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You should have all of the blood collection tubes arranged close by in order to be able to efficiently switch out the tubes. The recommended order of draw is as follows; tubes for sterile samples, tubes for coagulation profiles (e.g. citrate), serum separator (SST) tubes and then any other tubes with additives (e.g. EDTA, heparin, etc.). If any samples are to be drawn directly into a syringe (ex. NOVA), draw this sample last so that the vacuum pressure is not lost.

If a citrated tube needs to be filled, the manufacturer recommends first using a discard tube. A discard tube is a no-additive tube that is used just to prime the butterfly line with blood. Once the line is primed, the discard tube is removed. This protocol ensures that the sample used for coagulation testing will have the appropriate blood to citrate ratio, allowing for the most accurate results.

The first to be filled can be placed into the tube holder before venipuncture is initiated. But, DO NOT push the sealed needle into the stopper of the tube prior to venipuncture or the vacuum inside the tube will be deactivated.