Red-Top Tube - This tube has no anticoagulant and is used for many chemistry tests, drug levels, and

blood bank
procedures.
 Red-top tube, glass
This tube is a plain glass Vacutainer® containing no clot activators, anticoagulants,
preservatives or separator material.  These tubes can be used for Blood Bank tests.It is used for
collection of serum for selected laboratory tests as indicated

Green-Top Tube - Sodium Heparin or Lithium Heparin

 Light green-top tube (lithium heparin)

This tube contains lithium heparin and gel separator used for the collection of heparinized
plasma for routine chemistry tests.
NOTE:  After the tube has been filled with blood, immediately invert the tube 8-10 times to
mix and ensure adequate anticoagulation of the specimen.

 Dark green-top tube (sodium heparin)

This tube contains sodium heparin used for the collection of heparinized plasma or whole blood
for special tests.
NOTE:  After the tube has been filled with blood, immediately invert the tube 8-10 times to
mix and ensure adequate anticoagulation of the specimen.

 Blue-Top Tube - Sodium Citrate (NaCitrate): This tube is primarily used for coagulation studies (PT and
PTT). Complete filling of this tube is essential to obtain accurate results.

 Grey-Top Tube - Potassium Oxalate. This tube is used primarily for glucose tolerance testing
 Blood Collection Tubes
Most blood collection tubes contain an additive that either accelerates clotting of the blood
(clot activator) or prevents the blood from clotting (anticoagulant). A tube that contains a
clot activator will produce a serum sample when the blood is separated by centrifugation
and a tube that contains an anticoagulant will produce a plasma sample after centrifugation.
Some tests require the use of serum, some require plasma, and other tests require
anticoagulated whole blood.
The table below lists the most commonly used blood collection tubes.

Function of Common
Tube cap color Additive
Additive laboratory tests

Light-blue
Prevents blood from
3.2% Sodium
clotting by binding Coagulation
citrate
calcium

Red or gold
(mottled or Clot activator
Serum tube
"tiger" top used promotes blood
with or Chemistry,
with some tubes clotting with glass or
without clot serology,
is not shown) silica particles. Gel
activator or immunology
separates serum from
gel
cells.

Green Sodium or
lithium Prevents clotting by
Stat and routine
heparin with inhibiting thrombin
chemistry
or without and thromboplastin
gel

Lavender or pink
Potassium Prevents clotting by Hematology and
EDTA binding calcium blood bank

Glucose
Sodium Fluoride inhibits
Gray (especially when
fluoride, and glycolysis, and
testing will be
sodium or oxalate prevents
delayed), blood
potassium clotting by
alcohol, lactic
oxalate precipitating calcium.
acid

1. Red
The red bottle is less common – it is used for biochemistry tests requiring serum which
might be adversely affected by the separator gel used in the yellow bottle.

 Additive: None or contains silica particles which act as clot activators.

 What additive does: Clot activator promotes blood clotting with glass or silica
particles.
 Laboratory Uses: Serum testing (glucose, cholesterol, triglycerides, HDL,
potassium, amylase, alkaline phosphatase, BUN, CK, liver enzymes), blood bank, serology
(RH Typing, Antibody screening, Red Cell Phototyping, DAT, RPR, monospot, rheumatoid
factor, ANA)

2. Yellow
 Additive: anticoagulant SPS (Sodium Polyanetholsulfonate) & ACD (acid citrate
dextrose)
 What additive does: Prevents the blood from clotting and stabilizes bacterial
growth.
 Laboratory Uses: Blood and bodily fluid cultures (HLA, DNA, Paternity)
Tubes with SPS – For Blood and bodily fluid cultures (HLA, DNA, Paternity). The SPS aids
in the recovery of microorganisms by slowing down/ stopping the actions of complement,
phagocytes, and certain antibiotics.
Tubes with ACD are for cellular studies, HLA typing, paternity testing.

3. Light Blue
The blue bottle is used for haematology tests involving the clotting system, which require
inactivated whole blood for analysis.

 Additive: Sodium Citrate

 What additive does: Binds and remove calcium to prevent blood from clotting
 Laboratory uses: Coagulation (clotting process-P.T)
PT (Prothrombin Time – evaluates the extrinsic system of the coagulation cascade &
monitors coumadin therapy)
APTT/ PTT (Activated Partial Thromboplastin Time – evaluates the intrinsic system of the
coagulation cascade & monitors heparin therapy)
FDP (Fibrinogen Degradation Products)
TT (Thrombin Time)
Factor assays

4. Green
This less commonly used bottle is for biochemistry tests which require heparinised plasma
or whole blood for analysis.

 Additive: Heparin (Sodium/Lithium/Ammonium)

 What additive does: Inhibits thrombin formation to prevent clotting
 Laboratory uses: Chemistry Testing (Plasma determinations in chemistry) :
ammonia, carboxyhemoglobin & STAT electrolytes, chromosome screening, insulin, renin
and aldosterone

5. Lavender
These bottles are generally used for haematology tests where whole blood is required for
analysis.

 Additive: EDTA (Ethylenediaminetetraacetic Acid)

 What additive does: Removes calcium preventing clotting of blood
 Laboratory uses: Hematology testing (ESR, CBC w/diff., HgBA1c)
blood film for abnormal cells or malaria parasites, reticulocytes, red cell folate, Monospot
test for EBV, parathyroid hormone (PTH)

6. Grey
 Additive: Potassium oxalate and Sodium fluoride
 What additive does: Sodium fluoride acts as an antiglycolytic agent to ensure that
no further glucose breakdown occurs within the sample after it is taken. Potassium oxalate
removes calcium and acts as an anticoagulant.
 Laboratory uses: Chemistry testing, especially glucose(sugar) and lactate, Glucose
tolerance test (GTT)

7. Royal Blue
 Additive: Sodium Heparin also Sodium EDTA
 What additive does: Inhibits Thrombin formation to prevent
 Laboratory uses: Chemistry trace elements (such as Zinc, Copper, Lead and
Mercury), toxicology, and nutritional chemistry testing

8. Black
 Additive: Sodium Citrate
 What additive does: Forms calcium salts to remove calcium
 Laboratory uses: paediatric ESR

Lavender Top   Contains either K3EDTA (liquid) or

K2EDTA (spray-coating).
Prevents coagulation by binding to
Calcium. 
Invert tube 8 times.

What is the lavender tube commonly   Hematology procedures that require

used for? whole blood, such as Complete
Blood Count (CBC). Lavender
tubes are also used
for immunohematology
testing and blood donor
screening.

Black Top    Contain buffered sodium citrate.

Used for Westergren sedimentation
rates.
Differ from light blue tops because
they provide a blood to
anticoagulation ratio of 4 to 1.

Green Top   Contains Heparin (anticoagulant)

combined with lithium, sodium, or
ammonium ion. 
Primarily used for chemistry tests
performed on whole blood or
plasma.

How does heparin prevent clotting?  
Light Green Top  
Which tube is used for potassium  
determinations?
Why are light green tubes used for  
potassium determinations?
Yellow Top (SPS)  
Light Blue Top  
Which tube can contain a soybean  
tripisin inhibitor and thrombin?
What is the required anticoagulant  
for coagulation studies?
Red/Gray or Gold Top  
Which tube is spray-coated with  
   -Particularly stat tests or tests
requiring fast TAT (turn around time)
Invert 8 times
Not used for hematology.
By inhibiting thrombin in the
coagulation cascade.
*Can also be a green/black stopper.
*Contains lithium heparin and
a separation gel.   -Called Plasma
Separator Tubes (PSTs)
*Used for plasma determinations in
chemistry
*Used for potassium determinations.
Light Green tube
They are well-suited for potassium
determinations because Heparin
prevents the release of potassium by
platelets during clotting AND
because the gel prevents
contamination by red blood cell
potassium. 
Invert 8 times.
*Also green w/ yellow top
Contain SPS (sodium polyethanol
sulfonate)
Prevents coagulation by binding to
calcium
SPS aids in the recovery of
microorganisms.
Invert 8 times
*Contains sodium citrate which
prevents coagulation by binding to
calcium. Invert 3-4 times only. This
tube can never be underfilled or
mixed vigorously.
A special light blue tube
Sodium citrate
*Contain a clot activator and a
separation gel. *Frequently referred
to as SSTs  *The tubes are spray-
coated with the clot activator silicia to
increase platelet activation. *Invert 5
times
Red/Gray and Gold tops are spray-
silica and why?
What happens when a Red/Gray or  
Gold tube is centrifuged?
Why must SST tubes be allowed to  
clot completely being being
centrifuged?
Are SST tubes suitable for serology  
or immunology tests? Why or why
not?
Can SSTs be used for the blood  
bank?
Red Top  
What are red top tubes used for?  
Red Stopper Glass tubes are also  
called what?
Can serum tubes with a clot activator  
be used as a discard tube in
coagulation studies?
Red/Light Gray and Clear Top  
Orange Top  
Which tube is used for CBC?  
coated with silica to increase platelet
activation, thereby shortening the
time required for clot activation.
The polymer barrier gel at the bottom
of the tube undergoes a change in
viscosity. The gel forms a barrier
between the serum and cells to
prevent the cells from contaminating
the serum.
An incompletely clotted tube can
produce a non-intact gel barrier and
the serum could become
contaminated with cellular materials.
Not suitable for most, because the
gel may interfere with immunological
reactions.
No.
*Contains silica as a clot
activator. *Invert 5 times 
Serum chemistry tests and serology
tests and in the blood bank.
Clot or plain tubes because they
contain no additives or
anticoagulants. No need to invert.
NO.
Discard tube for coagulation studies,
when using a winged blood
collection set, or as a secondary
sample collection tube.
*Contains a thrombin-based clotting
agent and separation gel.  *Known
as RSTs (Rapid Serum
Tubes). *Ideal for stat chemistry
testing *Invert 5 times
Lavender