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The introduction of evacuated tubes greatly enhanced the precision and accuracy of test results by reducing errors in collection, (eg, blood-to-additive ratios or contamination).
This article reviews the history of evacuated tubes, the regulations and manufacturing of evacuated tubes, the additives used in evacuated tubes, and some environmental factors influencing product performance.
"A laboratory test is no better than the specimen, and the specimen no better than the manner in which it was collected." So stated the advertising language of BD (Becton Dickinson andCompany) to promote the first evacuated blood collection tubes, back in the late 1940s and early 1950s.1 This technology for blood collection, patented in 1949, is substantially similar to the technology pervasive in clinical practice today.
Consider what it was like to draw blood without an evacuated tube system. Even before collecting blood, the laboratory had to prepare solutions for the additive tubes (eg, EDTA, citrate) and dispense them into test tubes for blood anticoagulation. Then, to identify the proper draw volume, the laboratory had to etch lines in the borosilicate glass tubes. The phlebotomist collected blood specimens with needles and glass syringes. For patients who required many tests, the phlebotomist might have to stick the patient multiple times, at least once for chemistry, once for hematology, and once for coagulation.
After collection, the phlebotomist would transfer the blood into a series of test tubes. They sealed the tubes with black rubber stoppers for transportation of the specimens to the laboratory. For electrolyte measurements, they added mineral oil to the tubes to prevent loss of CO2.
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