Blood testing provides extremely helpful insight into a patent’s state of health. Doctors order these tests for diagnosis of diseases, evaluation of treatment, as part of regular physicals, and many other reasons.


Blood collection and testing require many resources to ensure results can be obtained with optimal safety, efficiency, and accuracy. Just one element in the process is the blood collection tubes used to contain and transport specimens for testing.

But like many patient care and medical essentials, supplies of test tubes have been depleted by the demands of the Covid-19 pandemic. The shortage is due in part to increased patient monitoring for blood clots and coagulation complications from the coronavirus.

Subsequent vender supply challenges have made it difficult to replenish supplies. At the start of 2022, the U.S. Food and Drug Administration (FDA) added all blood collection tubes to its medical device shortage list under the Specimen Collection Testing Supplies & Equipment category.

In June of the previous year, only sodium citrate blue tubes were part of the supply shortage and interruption, but this has since been updated to include test tubes coded as GIM and JKA. These include serum separator tube (SST) vials with gold tops and EDTA tubes with lavender tops, both of which are some of the most common types of test tubes used for adult blood collection.

The shortage is widespread and is affecting more than just U.S-based labs, hospitals, and doctors. Health agencies in the UK, Canada, and all around the world have issued shortage notices and have instructed health care providers, phlebotomists, laboratory directors, and other personnel to practice various emergency conservation measures.

What Happens If There Aren’t Enough Blood Collection Tubes?

In the U.S., the FDA has recommended blood specimen collection tube conservation strategies. Specific guidelines include limiting blood collection to testing that is only medically necessary and reducing the vials of blood used per test. This means that duplicate test orders should be omitted and testing intervals should be extended when possible. Doctors have also been advised to reduce routine tests that require blue top, SST, and EDTA tubes, including blood tests for wellness visits and elective procedures or that are not targeting specific disease states or adjustments to treatment.

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Point of care testing that eliminates the need for blood specimen collection tubes, such as through lateral flow tests, has also been recommended. Laboratories have been encouraged to use add-on testing procedures or share samples between departments if previously collected specimens are available. Similar to the FDA, the Canadian Society of Clinical Chemists recently released an urgent practice alert to conserve testing resources and reserve the use of essential lab gear, syringes, and needles for high-priority patients.

The UK’s National Health Service has also recommended that blood specimen collection be reserved for situations that are clinically urgent or time-dependent. Globally, more and more doctors are being urged to cancel blood test orders if samples have not yet been collected. Countries that produce blood collection tubes are also limited or discontinuing exports.


When Will The Test Tube Shortage Problem Be Solved?

According to the FDA, the shortage of blood collection test tubes is expected to persist through the end of 2022 and may continue for as long as Covid-19 remains a public health emergency. Increasing production of SST and EDTA collection tubes can pose special challenges as these vials require anticoagulants and serum separators for the integrity of the sample. Meeting manufacturing practice requirements and increasing output is notably difficult for these and other more specialized medical supplies.

Although the shortage is likely to continue through the remainder of the year, the FDA states that any updates to the conservation guidelines will be maintained as part of its medical device shortage list.

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