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  • Title: The order of draw: much ado about nothing?
    Author: Indevuyst C, Schuermans W, Bailleul E, Meeus P.
    Journal: Int J Lab Hematol; 2015 Feb; 37(1):50-5. PubMed ID: 24712307.
    Abstract:
    INTRODUCTION: The 'order of draw' has been advocated since 1982 to reduce the risk of cross-contaminating blood tubes with additives from a previously filled tube. METHODS: We studied 193 patients receiving oral anticoagulation. Multiple tubes were collected in a specific order using the Sarstedt Safety Monovette System. We evaluated the effect of the 'order of draw' on the prothrombin time/international normalized ratio (PT/INR) and the activated partial thromboplastin time (APTT) when the citrate tube is drawn as the first tube, second tube or after a heparin, EDTA or serum tube with clot activator. RESULTS: There was no statistically significant influence on the PT/INR. The same applies for the APTT measured on a citrate tube drawn after a heparin tube. There was a small, but statistically significant bias on the APTT when the citrate tube was drawn as the first tube, after an EDTA tube or after a serum tube with clot activator. We consider this bias (max. 0.2 s) as not clinically significant. CONCLUSION: The order of draw has no significant influence on the PT/INR and APTT when measured on a Sarstedt citrate tube filled without the use of a discard tube or after a heparin, EDTA or serum tube with clot activator.
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