A vacutainer blood collection tube is a

sterile Sterile or sterility may refer to: *Asepsis, a state of being free from biological contaminants * Sterile (archaeology), a sediment deposit which contains no evidence of human activity *Sterilization (microbiology), any process that eliminates or ...

glass or plastic

test tube A test tube, also known as a culture tube or sample tube, is a common piece of laboratory glassware consisting of a finger-like length of glass or clear plastic tubing, open at the top and closed at the bottom. Test tubes are usually placed in s ...

with a colored rubber stopper creating a vacuum seal inside of the tube, facilitating the drawing of a predetermined volume of liquid. Vacutainer tubes may contain additives designed to stabilize and preserve the specimen prior to analytical testing. Tubes are available with a safety-engineered stopper, with a variety of labeling options and draw volumes. The color of the top indicates the additives in the vial. Vacutainer tubes were invented by Joseph Kleiner in 1949. ''Vacutainer'' is a registered trademark of Becton Dickinson, which manufactures and sells the tubes today.

Principles

The Vacutainer needle is double-ended: the inner end is encased in a thin rubber coating that prevents blood from leaking out if the Vacutainer tubes are changed during a multi-draw, and the outer end which is inserted into the vein. When the needle is screwed into the translucent plastic needle holder, the coated end is inside the holder. When a tube is inserted into the holder, its rubber cap is punctured by this inner needle and the vacuum in the tube pulls blood through the needle and into the tube. The filled tube is then removed and another can be inserted and filled the same way. The amount of air evacuated from the tube predetermines how much blood will fill the tube before blood stops flowing. Each tube is topped with a color-coded plastic or rubber cap. Tubes often include additives that mix with the blood when collected, and the color of each tube's plastic cap indicates which additives it contains. Blood collection tubes expire because over time the vacuum is lost and blood will not be drawn into the tube when the needle punctures the cap.

Types of tubes

Vacutainer tubes may contain additional substances that preserve blood for processing in a

medical laboratory A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical medical labor ...

. Using the wrong tube may make the blood sample unusable for the intended purpose. These additives are typically thin film coatings applied using an ultrasonic nozzle. The additives may include

anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...

s (

EDTA Ethylenediaminetetraacetic acid (EDTA), also called EDTA acid, is an aminopolycarboxylic acid with the formula . This white, slightly water-soluble solid is widely used to bind to iron (Fe2+/Fe3+) and calcium ions (Ca2+), forming water-solubl ...

, sodium citrate,

heparin Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. Heparin is a blood anticoagulant that increases the activity of antithrombin. It is used in the treatment of myocardial infarction, ...

) or a gel with density between those of

blood cell A blood cell (also called a hematopoietic cell, hemocyte, or hematocyte) is a cell produced through hematopoiesis and found mainly in the blood. Major types of blood cells include red blood cells (erythrocytes), white blood cells (leukocytes), ...

s and

blood plasma Blood plasma is a light Amber (color), amber-colored liquid component of blood in which blood cells are absent, but which contains Blood protein, proteins and other constituents of whole blood in Suspension (chemistry), suspension. It makes up ...

. Additionally, some tubes contain additives that preserve certain components of or substances within the blood, such as glucose. When a tube is

centrifuge A centrifuge is a device that uses centrifugal force to subject a specimen to a specified constant force - for example, to separate various components of a fluid. This is achieved by spinning the fluid at high speed within a container, thereby ...

d, the materials within are separated by density, with the blood cells sinking to the bottom and the plasma or serum accumulating at the top. Tubes containing gel can be easily handled and transported after centrifugation without the blood cells and serum mixing. Vacutainer blood bottles

The meanings of the various colors are standardized by the

Clinical and Laboratory Standards Institute The Clinical and Laboratory Standards Institute (CLSI) is a volunteer-driven, membership-supported, not-for-profit, standards development organization. CLSI promotes the development and use of voluntary laboratory consensus standards and guidelin ...

and are the same across manufacturers. The term ''order of draw'' refers to the sequence in which tubes should be filled. The needle which pierces the tubes can carry additives from one tube into the next, so the sequence is standardized so that any cross-contamination of additives will not affect laboratory results.

History

Vacutainer technology was developed in 1947 by Joseph Kleiner, and is currently marketed by Becton Dickinson (B-D). The Vacutainer was preceded by other vacuum-based phlebotomy technology such as the Keidel vacuum. The plastic tube version, known as Vacutainer PLUS, was developed at B-D in the early 1990s by E. Vogler, D. Montgomery and G. Harper amongst others of the Surface Science Group as US patents 5344611, 5326535, 5320812, 5257633 and 5246666. Vacutainers are widely used in

phlebotomy Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a ...

in developed countries due to safety and ease of use. Vacutainers have the advantage of being prepared with additives, allowing easy multi-tube draws, and having a lower chance of

hemolysis Hemolysis or haemolysis (), also known by #Nomenclature, several other names, is the rupturing (lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may ...

. In developing countries, it is still common to draw blood using a syringe or syringes. Many brands have now started manufacturing Vaccutainer such as Vacu-8, Hemo Tube and Hemo Vac Plus. These tubes are now also available in pre-barcoded forms.

References

{{Reflist

External links

Blood Collection Tube Coating Video

Pre barcoded tubes
Medical equipment Blood Containers