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Synonyms
Specimen Requirements
  
Storage and Transport
Reference Range
Interpretation
Causes for Rejection
Turn Around Time
Availability
  
Indications
  
  
Methodology
Limitations and Contraindications
  
Test Consists
Critical Values
  
Comments
  
  
  
  
  
  
  
Special Instructions
Request Form
Patient Prep
Post Processing
Collection Guidelines
Additional Information
  
  
  
Aceta Lvl or Acetaminophen Lvl
Tylenol
4.0 mL blood
Gold SST tube; red or gold microtainer acceptable
Therapeutic range: 10 - 30 mcg/mL
Wrong container; improper labeling; insufficient volume
Routine: 2 - 3 hrs.;

Urgent/Emergent: 1 hr.

82003
Core Laboratory,  BI-2023, 706-721-287624/7/365
Low reportable limit: < 10 mcg/mL
Toxic level:

>= 150 mcg/mL four hours after ingestion

>50 mcg/mL twelve hours after ingestion

17,219,35010/07/2003 10:59:271 full gold microtainer
Frequently Requested Tests requisition. Indicate medical necessity.
Half life: 2 - 3 hrs.
1
  
Acetone
Ketone bodies
4 mL whole blood
5 mL gold top SST tube
Cover and refrigerate until analysis.
negative
Wrong container; hemolysis; improper labeling; insufficient volume
Routine: 2 -4  hrs.;

Urgent/Emergent: 1 hr.
82009
Elevated in diabetic or fasting ketoacidosis, 2-propanol poisoning, starvation, and severe carbohydrate restriction.
Core Laboratory,  BI-2023, 706-721-212024/7/365
Acetest tablets with visual reading
Unable to read if sample is hemolyzed.
17,219,35110/07/2003 10:59:27
Frequently Requested Tests requisition. Indicate medical necessity.
1
  
Smr Acid Fast
AFB Smear, Stain Acid Fast for Mycobacteria
Sputum  early morning deep cough to produce lower respiratory specimen, bronchoalveolar lavage, bronchial brushing, sterile body fluids, tissue.
Sterile sealed leak-proof container
Maintain at room temperature and transport to Microbiology Laboratory within one hour.
No acid fast organisms present.
Use of nonsterile container; Delay in transport; Improper labeling; Insufficient volume
Result available within 24 hours, unless ordered as Emergent. Urgent test available upon request with same day results.
Non-urgent sent to ARUP reference laboratory; Urgent available same day
87206
Suspected mycobacterial infection.
Microbiology  BA-1672  721-280724/7/365
Fluorochrome acid fast stain. If positive, a Kinyoun stain is performed to confirm.
Weakly acid fast organisms may not be detected. Culture is more sensitive and is needed for organism identification and susceptibility testing.
Mycobacterial [AFB] smear only; no culture performed.
Phone report of smears positive for acid fast organisms.
17,219,35210/07/2003 10:59:27> 1 mL1 mL for most specimens; for CSF at least 5 mL; for urine at least 40 mL.
Microbiology & Infectious Serology requisition. Indicate medical necessity.
Observe for complications of collection procedure.
Sputum -  See Collection Guidelines for Common Specimens;

Bronchalveolar lavage, bronchial brushings and transbronchial biopsy - Contact Pulmonary Medicine for collection;

Sterile body fluids - Collect using aseptic technique.
If Nocardia is suspected, a weak acid fast stain is recommended.  Notify lab if a concentrated AFB smear is needed; these are done using a bleach cytocentrifuge technique .
1
  
APTT or PTT
aPTT, PTT
2.7 mL of blood
Blue top (sodium citrate) tube
Send at room temperature.
28.0 - 35.7 sec   (May vary with lot number changes) Therapeutic range 50 - 80 seconds.
Tube improperly filled especially underfilling;

Specimen clotted;

Hemolysis
1 hour
85730
Evaluate intrinsic system, monitor heparin therapy, DIC, liver failure
Core Lab, BI 2023, 706-721-212024/7/365
> 100 seconds
17,219,35510/07/2003 10:59:27
Allow blue top/citrate tubes to fill completely. Immediate delivery at room temperature to laboratory.
Frequently Requested Tests requisition. Indicate medical necessity.
Gently mix 8 - 10x post collection.
1
  
Antibody titer, isohemagglutinin titer (immune anti-A or anti-B titer, prenatal titer, Rh titer, atypical antibody titer, AHG titer, IgG titer.
Blood
Plain red stoppered tube or pink EDTA tube.
Send to Blood Bank.  Serum may be frozen in prenatal workups when a subsequent parallel titer is required.
Not applicable
Reported as the last dilution resulting in a 1+ reaction.
Improper labeling; wrong tube; severe hemolysis; insufficient quantity
24 hours
86886
To follow antibody levels in potential maternal-fetal blood incompatibility, to assess HDN, to assess IgG isoagglutinin levels in adults or infants, to assess antibody levels in transfusion reaction, or determine antibody concentration in a serum sample containing a known clinically significant antibody.
Blood Bank  BI-1230  721-2731Testing Daily
This is a semiquantitative method used to determine antibody concentration.  The reciprocal of the highest dilution of serum giving a 1+ reaction is referred to as the titer.
Titers may not reflect the unborn infant''s condition; technical variables affect results'' completely reproducible results are not possible to achieve; can have biologic variability; results may differ by one dilution in tests performance; and titer values alone can be misleading.  Contraindictions: no antibody present, biologic father lacking corresponding antigen, antibody identified does not cause HDN, antibody identified not clinically significant.
Antibody titration using appropriate RBC antigen.  Antibody detection and identification must be completed first.
In prenatal evaluations titer values above 32 or rising titer
17,219,37410/07/2003 10:59:2710 mL7 mL
Indicate reason for request i.e. HDN
Complete a Blood Bank Miscellaneous Test Requisition Form. Indicate medical necessity.
None indicated.
Label tube with patient name, MRN#, date collected, and phlebotomist initials
1
  
ATIII
AT-III
2.7 mL blood
Blue top (citrate) tube
Room temperature transport
84 - 123.0%
Low values may predispose patient to thrombosis.
Wrong container; insufficient quantity; improper labeling;clotted; hemolyzed
Routine: 2-4 hrs. after testing begins
85300
Core Laboratory  Bi 2023  721-212024/7/365
17,219,37610/07/2003 10:59:272.7 mL blood
Frquently Requested Tests requisition. Indicate medical necessity.
1
  
Apheresis pigtail
Pigtail
Fresh samples at room temperature; cryopreserved specimens should be delivered in liquid nitrogen.
Not applicable
Insufficient quantity; improper labeling
Urgent/Emergent- 4 hrs
89050
Blood Bank
Check viability on apheresis pack of stem cells for transplantation.
17,219,37810/07/2003 10:59:271 mL1 mL
Please contact the Blood Bank
 Indicate medical necessity.
1
  
Aerobic and Anaerobic Culture + Gram
Culture Aerobic + Anaerobic Baceterial + Gram, Aer+Ana Cul Gm, Aer/Ana+Gm
Aspirated body fluid, wound aspirate, tissue, bone, abscesses, lymph node, drainage, cyst and separate (AER + ANA) culture swabs from wound sites.
Sterile container - glass tube, plastic cup, anaerobic collection system. Swabs provide markedly inferior sampling. In spite of package labelling, aerobe swabs are NOT acceptable for anaerobic culture.
Ambient temperature and transport to Microbiology Laboratory within 30 minutes of collection.
No growth
Use of nonsterile container; leaking specimen; delay in transport; improper labeling; insufficient quantity; catheter tips are not accepted for Gram stain and anaerobic culture
Gram stain  <4 hour; Preliminary Culture  24 hours aerobe; 48 hours anaerobe; Final Culture  2-7 days aerobe; 7-10 days anaerobe
Gram stain 87205;  Aerobic Culture 87070;   Anaerobic Culture 87075;   Susceptibility 87186;   Definitive Anaerobe ID 87076;   Definitive Aerobic ID 87077.
Suspected bacterial infection in tissue or closed space.
Microbiology  BA-1662  721-2807Daily
Aerobic and anaerobic culture on selective and nonselective media.
Cultures from nonsterile sites growing >3 aerobic and/or >3 anaerobic organisms have limited identification performed unless the requesting physician deems further culture workup is clinically indicated.
Aerobe and anaerobe culture with Gram stain
Microbiology alert on sterile body fluids; Phone report of epidemiologically significant bacteria.
Swabs collect and release minimal volume of material that may not be representative of the infection. Avoid their use whenever possible.
17,219,35710/07/2003 10:59:275 mL fluid0.5 mL fluid
Indicate medical necessity for each test.
Sterile preparation of aspiration or wound site following hospital epidemiology recommendations.
Observe for complications of collection procedure.
Aseptic collection, proper skin prep before aspiration.  Scrupulously avoid contamination by adjacent mucosal surfaces.  As a general rule, swabs provide suboptimal specimens.  Submit fluid whenever possible.
Potentially pathogenic bacteria from non sterile sites are identified to the level necessary to guide therapy.  From sterile sites bacteria are fully identified.  Susceptibility testing is performed on potential aerobic pathogens that do not have a predictable susceptibility and anaerobic on request.
1
  
Aerobic Culture
Culture Aerobic Bacterial, Cul Aerobe
Abscess, aspirate, biopsy, bone, catheter tips, cyst, drainage, cornea, lesion, lymph node, tissue, ulcer, valve, vesicle, or wound.
Sterile sealed leakproof container. While accepted, swabs are markedly inferior sampling of the infected area.
Ambient temperature and transport to Microbiology Laboratory within 30 minutes of collection.
No growth
Use of nonsterile container; leaking specimen; delay in transport; improper labeling; insufficient quantity
Preliminary Culture Report  24 hours; Final  2-5 days
Aerobic Culture 87070;   Definitive Aerobic ID 87077;   Susceptibility 87186
Suspected aerobic bacterial infection.
Microbiology  BA-1672  721-280724/7/365
Aerobic culture using nonselective and selective media.
Cultures from nonsterile sites growing >3 aerobic organisms have limited identification performed unless the requesting physician deems further culture workup is clinically indicated.
Aerobic Culture; no Gram stain reported.
Phone report of epidemiologically significant bacteria.
Gram stain recommended to guide initial therapy and to aid in interpretation of culture results. Swabs collect and release minimal volumes of material that may not be representative of the infection. Avoid their use whenever possible.
17,219,35910/07/2003 10:59:270.5 mL0.5 mL
Indicate medical necessity.
Sterile preparation of site.
Observe for complications of collection procedure.
Aseptic collection, proper skin or mucosal prep before aspiration.
Potentially pathogenic bacteria are identified to the level necessary to guide therapy.  Susceptibility is performed on potential pathogens that do not have a predictable susceptibility.

1
  
Aerobic Culture + Gram
Culture Aerobic Bacterial + Gram, Cul Aer Gm, Aer Cul + Gm
Abscess, aspirate, biopsy, bone, cyst, drainage, cornea, lesion, lymph node, tissue, ulcer, valve, vesicle, or wound.
Sterile container. Aerobic swabs can be used but provide minimal volume for culture and smears and may not be representative of the infected area.
Ambient temperature and transport to Microbiology Laboratory within 30 minutes of collection.
No growth
Use of nonsterile container; leaking specimen; delay in transport; improper labeling; insufficient quantity
Gram stain report  <4 hour; Preliminary culture report  24 hours;
Final  2 - 5 days
Gram stain 87205;   Aerobic Culture 87070;   Susceptibility 87186;   Definitive Aerobic ID 87077
Suspected aerobic bacterial infection.
Microbiology  BA-1672  721-2807Daily.
Aerobic culture on selective and nonselective media
Cultures from nonsterile sites growing >3 aerobic organisms have limited identification performed unless the requesting physician deems further culture workup is clinically indicated.
Aerobic culture and Gram stain
Phone report of epidemiologically significant isolates.
Swab specimens are markedly inferior to fluid specimens.
17,219,36110/07/2003 10:59:270.5 mL0.5 mL
Indicate medical necessity.
Appropriate preparation of site.
Observe for complications of collection procedure.
Aseptic collection, proper skin or mucosal prep before collection.
Potentially pathogenic bacteria are identified to the level necessary to guide therapy.  Susceptibility is performed on potential pathogens that do not have a predictable susceptibility.
1
  
Patient AG; Patient Antigen Typing
RBC phenotyping, AHG antigens
Blood
Lavender top (EDTA) or pink top (EDTA) tube
Room temperature transport
Not applicable
Results are reported positive or negative for the specific antigen tested.
Improper labeling; wrong tube; severe hemolysis; insufficient quantity
24 hours
86905
Antigen testing in patients with antibodies, transfusion reactions, sickle cell patients, incompatible crossmatches, in certain disease states, and per physician request.
Blood Bank  BI-1230  721 -2731Daily
Antigen typing is dependent oncommercial antisera available.  Testing is contraindicated if the specimen is hemolyzed.  If a patient has a positive DAT, or if a patient has recently been transfused, antigen results may be invalid.  Positive DAT results may require specialized testing to identify the cause.  The sample may be sent to a reference laboratory.  If a patient has antibodies, the donor units must be antigen testing to ensure that any transfused units do not contain the antigen reactive with the patient''''''''''''''''s antibody.  False negative and false positive results can occur.
Typing for specific AHG RBC antigens
17,219,36210/07/2003 10:59:277 mL3 mL
Indicate antigen(s) to be identified, and reason for testing
Skin disinfection.
Mix well soon after collection. Label tube with patient''''s name, MRN, date, and phlebotomist initials. Any missing information will result in specimen rejection.
Antigen testing analyses is useful in parentage testing.  If requested, such testing is referred to a reference laboratory.
1
  
Albumin or Albumin Level
Albumin
2 mL whole blood
5 mL light green top tube (lithium heparin); light green cap microtainer acceptable
3.2 - 4.8 gm/dL
Wrong container; improper labeling; insufficient volume
Routine: 2-4 hrs.;

Urgent/Emergent: 1 hr.
82040
Nutritional status
Core Laboratory,  BI-2023, 706-721-2120;  Cancer Center Laboratory, AM-2610, 706-721-1739Core Laboratory  24/7/365;  Cancer Center Laboratory 8AM-5PM Mon-Fri
Advia 1800
Low reportable limit: < 0.6 gm/dL
<= 1.7 gm/dL
17,219,36310/07/2003 10:59:271 full light green cap microtainer
Frequently Requested Tests requisition. Indicate medical necessity.
1
  
Alcohol
Ethanol, Ethyl alcohol, EtOH
2 mL whole blood
Gold top SST tube; red or gold microtainer acceptable
Room temperature
< 10 mg/dL
Wrong container; hemolysis; insufficient quantity; improper labeling
Routine: 2-4 hrs;

Urgent/Emergent: 1 hr.
82055
Intoxication
Core Laboratory,  BI-2023, 706-721-212024/7/365
Advia 1800
Low reportable limit < 10 mg/dL. Not valid as legal result.
Toxic limit >= 300 mg/dL
17,219,36510/07/2003 10:59:271 full gold microtainer
Do not use alcohol for skin disinfection.
Frequently Requested Tests requisition. Indicate medical necessity.
Do not prepare venipuncture site with any alcohol containing swab.
Not valid as legal alcohol result.
1
  
AlkP HS or Alk Ptase Heat Stable
AlkP HS, Alk Ptase Heat Stable, Fractional alkaline phosphatase, alkaline phosphatase isoenzymes
4 mL whole blood
Gold top SST tube; red or gold microtainer acceptable
25 - 33% of total alkaline phosphatase
Bone fraction of alkaline phosphatase is inactivated by heat while the liver fraction remains stable.
Wrong container; insufficient quantity; improper labeling
Routine: 2-4 hrs;

Urgent/Emergent: 2 hrs.
84078
Core Laboratory  BI 2023  721-2120M-F 6:00 AM - 8:30 PM Sa-Su 6:00 AM - 2:30 PM
Sample heated to destroy bone fraction.
None
17,219,36610/07/2003 10:59:271 full gold microtainer
Frequently Requested Tests requisition. Indicate medical necessity.
1
  
HLA LXHDABID I (PRA Luminex Class I High Definition)  HLA LXHDABID II (PRA Luminex Class II High Definition)
HLA DSA (HLA Donor Specific Antibody)
Blood
10 mL Plain Red Top
Room Temperature
NA
Wrong Container; Improper Labeling; Insufficient Quantity
48 Hours or 2 Working Days.  By 7 PM on date of testing.
Tuesdays and Fridays.  Please notify the HLA Lab 721-3311 by 10:00 AM if Testing Required, or if Emergent
86807
1.  Solid Organ Transplant Candidate - Post Transplant  - HLA Antibody Screen/ID for Potential Rejection

2.  Stem Cell Transplant Candidate - Pre-transplant Antibody Identification
Histocompatibility Immunology Laboratory BA 1641
Solid Phase Luminex Single Antigen Beads
Solid Phase Luminex Single Antigen Bead testing for antibodies to Class I and II HLA Antigens
40,367,01210 mL Plain Red.  Contact the HLA Lab 721-3311 for Pediatric Volumes5-10 mL .  Contact the HLA Lab 721-3311 for Pediatric Volumes.
Histocompatibility Immunology Pink Request
Schedule. Call HLA Lab 721-3311
1
  
AFP or AFP Tmr Mrkr or AFP Tumor Marker
Alpha-Fetoprotein Tumor Marker
2 mL whole blood
Gold top SST tube
Serum may be stored at 2 to 8 degrees C if assay will be performed within 48 hours.  Samples which will not be tested within 48 hours should be frozen.
< 1.3 - 8.1 ng/mL
99% of healthy subjects have AFP levels < 8.9 ng/mL
Wrong container; improper labeling; insufficient volume
Run once daily M-F when batch size is adequate.
82105
The AFP assay is valuable in the management of patients with nonseminomatous testicular cancer when used in conjunction with clinical information.  Various other conditions such as ataxia telangiectasia, herediatry tryrosinemia, primary hepatocellular carcinoma. teratocarcinoma, gastrointestinal tract cancers with and without liver metastases, and other benign hepatic conditions such as acute viral hepatitis, chronic active hepatitis, and cirrhosis can also cause elevated serum AFP levels.
Core Lab, BI 2023, 706-721-2120M - F 8:00 AM - 2:00 PM
Advia Centaur XP
The quantitative measurement of alpha-fetoprotein in serum or plasma.
None
Maternal serum AFP and amniotic fluid AFP will be mailed to a reference laboratory.
17,219,36710/07/2003 10:59:27
The same specimen type (serum vs. plasma) should be used when a patient is being monitored over a period of time with serial samples.
Write in on Frequently Requested Tests requisition. Indicate medical necessity.
Avoid hemolysis
1
  
Nonspecific Esterase Stain
Bone Marrow Smear;

Blood
Blood: Lavendar (EDTA) or green (heparin) top tube
Not applicable
No bone marrow particles on smear;

Improper labeling
24 hours
88319
Cytochemical evaluation of a myeloproliferative disorder.  Alpha-Naphtholl/Acetate Esterase stain with fluoride inhibition may be used to further distinguish cells of monocytic lineage.
Bone Marrow Laboratory  BI-2030  721-2508M - F 8:00 AM - 4:30 PM
17,219,36810/07/2003 10:59:27Enough material for 2 slides (4 drops)
Procedure must be ordered by a hematolgist, oncologist or pathologist.
Hematology-Bone Marrow Laboratory Request Form (available from Hematology). Indicate medical necessity.
1
  
Amika Lvl or Amikacin Lvl; also Amika or Amikacin Pk or Tr
Amikin
2 mL Blood
Red top tube ONLY
Therapeutic Range:

Trough: <8 mcg/mL standard; The American Thoracic Society (ATS) recommends trough levels of <4-5 mcg/mL for patients with hospital-acquired pneumonia.



Peak: 15 - 40 mcg/mL standard; Life-threatening infections: 25-40 mcg/mL; Serious infections: 20-25 mcg/mL; Urinary tract infections: 15-20 mcg/mL
Wrong container (gold top SST tube); improper labeling; insufficient quantity; time of collection and last dose not provided; improper collection time in relation to dose
Routine: 2-4 hrs;

Urgent/Emergent: 1 hr.
80150
Core Lab, BI 2023, 706-721-212024/7/365
Low reportable limit: < 3.0 mcg/mL
Toxic Limit:

Trough: >= 10 mcg/mL



Peak: >= 30 mcg/mL
17,219,36910/07/2003 10:59:27
Also available as Peak or Trough as Amika Pk or Amikacin Pk and Amika Tr or Amikacin Tr. Indicate peak or trough on requisition and give precise time of collection and of initiation of last dose.
Frequently Requested Tests requition. Indicate medical necessity.
Draw trough within 30 minutes prior to next dose.  Draw peak 30 minutes after completion of 30-minute infusion or at 1 hour following initiation of infusion or I.M. injection.
Half life: 2 - 3 hrs.
1
  
Amylase
Diastase
3 mL blood
light green top Lithium Heparin tube
Room temperature
30 - 118 U/L
Wrong container; insufficient quantity; improper labeling
Routine: 2-4 hrs;

Urgent/Emergent: 1 hr
82150
Core Laboratory  BI 2023  721-212024/7/365
Advia 1800
17,219,37110/07/2003 10:59:271 full light green microtainer
Frequently Requested Tests requisition. Indicate medical necessity
1
  
Antibody Identification
Antibody panel, panel testing, red cell antibody identification
Blood
Pink top (EDTA) tube. (Both a lavender and red stoppered tube may be requested if more tests are required for identification purposes).
Send to Blood Bank at room temperature
Not applicable
Improper labeling; wrong tube; gross hemolysis; insufficient volume
24 hours
86870, 86885
Necessary prior to transfusion to identify antibody or antibodies when the antibody screen test is positive.  May be done on eluates from red cells having a positive DAT test.  Necessary to work up obstetric patients for antenatal diagnosis of HDN.  To work up hemolytic anemia when the DAT and or indirect Coombs' test is positive.
Blood Bank  BI-1230  721-2731Testing Daily
Immediate spin, 37C phase using LISS, then indirect Coombs' phase.  May require adsorption and elution procedures, selected panels, and other mediums for identification purposes.
Antibody may be too weak to identify.  Panel cells may not contain specific antigen to antibody inserum.  Antibody may be to a low incidence antigen that may not be detected in the antibody screen test procedure.  May require sending specimen to a reference laboratory to identify and to obtain compatible units for transfusion.
Investigation of serum to identify antibody(ies) that were detected in the antibody screen procedure or crossmatch procedure.  Requires testing the serum against a panel of red cell specimens of known red cell antigen phenotypes for the major blood group systems.
Significant findings include identification of clinically significant antibodies or antibody.
17,219,37310/07/2003 10:59:2710-20 mL
Indicate on requisition form diagnosis, transfusion history, recent drug history, and pregnancy history.
None
Label tube(s) with patients name MRN#, date, and phlebotomists initials.  If blood components are required, label red stoppered tube using Fenwal Arm Band labeling system.  Refer to crossmatch test for labeling specifics.
Difficulty in crossmatching patients sensitized to red cell antigens may result in delay of blood availability.  Identified clinically significant antibodies known to cause HDN will be titered if identified in obstetric patients.
1
  
DERMAT
Skin scrapings, nail clippings, affected hairs
Sterile dry container
Transport at ambient temperature to Microbiology within 2 hours.
No fungus isolated in 4 weeks.
Delay in transport; improper labeling; wrong container; insufficient quantity
Final negative report in 4 weeks
Culture 87101;   Dermatophyte ID 87106
Suspected dermatophytosis
Microbiology Laboratory  BA1672  721-2807Daily
Fungal culture on selective and non-selective media.
Antifungal therapy may interfere with culture.
Fungal culture of skin, nails, or hair
17,219,43910/07/2003 10:59:27Small amount of scrapings or clippings, or several hairs.Visible amount of scrapings - appropriately enough to cover the head of a thumb tack.
If KOH needed, order Potassium hydoxide (KOH) exam.
Indicate medical necessity.
Observation for complications due to collection procedure.
SKIN - Wipe the affected area with gauze and 70% alcohol.  Gently scrape the surface at the actual margin of the lesion but do not draw blood.  Place sample in a sealed dry container.    NAILS - Using gauze, wipe nail with 70% alcohol.  Clip a generous portion of the affected nail and collect any material under the nail.  Place in a dry sterile container.    HAIR - Pluck several affected hairs.
Please note on requisition if patient has been treated.
1
  
Digoxin Level
Lanoxin Level
2 mL blood
5 mL gold top SST tube; red or gold microtainer acceptable
0.5 - 1.2 ng/mL
Wrong container; improper labeling; insufficient quantity; improper collection time
Urgent/Emergent 1 hour; Routine 2-4 hrs.
80162
Core Laboratory  BI-2023 721-212024/7/365
>= 2.4 ng/mL
17,219,44110/07/2003 10:59:27
Wait at least six hours after dose before collecting sample for digoxin monitoring.
Frequently Requested Tests requisition. Indicate time of collection and of last dose. Indicate medical necessity.
Collect at least six hours after dose
Digoxin half life is 1.4 - 1.8 days with normal renal status and much longer with renal failure. The distribution time in the body is 8 hours, longer in patients with congestive heart failure, thus the need to wait at least six hours after dosing before collection.
1
  
DRVVT
2.7 mL blood
2.7 mL blue top (sodium citrate) tube
Send at room temperature
31.0-37.0 seconds or Ratio of 1.0-1.1
Suggests the absence of a Lupus Anticoauglant
Wrong container; improper filling; clotted or hemolyzed specimen; improper labeling; insufficient volume
Batch testing
85613
Helpful in diagnosis of lupus anticoagulant
Core Laboratory  BI 2023  721-2120Tuesday or by other arrangement.
Patient and control results
17,219,44210/07/2003 10:59:27
Frequently Requested Tests requisition. Write in under Other. Indicate medical necessity.
Avoid Coumadin for 2 weeks and heparin for 2 days
Gently mix 8-10 times after collection
1
  
Direct Antihuman Globulin Panel
Broad Spectrum Direct Coombs, Direct Antihuman Globulin Test
Blood
Lavender top (EDTA) or pink top (EDTA) tube.
Send to Blood Bank
Negative
A positive DAT indicates that antibody and/or complement is coating the red blood cells unless a false positive result has occurred.  Requires elution and panel testing to determine the reason.
Improper labeling; wrong tube; severe hemolysis; insufficient quantity
45 minutes
86880
Requested to determine if the patient's DAT is positive, and to determine when results are positive what has in-vivo coated the patient's red blood cells.  Used in the evaluation of immune hemolysis resulting from bound antibody or complement associated with hemolytic anemia, hemolytic disease of the newborm, drugs, or transfusion reaction causes.
Blood Bank  BI-1230  721-2731Testing daily
AHG Testing
False negative and false positive reactions can occur in testing.  Abnormal proteins and cold autoagglutinins can interfere in testing and interpretation of results.  The test will not detect all antibodies that may be present (a positive DAT requires 300-500 IgG molecules per red cell).  Some instances of warm autoimmune hemolytic anemia have a negative DAT.
Broad Spectrum DAT, IgG DAT, and Complement Direct Coombs Test
Positive DAT (elution, panel, and other testing would be required to define and identify the reason).
17,219,44310/07/2003 10:59:277 mL3 mL
Indicate on order form request for the DAT panel.
Label tube with patient''s name, MRN#, date, and phlebotomist initials.
The broad-spectrum AHG reagent contains antibody to human IgG and to the C3d component of human complement.  A positive broad spectrum DAT with a negative IgG DAT implies that the positive DAT is due to complement.  IgG positive DAT alone, without complement DAT is found in 20-40% WAIHA cases.  Drugs that can result in a complement positive DAT include quinidine and phenacetin, and those that can cause a positive IgG DAT include methyldopa and IV penicillin.
1
  
Not ordered in CPOE must be coordinated with Blood Donor Room
Autologous, Autotransfusion
Autologous unit collected and processed.  When autologous donor/patient requires the unit(s) to be transfused, submit a plain red stoppered tube or pink EDTA tube labeled with a Fenwal Typenex blood identification label containing the patient''''s name, medical record number, date, and phlebotomist''''''''s initials.
Lavender top (EDTA) or pink top (EDTA) tube. Fenwal label
Send patient pretransfusion sample to Blood Bank at room temperature no more than 72 hours prior to transfusion.
Not applicable
Elimination risks of alloimmunization, viral transmission, and other transfusion hazards.
Autologous donor/patient not meeting SOP and regulatory requirements.  Patient sample drawn prior to transfusion time labeled incorrectly, submitted in wrong tube, or grossly hemolyzed.
5 working days from autologous donor/patient collection time.
86890
Elective surgery (patients undergoing orthopedic procedures, vascular surgery, openheart surgery).  Indications for transfusion should follow same requirements as for red blood cells.
Blood Bank  BI-1230  721-2731;  Donor Room  BI-1202  721-3694For autologous donation call M-F for appointment.
Same as with regular blood donor donation procedure.
Autologous units should not be drawn for patients that seldom require transfusions, or patients in which blood transfusions are not indicated.  These autologous units may not be transfused to anyone except to the donor/patient that donated the unit.  Any adverse reaction must be treated the same as with any transfusion in detection, reporting, and evaluation.
Removal of unit of autologous blood fron a donor/patient and processing the autologous red cells for subsequent reinfusion to the same donor/patient.
If an autologous donor/patient unit in testing is found to be reactive to the human immunodeficiency virus antigen or found reactive for antibodies to HIV, the unit will not be used.  The patient's physician will be notified.  If any other autologous unit testing results are positive, a biohazard label will be applied to the autologous unit.
17,219,38110/07/2003 10:59:2710 mL patient sample for pretransfusion tests7 mL patient sample for pretransfusion tests
The autologous donor/patient is given predonation material, education material, and after blood donation postdonation instructions.
Form from Blood Donor Room requesting Autologous blood must be completed by patient and physican.
For autologous donor/patient unit to be collected, the donor room must have consent of the donor patient's physician and blood bank physician to collect the autologous donor unit.  Hemoglobin must be no less than 11 g/dL.  The autologous donor unit can not be drawn within 72 hours of anticipated surgery.  The donor/patient should be in general good health before donation.  Iron therapy may be considered by the attending physician for the patient when several autologous donor units are to be collected.
Monitor the patient's hemoglobin when several autologous donor units are being collected.  Advise patient/donor to maintain a high fluid intake to restore blood volume after donation.
For an autologous donor unit collection, FDA regulatory requirements, and SOP procedures are followed during donor/patient collection and processing of the autologous donor unit. Patient crossmatch sample must be collected within 3 days of anticipated transfusion and submitted in a Fenwall Typenex-labeled tube.
If units are not used, the patient will be billed for collection and processing fees associated with each unit.
1
  
Preg or Pregnancy Test Serum
Serum pregnancy test, Pregnancy Test Qualitative
1 mL blood
5 mL gold top SST tube
Negative
Wrong container; insufficient quantity; improper labeling
Routine: 2-4 hrs.;

Urgent/Emergent: 1 hr.
84703
Pregnancy
Core Laboratory  BI-2023  721-2120; Cancer Center Lab  AM 2610  721-1739Core Laboratory 24/7/365;  Cancer Center Lab  8AM-5PM  Mon-Fri;  OB/GYN Laboratory M-F 9:00 AM - 4:30 PM
17,219,38710/07/2003 10:59:27
Specify qualitative on requisition.
Frequently Requested Tests requisition. Indicate medical necessity.
1
  
Ur Preg or Ur Pregnancy
Urine Pregnancy Test, Urine Pregnancy Qualitative
5 mL Random Urine
Screw-cap urine container
Negative, Positive in pregnancy or with tumors producing hCG.
Routine: 2-4 hrs.;

Urgent/Emergent: 1 hr.
84703
Suspected pregnancy
Core Laboratory  BI-2023  721-2120;  Cancer Center Lab  AM 2610  721-1739  Family Medicine Laboratory  BP-1148  721-4596;  Pediatric Laboratory  BP-3230  721-7536Core Laboratory 24/7/365;  Cancer Center Lab M-F 8AM-5PM  Family Medicine Laboratory M-F 8:30 AM - 5:00 PM;  Pediatric Laboratory M-F 8:30 AM - 5:30 PM
Enzyme immunoassay
17,219,38810/07/2003 10:59:27
Specify QUALITATIVE on requisition.
Frequently Requested Tests requisition. Indicate medical necessity.
Freshly voided first morning specimen preferred.
1
  
Beta-hCG Quant
Human Chorionic Gonadotropin, Gonadotropin Chorionic (hCG) Quantitative
2 mL Blood
5 mL gold top SST tube
0 - 5 mIU/mL
Routine: daily;

Urgent/Emergent: 2 hrs.
84702
Suspected hCG-secreting neoplasm. NOT for pregnancy testing.
Core Laboratory  BI-2023  721-2120Urgent and Emergent: 24/7/365;  Routine: 1 run daily with results out by noon.
Enzyme immunoassay
Low reportable limit: < 2.0 mIU/mL. Patients with human anti-mouse antibodies may have inaccurate results.
Testing for subtypes (eg, nicked) of hCG available through reference laboratory.
17,219,38910/07/2003 10:59:27
Specify QUANTITATIVE on requisition.

Not a pregnancy screening test.
Frequently Requested Tests requisition. Indicate medical necessity
1
  
D Bili or Bili Direct
DBIL, conjugated bilirubin
2 mL blood
5 mL light green top tube (lithium heparin); light green cap microtainer acceptable
0 - 0.2 mg/dL
Wrong container; hemolysis; insufficent quantity; improper labeling
Routine: 2 - 4 hrs.;

Urgent/Emergent: 1 hr.
82248
Liver and biliary disease
Core Laboratory  BI-2023  721-2120; Cancer Center Lab  AM 2610  721-1739Core Laboratory 24/7/365; Cancer Center Lab  8AM-5PM Mon-Fri
Advia 1800
None established. Elevated levels in neonates may produce kernicterus.
Hemolysis will interfere with assay.
17,219,39010/07/2003 10:59:271 full light green cap microtainer
Avoid hemolysis. Protect from light
Frequently Requested Tests requisition. Indicate medical necessity.
1
  
T Bili or Bili Total
TBIL, total bilirubin
2 mL blood
5 mL light green top tube (lithium heparin); light green cap microtainer acceptable
Avoid hemolysis. Protect from light.
0.3 - 1.2 mg/dL
Wrong container; hemolysis; insufficient quantity; improper labeling
Routine: 2 - 4 hrs.;

Urgent/Emergent: 1 hr.
82247
Core Laboratory  BI-2023  721-2120; Cancer Center Lab  AM 2610  721-1739Core Laboratory 24/7/365; Cancer Center Lab 8AM-5PM Mon-Fri
Advia 1800
>= 20 mg/dL in neonates
17,219,39110/07/2003 10:59:271 light green cap microtainer
Avoid hemolysis
Frequently Requested Tests requisition. Indicate medical necessity.
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