Order of Draw and Additives | Blood Collection

Summary

This ICU Advantage video lesson, presented by Eddie Watson, delves into the critical procedure of blood sampling, emphasizing the proper order of draw to avoid contamination and ensure accurate test results. The video educates on various blood collection tubes, their purposes, and additives, concluding with a mnemonic 'Stoplight Red Stay Green, Power Light Go' to memorize the correct sequence. It highlights the importance of this process for patient care and accurate diagnosis.

Takeaways

• 🧬 The proper order of draw in blood sampling is crucial to prevent inaccurate results and potential misdiagnosis.
• 💉 Blood culture tubes should be filled first to minimize the risk of contamination.
• 🔵 The light blue tube is used for coagulation studies and contains sodium citrate to prevent clotting.
• 🔴 The red top tube is used for certain chemistry panels and serum tests, and may contain a silica clot activator.
• 🟠 The gold or SST tube is used for chemistry tests and has a gel separator to divide cells from serum.
• 🟢 The green top tube is commonly used for a wide range of chemistry tests and contains heparin as an anticoagulant.
• 🟣 The purple top tube is used for hematology studies and contains EDTA to preserve cell morphology and inhibit clotting.
• 💖 The pink top tube, identical to the purple top, is specifically used for blood type sampling.
• ⚪ The gray top tube is used for select tests like lactate level, ethanol level, and fasting glucose, containing sodium fluoride and potassium oxalate.
• 🔁 It's important to invert tubes with additives gently to ensure proper mixing without shaking.

Q & A

What is the main topic of the video lesson?

The main topic of the video lesson is the proper order of draw for blood sampling or phlebotomy, focusing on the sequence in which blood tubes should be filled to ensure accurate test results.

Why is the order of draw important in blood sampling?

The order of draw is important to prevent additives in blood tubes from contaminating each other, which can cause inaccurate results, misdiagnosis, and incorrect treatment for patients.

What should be the first blood sample collected and why?

Blood cultures should be the first samples collected to reduce the risk of contamination, as they require a sterile collection process to properly identify and grow bacteria.

What are the two types of blood culture bottles mentioned in the script, and how do they differ?

The two types of blood culture bottles mentioned are aerobic and anaerobic. They differ in the environment they provide for bacterial growth, with aerobic supporting the growth of bacteria in the presence of air, and anaerobic supporting the growth of bacteria without air.

What additive is found in light blue blood collection tubes, and what is its purpose?

Light blue tubes contain sodium citrate, which binds with calcium to prevent clot formation. This is crucial for coagulation tests as it maintains the blood in a liquid state for accurate testing.

What is the purpose of the red top tube in blood collection?

The red top tube is used for tests that require serum, such as chemistry panels, and sometimes includes a silica clot activator to help form a clot and separate the serum from the blood cells.

What does SST stand for, and what is its purpose in blood collection?

SST stands for Serum Separator Tube. Its purpose is to separate the serum from the blood cells using a gel, which is useful for certain chemistry tests that require serum.

Why should green top tubes be kept on ice immediately after drawing a blood sample?

Green top tubes should be kept on ice to preserve the integrity of certain tests, such as cardiac markers like troponin, ammonia levels, and ionized calcium, ensuring the accuracy of the results.

What is the chemical inside purple top tubes that preserves cell morphology and inhibits clotting?

The chemical inside purple top tubes is EDTA (Ethylene Diamine Tetraacetic Acid), which preserves cell morphology and inhibits clotting by binding calcium, preventing it from participating in the clotting cascade.

What is the significance of the high potassium content in EDTA, and how can it affect test results?

The high potassium content in EDTA can affect test results by skewing the potassium levels in blood samples if the additive from an EDTA-containing tube, like the purple or pink top tube, contaminates another tube that tests for potassium.

What is the recommended mnemonic to remember the proper order of draw for blood tubes?

The recommended mnemonic to remember the order is 'Stoplight Red Stay Green, Power Light Go', which corresponds to the colors and types of tubes in the order of draw: sterile (blood culture), light blue (coagulation), red (chemistry), SST/gold top, green (chemistry), purple (hematologic), pink (blood type), and gray (special tests).

Outlines

00:00

🧬 Introduction to Phlebotomy and Order of Draw

Eddie Watson introduces a lesson on phlebotomy, focusing on the critical order of draw when collecting blood samples. He emphasizes the importance of this procedure to avoid contamination and ensure accurate test results, which is vital for proper patient care. The video promises a breakdown of the order in which blood tubes should be filled and invites viewers to share their knowledge of the order of draw in the comments section for self-assessment.

05:00

🔬 Blood Cultures and Sterile Collection

The lesson delves into the specifics of blood cultures, highlighting their importance as the first step in the order of draw due to the need to minimize contamination risk. Blood culture bottles, which may vary by manufacturer, contain nutrients and anticoagulants to support bacterial growth and identification. The video explains the process of filling aerobic and anaerobic blood culture bottles, stressing the importance of maintaining sterility to affect patient treatment accurately.

10:01

🩸 Coagulation and Chemistry Tubes

The video script discusses various types of blood collection tubes used for coagulation studies and chemistry panels. The light blue tube, containing sodium citrate, is crucial for tests like PT, INR, and PTT. The red top tube, less commonly used for chemistry panels, may contain a silica clot activator. The gold or SST tube, with a gel separator, is typically used for send-out tests. Each tube's specific use and the importance of the proper ratio of additives to blood are covered, with a focus on the green top tube as the standard for in-hospital chemistry tests.

15:03

🌡 Specialized Chemistry and Hematology Tubes

This section covers specialized chemistry tubes, such as the gray top tube used for lactate, ethanol, and fasting glucose tests, which contain sodium fluoride and potassium oxalate to preserve results and prevent clotting. The purple top tube, used for hematology studies like CBC and A1c, is coated with EDTA to preserve cell morphology and inhibit clotting. The pink top tube, identical to the purple but used for blood typing, also contains EDTA. The importance of understanding the implications of additive contamination between tubes is stressed.

20:05

📋 The Proper Order of Draw

The script concludes with a detailed explanation of the proper order of draw for blood collection tubes. Starting with blood cultures to avoid contamination, followed by the light blue tube for coagulation studies, then red and SST tubes for less common chemistry tests, and green top tubes for standard chemistry tests. The purple and pink top tubes for hematology and blood typing come later, with the gray top tube for specialized tests last. The order is crucial to prevent additive cross-contamination that could skew test results.

📝 Conclusion and Memorization Aid

In the final paragraph, the presenter summarizes the lesson, reiterating the importance of the order of draw and providing a mnemonic device ('Stoplight Red Stay Green, Power Light Go') to help memorize the sequence. The video concludes by encouraging viewers to like, comment, and subscribe for more educational content, and to check out other series on hemodynamics and shock.

Keywords

💡Phlebotomy

Phlebotomy refers to the practice of drawing blood from a patient for medical testing, transfusion, or donation. It is a critical skill in healthcare, ensuring the proper collection of blood samples for accurate diagnosis and treatment. In the video, the importance of phlebotomy is highlighted, especially in the context of the 'order of draw' to prevent contamination and ensure accurate test results.

💡Order of Draw

The 'order of draw' is a standardized sequence for filling blood collection tubes to prevent interference from additives in one tube affecting the results of another. It is crucial for maintaining the integrity of blood samples. The video emphasizes the proper order of draw as a key takeaway, explaining that not following this order can lead to inaccurate results and potential misdiagnosis.

💡Blood Culture

A blood culture is a test to detect the presence of microorganisms, such as bacteria or fungi, in the blood. It is performed using a special type of collection bottle or tube designed to support the growth of these organisms. The video script mentions blood cultures as the first in the order of draw to minimize the risk of contamination, with aerobic and anaerobic bottles being distinguished by color-coded tops.

💡Coagulation

Coagulation refers to the process by which blood changes from a liquid to a solid state, forming clots to prevent bleeding. The video discusses the light blue tube, which is used for coagulation studies, including tests for Prothrombin Time (PT), International Normalized Ratio (INR), and Partial Thromboplastin Time (PTT). The tube contains sodium citrate, an anticoagulant that prevents clotting for these tests.

💡Serum

Serum is the liquid component of blood that remains after clotting has occurred and is typically used for various chemical tests. The red top tube mentioned in the script is used for tests that require serum. It may contain a silica clot activator to facilitate clot formation and separate the serum from the blood cells.

💡Serum Separator Tube (SST)

An SST, or serum separator tube, is designed to separate serum from blood cells through a gel that forms a barrier. It is used for chemistry tests that require serum. The video explains that the gold or tiger top tube is an example of an SST, which is not commonly used for routine chemistry panels within the hospital but may be used for send-out tests.

💡Chemistry Panel

A chemistry panel is a group of blood tests used to assess the body's chemical composition and organ function, such as liver and kidney function. The video mentions the red top and gold top tubes as potential containers for chemistry panels, although the green top tube is more commonly used for in-hospital chemistry tests.

💡Heparin

Heparin is an anticoagulant that prevents blood from clotting by inhibiting certain clotting factors. In the context of the green top tube discussed in the video, heparin is used as an additive to keep the blood from clotting, allowing for the separation of plasma from the blood cells.

💡EDTA

EDTA, or ethylenediaminetetraacetic acid, is a chemical used as an anticoagulant in blood collection tubes. It works by binding to calcium ions, which are necessary for the clotting process. The purple and pink top tubes mentioned in the script are coated with EDTA for hematology studies and blood typing, respectively. The high potassium content in EDTA can affect the results of certain tests if there is cross-contamination between tubes.

💡Hematology

Hematology is the branch of medicine concerned with the study, diagnosis, treatment, and prevention of diseases related to the blood. The purple top tube is used for hematology studies, including tests for complete blood count (CBC), hemoglobin, platelet count, and other related measurements. The video emphasizes the importance of EDTA in preserving cell morphology and inhibiting clotting for accurate hematology results.

💡Gray Top Tube

The gray top tube is used for specific tests such as lactate level, ethanol level, or fasting glucose tests. It contains additives like sodium fluoride, which stops glycolysis to preserve results, and potassium oxalate, which prevents clotting. The video script explains the importance of these additives and the need to invert the tube gently to mix them properly.

Highlights

The importance of the order of draw in blood sampling for accurate patient care and diagnosis.

Introduction to the video lesson on phlebotomy and the order of draw by Eddie Watson.

Engagement prompt for viewers to share their knowledge of the proper order of draw in the comments section.

Explanation of the consequences of not following the order of draw, such as inaccurate results and potential misdiagnosis.

Overview of blood culture tubes and their role in sterile collection to prevent contamination.

Details on the additives in blood culture bottles, including nutrient broth and anticoagulants, to support bacterial growth.

The recommended order for drawing blood cultures, starting with aerobic and then anaerobic bottles.

Introduction to light blue tubes used for coagulation studies and the importance of maintaining the correct ratio of sodium citrate to blood.

Description of red top tubes for chemistry panels and the use of silica clot activators for serum separation.

Explanation of gold or SST tubes for chemistry tests and the role of gel in separating cells from serum.

Discussion on green top tubes as the standard for in-hospital chemistry tests and the inclusion of cardiac markers.

Importance of placing green top tubes on ice for certain tests to preserve the integrity of the sample.

Overview of purple top tubes for hematology studies and the use of EDTA to preserve cell morphology and inhibit clotting.

Differentiation between pink top tubes for blood typing and purple top tubes despite their similarity.

Introduction to gray top tubes for specific tests like lactate levels, ethanol, and fasting glucose.

Explanation of additives in gray top tubes, including sodium fluoride and potassium oxalate, and their functions.

The proper order of draw reiterated, emphasizing the sequence from blood cultures to gray top tubes.

Mnemonic device 'Stoplight Red Stay Green, Power Light Go' to help remember the order of draw.

Conclusion of the lesson with an invitation to subscribe for updates on ICU advantage's educational content.

Transcripts

[Music]

you

all right well welcome everybody to

another video lesson from ICU advantage

in this lesson we're going to talk about

something that is extremely important

and the care that we provide to our

patients specifically when we talk about

blood sampling or phlebotomy and even

more specifically to the order of draw

there are some very important key

takeaways when we look at the order in

which we fill the blood tubes from the

samples that we draw and in this lesson

I'm gonna fully break that down for you

and so my name is Eddie Watson and I'm

gonna be presenting this lesson for you

today and so before we begin in order to

stay up to date on our videos as we

release them make sure and subscribe to

our channel below and don't forget to

hit that Bell icon in order to be

notified as the new lessons become

available alright so for this lesson I'm

actually gonna start this out a little

bit different than I normally do and I'm

gonna start things off with a question

and really this question is to kind of

check your knowledge and see where

you're at at the beginning of this

lesson and it's something that you can

come back to at the very end and check

and see how close were you and so that

question then is do you know the proper

order of draw and so in the comment

section below tell us what you think is

the proper order of draw and when we

reach the end of this video let's check

and see how close you were alright so as

we talk about the proper order of draw

like I said it's something that's

extremely important to the care that we

provide to our patients drawing blood

and sending sending samples down to the

lab to check a whole host of various

different things that are going on with

your patient is something that we do on

a daily basis and really the effects of

doing this properly can have a profound

impact on our patients and the care that

they receive and so it's really

important that we maintain that proper

order of draw essentially that the

proper filling of the blood tubes in the

correct order

because if that order of draw is not

followed then what can happen is the

additives that are in some of the tubes

can actually be transferred from one

tube to another and this can cause

inaccurate results cross contamination

and really those inaccurate results can

lead to a misdiagnosis in your patient

and it can prevent them from receiving

the correct treatment so like I said

it's a but most important that we get

this right and so what I'm gonna do is

I'm gonna start off and go through each

of the different types of sampling tubes

and bottles that that we use and talk

about what they are what's in them as

far as the additives what we use them

for and then at the very end of this

lesson is when I'll actually break it

down and show you the proper order of

draw as well as give you a handy little

acronym in order to help you remember

this all right so the first of these

that we're going to begin to talk about

are our blood cultures and for these we

can really think about these as our

sterile collection and so here is an

example of one type of blood culture

bottle now these bottles can vary from

facility to facility in fact even some

facilities use tubes that look very

similar to the typical lab collection

tubes that we normally use but for the

purposes of this lesson this is the

example that I have here and so with our

blood cultures we're really looking at

two things we're looking at our aerobic

and our anaerobic now again depending

which manufacturer you use these can

have different colored tops on the

bottles but if you look at the label all

the labels are gonna tell you which type

of tube it is that you're working with

and so the most important thing to

remember with our blood cultures is you

actually want to do these ones first and

the reason for that is it's really

important that we reduce that risk of

contamination and so if we look at our

blood culture bottle there's a couple

things that it contains that really help

this process of being able to grow the

bacteria and properly identify things

the first is there's a little bit of

film typically across the bottom

and this is primarily used to help

identify growth that's taking place and

then inside there's going to be some

sort of level of a nutrient broth and

this is again gonna help in and growing

that bacteria and helping it to

proliferate also inside of there there's

going to be some sort of anticoagulant

and even more importantly there's a

another chemical that's in here and the

sole purpose of this chemical is to

reduce the natural bacterial seidel

action that's normally present in the

blood itself and so it does this by

stopping complement and this slows down

the phagocytosis and really prevents the

the killing of the bacteria by the blood

and so when it comes to drawing our

blood cultures there's really a

recommended order to do this although

it's not required and the first is that

you want to start off with your aerobic

Bobble and the reason for this is

sometimes there's a little bit of air

that's in the syringe and so if you

start off with the aerobic bottle if

that air goes into the bottle it really

doesn't affect your results and so after

you've filled up your aerobic bottle

then next is when you would move on to

your anaerobic bottle and so really the

last thing that I'm going to talk about

with the blood culture bottles is again

going back to the basics of this is it's

really important that you maintain that

sterility because this truly can affect

or have an impact on the treatment that

your patient receives all right so now

moving on to our actual lab blood

collection tubes and so the first of

these that we're going to talk about is

the light blue tube and this light blue

tube we really can think about as our

coagulation tube and so not to list out

all of the tests that you can do with

this tube but some of the more common

ones that you would expect to see would

be things like your PT your INR you'd

also be looking for your PTT your anti

10a if your facility does this and also

check your fibrinogen your d-dimer as

well as your tag studies and so one

really important thing to know with the

like blue tube as these tubes actually

contain a set amount of sodium citrate

and so what this sodium citrate does is

it actually binds with calcium which

plays an important role in the clotting

cascade and therefore it helps to

prevent the formation of a clot but the

most important thing to know about this

is that it is truly a defined ratio of

sodium citrate to blood and so more so

than in almost any other tube there's a

line that it must be filled to in order

to have that proper ratio and if you use

the vacuum containers those have a

predefined vacuum in there that if you

just let the blood flow in it will

typically fill right up to that line and

again it's really important that you

have this right amount so that you have

the proper mixing of the sodium citrate

with the blood because when they go to

actually run the test all they have to

do is provide a reagent that has calcium

in it and then they can begin the whole

clotting cascade process and test the

coagulation of the blood all right and

so moving on the next tube that we're

going to be talking about is our red top

tube really there's a whole slew of

tests that we can do with this tube but

if you think about this is really just

one option available if we need to run

some sort of chemistry panel but this

isn't the common one that facilities

will use for chemistry panels they're

typically for certain types of tests in

particular if you need serum which is

basically the liquid portion of the

blood after a clot is formed and so

often times you'll find these tubes with

no gel or additive in there but

sometimes you may find them that they

have what they call a silica clot

activator and essentially what this does

is it just helps to form a clot inside

of the tube in order to give them the

serum that they're looking for and again

this isn't a very common tube typically

you're not going to use this one all

that often but there are certain tests

that

they do ask for the sample to be drawn

in the red top tube alright and so on to

our next tube and so this tube is gonna

be our gold or what we sometimes call

our SST and in case you ever wondered

the SS T stands for serum separator tube

in some facilities you may also find

this in what we call a tiger top and

really you can think of this as a red

and black stripe top tube but

essentially these are the same thing

and again this tube can be used for a

whole host of different chemistry's but

again this isn't the common tube that we

typically will use and more often than

not these are going to be our send out

tubes and typically here they're

checking for the antigen antibody and

one of the things that this tube has

it's a little bit different as it has a

gel in here and what this gel does is it

helps to separate the cells from the

serum of the blood and it does this just

naturally with the gel and so you know

the serum is the portion of the blood

that's like the plasma but without any

of the clotting factors in there and so

sometimes you will find some of these

tubes that do have a clot activator to

help that process along but again this

gel works to separate the cells from

that serum inside of the tube and again

this is not a very regular tube that

you'll you'll often use but it is

something that you will see fairly

regularly but again not the primary tube

that we're gonna use for typical

chemistry's within the hospital alright

and so we've talked about it enough at

this point and so now we're gonna move

on and talk about our green top tube and

again this is going to be a wide range

of chemistry's but unlike the red and

the gold SST tube this is going to be

the one that we typically are using to

to run these tests in the hospital and

like I said there's a whole slew of

tests that can be run with this but it's

also important to note that in addition

to the chemistry's this is typically

going to be what we draw our cardiac

markers such as our troponin and so with

these tests typically you would just

draw the sample into the tube and send

down but there are a couple tests that

it's important that the tube actually

ends up on ice immediately and then sent

down to the lab and the point of having

it on ice is so that it helps to

preserve the value of whatever we're

checking at the time the blood is drawn

throughout the time it takes to get down

to the lab and actually run the tests

and so a couple of these tests that we

would be looking at would be things like

our ammonia levels also our ionized

calcium and while not typical for most

facilities as we do have another tube

specifically for this purpose you can

also draw your lactate levels again

ensuring that as soon as the sample is

drawn and labeled that it ends up in a

bag with ice in order to be sent down to

the lab to get those proper results now

the green tubes you may sometimes hear

them referred to as a PST which is

essentially a plasma separating tube and

the reason for this is you'll find a gel

down here in the bottom similar to the

SST but in these PS T's they actually

contain fiber nogen and what it does is

it separates out the plasma from the

specimen and so as we talked about the

way this differs from the serum is that

the plasma actually contains all those

clotting factors now in addition to that

plasma separating gel you're also gonna

find heparin which is used as an

anticoagulant and helps to keep the

blood from clotting all right and so

moving right along the next of the tubes

that we're going to talk about is the

purple top and we can think of the

purple top as our hematology tube and so

again not to list out everything that

you can do with this tube but these are

gonna be things like our CBC which will

tell us our white count our haemoglobin

our platelets can check our ESR or what

we refer to as our sed rate or we can

also check our

a1c which will give us an indication of

how our patient is maintaining their

blood sugars and so when we look at our

purple top there's actually something

very important that we need to know

these tubes actually comes

sprayed right along the inside of the

tube with a chemical that we call EDTA

and I'm not even gonna try and tell you

what that stands for because I probably

would pronounce it wrong but essentially

what this does is a couple things first

it preserves the natural cell morphology

so if they need to look at the the blood

specimen under microscope the cells

maintain that that shape and morphology

that they had when they were inside the

body but in addition to that it also

works by inhibiting the clotting cascade

by binding calcium again not allowing

that to be available and preventing a

clot within the specimen but the

important thing to know about EDTA is

that it's very high in potassium and so

we'll talk about this more in a little

bit here but just start to think about

some of the issues that can come up if

you start to cross contaminate the

additives from one tube into another and

how that might actually skew your

results alright so on to our next tube

and for this tube this is gonna be our

pink top and really the pink top is

identical to the purple top hematology

tube except before we use it for a

specific purpose and this specific

purpose that we use it for is our blood

type sample and so once again this tube

is again coated with that EDTA which

means it's also gonna have a high

potassium and so again typically these

tubes are are just used when you're

sending a specimen down to blood bank

but again they're identical to the

purple top tube alright and so now we're

gonna move on to the last tube that

we're going to talk about and that tube

is gonna be our grade top and for the

gray top there's really not a type to go

along with this there's just a handful

of select tests that will typically be

run on this and those tests are going to

be things like checking our lactate

level or a lactic acid you also can use

this tube to check an ethanol level

or if your patient needs to have a

fasting glucose check you would use this

tube as well and so for the gray tube

there's actually two different additives

that are in there that achieve different

things the first of these is going to be

what is typically sodium fluoride and so

what the sodium fluoride does is it

actually stops glycolysis and by

preventing the glycolysis this is going

to help to preserve some of those

results and findings that you're looking

to get from this tube now it also will

work to prevent bacterial growth again

working to help preserve those results

that you're looking for now in addition

to the sodium fluoride you're also going

to find what we call potassium oxalate

and what potassium oxalate does is again

this is another one that is going to

bind our calcium which is going to

prevent clotting and so with all of

these additives and chemicals it's

really not important that you know what

they are but that you understand some of

the implications that some of these

additives can have if they end up in the

wrong tube one important thing that I do

want to add is since these tubes do have

those additives in there is that you do

want to quickly invert them three to

five times for each tube you don't want

to shake them but you just want to

gently mix them by inverting repeatedly

and the point is to ensure that we have

proper mixing of whatever that reagent

or additive is that's in the tube all

right and so we have covered all of the

different tubes that you will typically

be drawing for your patients and so now

let's go ahead and talk about what the

actual proper order of draw is and if

you haven't figured it out yet well

surprise the order is we actually just

went through everything in the proper

order but just to refresh you I'll bring

it up here again and one

handy place so the first thing that we

want to draw are those blood cultures

and again think of these as our sterile

and then next is going to be our light

blue again think our coagulation studies

next will be our red top tube is there

are not so commonly used chemistry tubes

in addition to our cold SST tubes again

not so common chemistry tubes typically

used for our send out tests and then

from there we have our green top which

is going to be our common chemistry tube

then next is going to be the purple top

and this is going to be those hematology

studies coming near the end we have our

pink top which is our blood type studies

and finally our gray top - some of those

tests like the lactic acid fasting

glucose and ethanol and so like I said

this order of draw here really kind of

matters it's important that we have our

blood cultures being drawn first because

we don't want to risk contaminating

those by filling up some of these other

tubes and then putting blood into the

blood culture bottles but then if you

look at really the the first actual

blood collection tube we do as the light

blue tube which is those hematology

studies because it has that defined

ratio of that sodium citrate and so that

we can get an accurate assessment of a

patient's coagulation factors and

clotting times and if we get some of

these other additives such as the Green

heparin that gets in here then that's

gonna throw off the results of your

coagulation studies also in addition to

that if you remember our pink and our

purple tubes have that EDTA which if you

think about is high in potassium but

then also binds calcium if you were to

draw that first and that were to end up

in let's say your green top tube this is

going to skew the results of your

potassium in your calcium so you could

either end up with high or critically

high levels of potassium or if your

patient is actually

low in potassium you couldn't mask that

by having a abnormally normal result

when your patient is actually

hypokalemic so again like I said at the

very beginning it's absolutely vital

that you you draw these in the proper

order and so it's important that you

memorize this order and be able to draw

it quickly without having to think about

it so like I said I'm gonna give you a

quick little acronym that hopefully will

help you to be able to remember the

proper order in which to draw lees and

so I'm gonna list it out here first and

that'll be s L R s g p l g and so

there's a stupid little mnemonic but

maybe it will help you memorize this and

it's gonna be stoplight red stay green

power light go

and so if you think about it the essence

top is gonna be the same as our sterile

that Ellen light is going to be for our

light blue the R is gonna be for the R

in red the essence day is going to be

for the SST or the gold top the G in

green is gonna just match up with the

green the P and power is for a purple

the Ellen light is really for our if we

think about a light pink and the G and

go is gonna be for gray and so hopefully

this silly little acronym mnemonic will

help you to memorize this and be able to

keep them in order and eventually as you

do them enough you'll you'll learn what

goes before what but for me it's always

been helpful to think about not only the

the what of what I'm trying to do but

the why behind it so that I understand

it and I'm able to implement it easier

alright and so that is gonna conclude

this lesson and as always I do want to

thank you for watching this video and I

really hope that this lesson was

informative for you if you did like this

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