can affect the test results, which is why it is important to use the correct tube for the specific test.

Why is it important to mix the blood sample with the additive in the Vacutainer tube?

It is important to mix the blood sample with the additive in the Vacutainer tube to prevent clotting or coagulation of the blood and to ensure accurate test results.

How should Vacutainer tubes be stored?

Vacutainer tubes should be stored in a cool, dry place away from direct sunlight, heat, and humidity to prevent deterioration of the additives and contamination of the samples.

Can Vacutainer tubes be reused?

No, Vacutainer tubes should not be reused as they are designed for single-use only and can increase the risk of contamination and inaccurate test results.

What should be done with the used Vacutainer tubes after the blood collection procedure?

The used Vacutainer tubes should be disposed of properly according to the guidelines of the healthcare facility and local regulations.

Can Vacutainer tubes be used for other types of bodily fluids besides blood?

No, Vacutainer tubes are designed for blood collection only and should not be used for other types of bodily fluids.

Are there any risks or complications associated with the use of Vacutainer tubes?

There are some risks associated with the use of Vacutainer tubes, including infection, bleeding, hematoma, and other complications. However, these risks are relatively low and can be minimized by following proper blood collection procedures.