Order of Draw in Phlebotomy

Did you know that phlebotomy is one of the oldest forms of medicine? Thousands of years ago, as far back as the Egyptians and perhaps even further, “physicians” would draw blood (this was called blood-letting) for the perceived medical benefits. Today their methods seem foolish and barbaric but at the time, they were on the cutting edge of medicine.

            Today, drawing blood is one of the most common medical procedures worldwide with hundreds of millions, if not billions, of samples of blood being drawn every year. As with all medicine, processes change as new information becomes available and drawing blood is no different. These procedures have changed to accommodate for advances in blood medicine and upgrades in medical technology, such as the transition to plastic tubes as opposed to glass tubes.

What is the Order of Draw and Why is it Important?

The order of draw was designed to protect against contamination in the blood samples that are drawn. An internationally recognized and uniform process is the elegant solution that was designed to tackle this significant challenge.

      What exactly is it? It is the precise order in which the specimens are to be drawn from the patient and which labeled tubes these samples are to be drawn into. Why is it important? If the order of draw is not followed, there is a chance that there could be additive carryover from one tube to the other and this could alter the lab results. This can have incredibly significant consequences.

Is it important to follow this order? Absolutely it is. While there are some situations in which the order of draw may be different, understanding the standard order of draw is critical in phlebotomy training and practice. What is this order of draw?

The Order of Draw: The Process

            First thing first, always make sure that the documentation for your patients matches and is accurate. This ensures that after the specimens are tested, the results are given to the right people. For these results to be accurate and reduce the risk of contamination, follow this order.

  1. Blood culture tubes

This is a specimen that is meant for the culture of microorganisms for the recovery of potential pathogens.

  • Sodium citrate tubes (e.g., blue-stopper)

This tube and its blood specimen are for coagulation tests.

  • Serum tubes with or without clot activator, with or without gel separator (e.g., red-, gold-, speckled-stopper)

The serum is what is left after the blood clots. It is a cell-free liquid that has no coagulation factors. Many tests are done on this serum to measure lipids, electrolytes, hormones etc.

  • Heparin tubes with or without gel (e.g., green-stopper)

This “heparinized blood is used for special whole blood tests, among other uses.

  • EDTA tubes (e.g., lavender-stopper)

These tubes use EDTA as a coagulant and are preferred for molecular tests.

  • Glycolytic inhibitor tubes (e.g., grey-stopper)

Also known as potassium oxalate/sodium fluoride tubes they use potassium oxalate as a coagulant and sodium fluoride as a preservative. These are used to preserve glucose in the blood and are helpful for other special chemistry tests.

The Order of Draw Can Have Exceptions

      As with almost all medical procedures, there can be exceptions to the rule. What it comes down to are the policy and trust. In certain situations, the order of draw may be different and if the policy suggests that it should be drawn in a different order, after making sure you understand why, always follow the policy.


Taking the Next Step in Your Career with Phlebotomy

Provided that you aren’t the squeamish type, phlebotomy is a very useful skill to have in a wide variety of medical and healthcare professions, which include:

  • Dental Practices
  • Nutritionists
  • Midwifery
  • Physicians and Nurses
  • Care workers
  • And more…

Professionals in these industries are already providing a quality service to patients and clients. Whether a public or private sector healthcare professional, additional qualifications can do no harm to career aspirations.

Many of the gaps to the next level are just one qualification away and improving your own skillset could be the difference in taking your company or your career to the next level.

For private sector healthcare professionals, an additional qualification in phlebotomy could help boost client retention and acquisition. For public sector healthcare professionals, that qualification could be the trigger to the next phase of your career and be the life changing difference in a patient’s life.

Healthcare professionals at the more experienced levels of their careers such as specialists or consultants may have embarked on a phlebotomy training course at some point in their career.

Whatever reason you have for wanting to broaden your skills in healthcare, phlebotomy training courses are a useful way to add more qualifications to your repertoire.

At Phlebotomy Training Services, we roll out our Advanced Courses throughout Great Britain*. To learn more about our courses, feel free to call us on 01609 751 610, or visit the Book a Course section on our website to get involved.

*To find out more about our Ireland courses, visit Book a Course for Ireland.


Where are PRP Injections Used?

At Phlebotomy Training Services we have a number of courses that are aimed at commercial clients, as opposed to private. These commercial clients typically want to learn to be a phlebotomist as it allows them to offer services that they usually wouldn’t be able to. In the past we have worked with medical researchers, nutritionists, dentists, beauticians and many more.

One of the most common reasons people want to learn phlebotomy is so that they can then go on to offer various PRP related therapies/treatments.

But what exactly is PRP, and can you use it in your business?

PRP, or platelet rich plasma, is a substance that is thought to have fantastic healing properties when injected. This is because the platelets contain ‘growth factors’ – these are thought to essentially be concentrated repair and growth minerals. When these are put into the body the help create localised repair.

How is it done?

The procedure is actually very simple and safe, if done properly. The procedure may vary depending on the purpose, but it is essentially the same. A small amount of blood is taken from the patient. This blood is then placed into a centrifuge which spins at an extremely high speed. This separates the component parts of blood. The PRP is taken from this, and then injected back into the patient.

Who Uses it?

There are many uses for PRP, from injury recovery to aesthetic treatments and speeding up the healing time for surgeries. As mentioned above, some of our past clients who have gone on to use PRP include beauticians who use them for ‘vampire’ facials, sports injury recovery specialists, dentists who use PRP to help speed up recovery time and aesthetic clinics who offer hair loss prevention treatments.

If you are thinking about offering PRP treatment then it is vital that every step of the process be carried out properly – this includes the initial step of extracting the patient’s blood, known as phlebotomy.

If you are looking for a phlebotomy training provider then we are more than happy to help. If you are curious about PRP, and how we can help you offer this treatment, then just call us on 01609 751 610 or contact us here.


Funding Available for Phlebotomy Diploma

The Phlebotomy Diploma, developed by Phlebotomy Training Services is the most advanced course available in phlebotomy. It was designed and developed for those who not only want to pursue a career in phlebotomy, but to also master their craft and provide the best care possible for anyone they are taking blood from.

There are 3 levels of the course: the award, the certificate and finally the diploma, with each level building on the last. This is an advanced course at the end of which the learner will be provided with a nationally recognised and will be accredited up to the equivalent NVQ Level 3.

We have recently found out that anybody looking to pursue the Diploma in Phlebotomy may be able to apply for funding to help them afford it and develop their career.

The loan is from the government’s Professional and Career Development Loans. If you meet the criteria then you can apply for a loan with a value of between £300 and £10,000. These loans are typically given at a reduced interest rate and the government pays the interest while you are undertaking the course.

As mentioned, there is certain eligibility criteria, which includes:

  • You have to be 18 or over
  • You have to be a British citizen
  • You have been living in the UK for at least 3 years before your course starts
  • You have to plan to work in the UK, European Union (EU) or European Economic Area (EEA) after the course is completed

This scheme ends in January 2019, therefore you have to act quickly if you would like to take advantage of this generous offer and work toward getting your diploma in Phlebotomy.

To find out more about funding, or the diploma, just call the Phlebotomy Training Services Team on 01609 751 610 or contact us here.


PTS Train Team at Beckton Hospital

Phlebotomy Training Services work with a range of commercial clients. We provide various training programmes to teams within organisations, and, if needed, can tailor our training to the specific needs and demands of the client. One such example of this is Cygnet Health Care.

Cygnet Health Care is a provider of specialist care for those suffering from mental health issues in the UK. They are classed as thought leaders in their field and pioneer the way for mental health treatment and care. Phlebotomy Training Services are proud to work closely with this organisation.

Recently we provided our Basic Phlebotomy Course to a number of learners in Beckton Hospital. The Basic Course, officially titled ‘Understanding Phlebotomy Skills and Techniques’ takes two days and at the end of it learners are awarded with a certification of competence and have the skills necessary to become a competent phlebotomist.

Unlike many other training providers, our basic course is accredited by One Awards, a nationally recognised awarding body.

We provided the course in the weekend preceding the Women of the Year Event, an initiative which aims to recognise the amazing achievements women in the UK make every year. In the website’s own words:

                ‘Each year a nominating council elects just 450 women to attend the annual Women of the Year Lunch handpicked for their achievements and contribution to society. Each guest is regarded as a ‘Woman of the Year’, representing herself, her work and the millions of extraordinary women who make a difference every day. In a world which often celebrates ‘celebrity’, Women of the Year sets itself apart by honouring real achievement and diversity.’

With their newly found skills who knows what this group of learners will go on to achieve?

To find out more about phlebotomy training, or to organise some specialist training for your team, call us on 01609 751 610 or contact us here.


Urgent Need for O Negative Blood Type

There is a constant need for blood donations in the UK. Hospitals can never have too much blood to be used for life saving transfusions. However, following on from the hot weather and world cup, reserves are currently startlingly low – especially in type O-negative.

The combined cost of the heat and the world cup cost the NHS around 2,000 donations. This brings the reserves down to around 3 days, which is half of the 6-day ideal – and is still looking to drop if the warm weather continues.

Mike Stredder, Director of Blood Donation for NHS Blood and Transplant, said: ‘The long spell of sunshine has been great in many ways but some people have chosen to stay in the sun instead of giving blood, and some people haven’t been hydrated enough to donate safely.’

O Negative is a particularly important blood group as it is a universal donor group and can be given to most people in the case of an emergency.

The NHS are crying out for people with O negative to visit their local donation centre as soon as possible. Find your nearest donation point here. You do not necessarily need an appointment, however it is vital that you are adequately hydrated which the heat can have an obvious effect on.


Blood Test Could Help Detect Lung Cancer Early

Scientists are currently “one step closer” to detecting the early stages of lung cancer using just a blood test, according to experts. The initial evidence is from an on-going study which suggests that liquid biopsies could be the starting point of discovering the first signs of the disease developing.

Lung cancer is the third most common cancer, with over 300,000 people dying from the disease each year in the UK alone.

Scientists have created three sequencing techniques that analyse cell-free DNA within the blood. These methods, which look for mutations and genomic changes, have said to be between 38 and 51% accurate at detecting the disease early on and up to 89% effective at detecting late-stage cancers.

These findings have been deemed “very promising” by cancer charities and we are expected to see further development for the use of this potentially life saving blood test.

Lead author Geoffrey Oxnard, associate professor of medicine at Dana-Farber Cancer Institute, said: “we’re excited that initial results from the study show it is possible to detect early-stage lung cancer from blood samples using genome sequencing.”

Oxnard then went on to say that there is an “unmet global need for early detection, that can be easily implemented by health care systems.”

This research opens doors for scientists as well as opening up the opportunity for more funding for research on the deadly disease and how to prevent and/or eliminate it at the earliest possible stage.

Dr Jodie Moffat, Cancer Research UK’s head of early diagnosis, said that it is “exciting to think that one day we could offer people a blood test to find lung cancer earlier, meaning they could benefit from treatments which give them a better chance of beating the disease.”

Phlebotomy Training Services are keen to encourage aspiring nurses, researchers and scientists to become involved in the skill of taking blood. Our training services provide a brilliant opportunity to gain qualifications and experience with the medical world. If you’d like more information or you’d like to book a course, call us today on 01609 751 610.


New Blood Test Could Predict Premature Births

A recent study from students at Stanford University has been said to be able to identify a pregnant woman’s exact due date. The new blood test was created to offer an alternative/cheaper option to measure due dates, than ultrasound scans, which can cost around £100 per screening.

The technique could play an important role in predicting premature births and opening up more doors for research and funding for the care of pregnant women. The blood tests and research carried out so far have shown a 75-80% accuracy in predicting due dates and complications.

In the UK alone, more than 15 million babies are born prematurely, often with little to no explanation. Doctors have never had access to a great deal of funding for the research, leaving many mothers with the answer of “these things just happen.”

The tests measure genetic activity in the maternal, placental, and foetal genes. It looks at the mother’s blood levels of cell-free RNA (the body’s messenger to ‘protein-making factories.’) The blood samples collected during a pregnancy, can determine which genes give accurate readings of gestational age and the risk of premature births.

“I’ve spent a lot of time over the years working to understand preterm delivery. This is the first real, significant scientific progress on this problem in a long time” said Professor Mads Melbye.

Prematurity is largest cause of infant mortality and the biggest cause of death of children under 5 in the world – the student’s research could massively impact this statistic, if more development is to be made on their testing method.

“This gives a super high-resolution view of pregnancy and human development that no one’s ever seen before.”

Phlebotomy Training Services provide a brilliant opportunity for students to learn the skill of extracting blood – opening a number of doors for future careers in research and development. For more information, or to book a course, call us today on 01609 751610.


Man With Miracle Blood Makes His Final Donation

Anybody donating blood is a special thing; blood donations save countless lives per year. But in Australia a very special, record holding man, has just made his last donation.

James Harrison, 81, has donated blood 1173 times and it is estimated that his blood donations have saved the lives of over 2,000,000 babies. For this he was awarded a Medal of Order and was known as ‘The Man with The Golden Arm’.

The reason why James’s blood is so special is that it contains a special antibody which can be used to treat Rhesus Disease. This is a condition in which the blood of pregnant mother’s attacks the fetus in the womb.

The only reason Mr Harrison has stopped giving blood is that he has reached the upper legal age limit of 81, he stated that if he could keep donating then he would, “I’ve saved a lot of lives and got a lot of new kids into the world, so, that makes me feel good.”

It is thought that he developed this particular antibody when he had a lung removed at the age of 14 and needed a blood transfusion in order to survive the operation. Then at the age of 20 he made his first donation and has carried on every fortnight ever since at his local red cross centre.

In the UK there is a blood donation service ran by the NHS who are constantly crying out for blood donations. To find out how and when to donate blood you can visit their website here.

Phlebotomy Training Services are the most established and respected phlebotomy training provider in the UK. We provide a range of training courses from our entry level basic course, through to corporate training and the phlebotomy diploma.

To find out more about phlebotomy, how to forge a career out of it or any of our services simply call us on 01609 751 610 or contact us here.


Thanks Guys!

‘Dear Alison & Andrew, I would like to thank you once again for delivering an excellent phlebotomy training to our school’s staff and PhD students here at Loughborough University – SSEHS. All the participants had some very good things to say about the training from which they learnt a great deal and now progressing onto properly collecting samples for their research etc.. I think this must have been fourth or fifth time, within last ten years that I have known you where  “Phlebotomy for NDR” training was delivered and every time it gets better. Looking forward to next one as it’s always a joy to have you here at SSEHS – Loughborough University.
 – Jayshree Savania, SSEHS – Loughborough University.’