Special Communication
Light Blue Coagulation Tubes: National Supply Shortage – Update
There is a severe nationwide shortage of light blue sodium citrate blood collection tubes used for coagulation laboratory tests such as prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer.
Currently, no other substitute tube is readily available for coagulation testing.
Given coagulation testing’s critical role in many areas of medicine and surgery, Cleveland Clinic is implementing several supply conservation measures, including:
- Using a “no additive” tube as a waste tube (instead of a light blue tube) when collecting other blood specimens.
- Restricting light blue tubes for use in the ED only for coagulation testing rather than in a routine rainbow draw.
For Ordering Providers:
If a patient is not on anticoagulants or is not going to surgery:
Reconsider the need for routine coagulation testing or consider extending the interval between daily coagulation testing orders.
If a patient is undergoing treatment with direct oral anti-Xa anticoagulants, such as apixaban or rivaroxaban:
Consider not ordering PT and APTT (they are usually normal in these patients and not helpful in anticoagulant management).
Due to the severe nationwide shortage, the Robert J. Tomsich Pathology & Laboratory Medicine Institute has updated specimen collection quantity guidelines for 1.8 mL, 2.7 mL, and 3.5 mL light blue sodium citrate coagulation tubes. Refer to the table below for details.
Test Name
Order Code
# of 1.8 mL light blue tubes needed
# of 2.7 mL light blue tubes needed
# of 3.5 mL light blue tubes needed
Cleveland Clinic Laboratories will communicate further updates when available. Please continue to check our website or contact Client Services at 800.628.6816 for assistance.