2019
Rutland Regional Medical Center
1/2/2019
Laboratory Specimen Collection and Labeling Guidelines
Table of Contents
LABORATORY SPECIMEN LABELING GUIDELINES ..................................................... 1-2
GENERAL LABORATORY ........................................................................................................................... 1 BLOOD BANK ............................................................................................................................................. 1 CYTOLOGY AND PATHOLOGY ................................................................................................................... 1 ACCEPTABLE & UNACCEPTABLE LABELING FOR LABORATORY SPECIMENS ...................................... 2
HEMATOLOGY, COAGULATION, AND URINALYSIS ..................................................... 3-6
BODY FLUID CELL COUNT (NON CSF) ................................................................................................. 3 COMPLETE BLOOD COUNT ....................................................................................................................... 3 COMPLETE BLOOD COUNT WITH AUTO-DIFFERENTIAL ........................................................................ 3 CORRECTION STUDIES (PT OR PTT) ..................................................................................................... 3 CSF CELL COUNT...................................................................................................................................... 4 D DIMER .................................................................................................................................................... 4 FETAL MEMBRANE RUPTURE (ROM)…………………………………………………………………………4 FIBRINOGEN .............................................................................................................................................. 4 MONONUCLEOSIS SCREEN ....................................................................................................................... 4 PARTIAL THROMBOPLASTIN TIME ......................................................................................................... 4 PLATELET FUNCTION ASSAY ................................................................................................................... 5 PROTHROMBIN TIME ................................................................................................................................ 5 SEDIMENTATION RATE ............................................................................................................................ 5 SYNOVIAL FLUID CRYSTALS ..................................................................................................................... 5 URINALYSIS REFLEX MICROSCOPIC AND CULTURE, IF INDICATED ...................................................... 5 URINALYSIS REFLEX MICROSCOPIC, IF INDICATED ............................................................................... 6 XA ............................................................................................................................................................... 6
I
TRANSFUSION TESTING ...................................................................................................... 7-9
ABO/RH AND ANTIBODY SCREEN ......................................................................................................... 7 ABO/RH CONFIRMATORY TYPE….…………………………………………………………………………….7 ABO/RH TYPE ......................................................................................................................................... 7 ANTIBODY SCREEN ................................................................................................................................... 7 CORD BLOOD TESTING ............................................................................................................................. 7 CRYOPRECIPITATE .................................................................................................................................... 7 DIRECT ANTIGLOBULIN TESTING ............................................................................................................ 8 FETAL SCREEN .......................................................................................................................................... 8 FRESH FROZEN PLASMA .......................................................................................................................... 8 HOLD CLOT ................................................................................................................................................ 8 MICRHOGAM ............................................................................................................................................ 8 PLATELET .................................................................................................................................................. 8 RED BLOOD CELLS .................................................................................................................................... 9 RH TYPE ................................................................................................................................................... .9 RHOGAM .................................................................................................................................................. 9 TRANSFUSION REACTION ......................................................................................................................... 9
CHEMISTRY ....................................................................................................................... 10-14
BODY FLUIDS .......................................................................................................................................... 10 CARDIAC MARKERS ............................................................................................................................... 10 CREATININE CLEARANCE ...................................................................................................................... 10 CRITICAL CARE MARKERS .................................................................................................................... 11 DRUG LEVELS (SERUM ONLY) ............................................................................................................. 11 DRUG LEVELS (SERUM/PLASMA) ....................................................................................................... 11 DRUG SCREEN (URINE) ........................................................................................................................ 11 GENERAL CHEMISTRIES ........................................................................................................................ 12 HORMONES ............................................................................................................................................. 13 INFECTIOUS DISEASE…………….……………………………………………………………………………...13 RANDOM URINE TESTING ..................................................................................................................... 13 TUMOR MARKER…………………………………………………………………………………………………14 24 HOUR URINE .................................................................................................................................... 14
II
MICROBIOLOGY ............................................................................................................... 15-20
ABSCESS, WOUND, ROUTINE CULTURE ............................................................................................... 15 AFB CULTURE ....................................................................................................................................... 15 ANAEROBIC CULTURE ........................................................................................................................... 15 BLOOD CULTURE.................................................................................................................................... 16 BODY FLUID CULTURE .......................................................................................................................... 16 C-DIFF .................................................................................................................................................... 16 CSF CULTURE ........................................................................................................................................ 16 CRYPTOCOCCAL ANTIGEN - CSF .......................................................................................................... 16 FUNGUS CULTURE .................................................................................................................................. 17 FUNGUS CULTURE SKIN, HAIR, NAILS ................................................................................................. 17 GARDNERELLA, TRICHOMONAS AND YEAST PROBE .......................................................................... 17 GI PATHOGEN ........................................................................................................................................ 17 GROUP A STREP CULTURE .................................................................................................................... 17 GROUP B STREP CULTURE .................................................................................................................... 18 LACTOFERRIN……………………………………………………………………………………………………. 18 MRSA/STAPH SCREENING .................................................................................................................. 18 RAPID FLU A/B ..................................................................................................................................... 18 RAPID RSV ............................................................................................................................................. 18 RAPID STREP .......................................................................................................................................... 19 SPUTUM CULTURE ................................................................................................................................. 19 STOOL GIARDIA AND CRYPTO ............................................................................................................... 19 STOOL OCCULT BLOOD ......................................................................................................................... 19 STOOL O&P ............................................................................................................................................ 19 TISSUE CULTURE ................................................................................................................................... 20 URINE CULTURE..................................................................................................................................... 20 VIRUS DETECTION ................................................................................................................................. 20
19
III
ANATOMIC PATHOLOGY ............................................................................................... 21-26
ANAL-RECTAL CYTOLOGY (ANAL PAP) .............................................................................................. 21 BODY FLUID CYTOLOGY ........................................................................................................................ 21 BONE MARROW SPECIMEN EVALUATION ........................................................................................... 21 BREAST LUMPECTOMY OR RESECTION ................................................................................................ 21 BRUSH/SCRAPING CYTOLOGY .............................................................................................................. 22 CHLAMYDIA GONORRHOEAE TESTING – NON-UROGENITAL SITES…………………………………….22 CHLAMYDIA GONORRHOEAE TESTING - UROGENITAL SITES…………………………………………….22 CORE NEEDLE BIOPSY ............................................................................................................................ 23 CSF CYTOLOGY ...................................................................................................................................... 23 CYTOGENETICS ON BONE MARROW SPECIMEN…………………………………………………………….23 CYTOGENETICS ON NON BONE MARROW SPECIMEN…………………………………………………….23 EOSINOPHIL EVALUATION .................................................................................................................... 23 FLOW CYTOMETRY ON BONE MARROW SPECIMEN ........................................................................... 23 FLOW CYTOMETRY ON NON BONE MARROW SPECIMEN ................................................................. 24 FNA CYTOLOGY (FINE NEED ASPIRATION) ....................................................................................... 24 FRESH SPECIMEN ................................................................................................................................... 24 FROZEN SECTION ................................................................................................................................... 25 GYN PAP TEST WITH REFLEX HPV-DETECTION ............................................................................... 25 HEMOSIDERIN EVALUATION ................................................................................................................. 25 HPV DETECTION WITH REFLEX TO GYN PAP TEST CYTOLOGY……………………………………….25 NASAL CYTOGRAM………………………………………………………………………………………….……26 PJP (PNEUMOCYSTIS JIROVECI EVALUATION).................................................................................... 26 SPUTUM CYTOLOGY ............................................................................................................................... 26 TISSUE SPECIMEN .................................................................................................................................. 26 TZANCK PREP ......................................................................................................................................... 27 URINE CYTOLOGY .................................................................................................................................. 27 WASH CYTOLOGY ................................................................................................................................... 27
1
Laboratory Specimen Labeling Guidelines:
ALL SPECIMENS MUST BE LABELED WITH PATIENT NAME AND AT LEAST 1 OTHER SIGNIFICANT IDENTIFIER (DOB/MRN)
General Laboratory (Chemistry, Hematology, Coagulation, Urinalysis, Microbiology, Reference)
• Labeled with a Cerner Accession Label or Patient Chart Sticker
• If labeled by hand, must have 2 patient identifiers (NAME and DOB/MRN)
• Labels placed so they are not covering any other patient identification
• Labels placed so the contents of the tubes/sterile containers are visible
• Cerner Accession labels must be as straight as possible for instrument reading
• Labels must be flat to tube, and not go over the bottom, or placed on the cap
• For microbiology, place the source and type of specimen on label
Blood Bank
DO NOT REMOVE A BLOOD BANK BRACELET WITHOUT VERIFYING WITH THE BLOOD BANK FIRST 1. Patient must be asked to verbally verify their full name (spell it) and date of birth, if possible, before collection or completion of the Blood Bank Bracelet. 2. Use a blue or black permanent ink pen (no gel pens) to legibly complete the Blood Bank Bracelet. 3. RRMC policy states that there must be at least 2 identifiers on the band. If possible, Blood Bank requests full completion of the information on the band, i.e.
Name/DOB/MRN. 4. Place the label vertically on the patient’s tube. 5. Place the bracelet on the patients arm before leaving the bedside. 6. Remove the tail of the bracelet and return it to the blood bank along with the tube.
Criteria for rejection: write overs, incorrect spelling, smudged or illegible writing.
Cytology and Pathology • Labeled with a Cerner Accession Label or Patient Chart Sticker
• Labels placed so they are not covering any other patient identification
• Labels placed so the contents of the tubes/sterile containers are visible
• Specimen type/source on label
2
Acceptable Labeling for Laboratory Specimens: Unacceptable Labeling for Laboratory Specimens:
3
Hematology, Coagulation, and Urinalysis
Cerner Order Name Useful for Specimen Stability
Expected TAT
What to Collect Collection Device
Body Fluid Cell Count (NON CSF)
• Body Fluid Cell Count
• Cell Count Body Fluid
• Synovial Fluid Cell Count
Providing the WBC in all fluids tested. A differential will indicate which WBC cells are present and how many of each type of cells are in the fluid being tested
Send to Lab STAT • ST - 1 hour
• TS - 1 hour
• RT - 1 hour
1 of the following Lavender K2 EDTA:
• 4.0ml
• 2.0ml Number of Inversions: 8-10
Complete Blood Count
• CBC Monitoring or detecting any of the following:
• Infection
• Anemia
• Bleeding disorder
• 48 hours @ 2-8°C
• 24 hours @ Room Temp
**For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Lavender K2 EDTA:
• 4.0ml (min 1ml)
• 2.0ml (min 1ml)
• 500µl- *must filled to top line
Number of Inversions: 8-10
Complete Blood Count with
auto-differential
• CBC Auto Diff reflex Manual Diff
• CBC-D
Monitoring or detecting any of the following:
• Anemia
• Infection
• Inflammation
• Bleeding disorder
• Leukemia
• 48 hours @ 2-8°C
• 24 hours @ Room Temp
**For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Lavender K2 EDTA:
• 4.0ml (min 1ml)
• 2.0ml (min 1ml)
• 500µl- *must filled to top line
Number of Inversions: 8-10
Correction Studies (PT or PTT)
• Corr PT
• CorrPTT
Determining whether a prolonged PT/PTT are due to an inhibitor or factor deficiency
1 hour @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 2 hour
• TS - 2 hour
• RT - 4 hours
SPECIAL REQUIREMENTS - CALL LAB
CSF Cell Count
• Body Fluid Cell Count
• CSF Cell Count
Provided the WBC and RBC count in CSF. If indicated, a differential will indicate what WBC cells are present, and how many of each type of wells are in the fluid tested.
Send to Lab STAT • ST - 1 hour
• TS - 1 hour
• RT - 1 hour
• Sterile CSF Collection containers
* Containers must be number according to order of fill.
4
Cerner Order Name Useful for Specimen Stability
Expected TAT
What to Collect Collection Device
D Dimer
• D Dimer Investigating/ruling out the presence of inappropriate blood clots seen in deep vein thrombosis, pulmonary embolism, or DIC (Disseminated Intravascular Coagulation)
8 hours @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Blue Sodium Citrate:
• 2.7ml
• 1.8ml Number of Inversions: 3-4
Tubes must be filled to line on tube for proper dilution
Fetal Membrane Rupture (ROM)
• ROM PLUS Detecting the Rupture of membrane in pregnant women
Send to Lab STAT *Testing must be completed within 30 minutes of collection
• ST - 15 minutes
• ROM Plus collection kit
Fibrinogen
• Fibrinogen Measuring the amount of fibrinogen and its ability to be converted into fibrin
8 hours @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Blue Sodium Citrate:
• 2.7ml
• 1.8ml Number of Inversions: 3-4
Tubes must be filled to line on tube for proper dilution
Mononucleosis Screen
• Mononucleosis Screen
• Monospot
Detecting, or ruling out, if patient has Mononucleosis
24 hours @ 2-8°C **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Lavender K2 EDTA:
• 4.0ml (min 1ml)
• 2.0ml (min 1ml)
• 500µl- *must filled to top line
Number of Inversions: 8-10
Partial Thromboplastin
Time
• Partial Thromboplastin Time
• PTT
Diagnosing unexplained bleeding or clotting
• 4 hours @ Room Temp- Patient not on Heparin
• 2 hours @ Room Temp- Patient on Heparin
**For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Blue Sodium Citrate:
• 2.7ml
• 1.8ml Number of Inversions: 3-4
Tubes must be filled to line on tube for proper dilution
5
Cerner Order Name Useful for Specimen Stability
Expected TAT
What to Collect Collection Device
Platelet Function Assay
• PFA
• Platelet Aggregate
• Platelet Function
Detecting platelet dysfunction induced by intrinsic platelet defects, von Willebrand disease, or exposure to platelet inhibiting agents.
4 hours @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 1 hour
PHLEB DRAW ONLY - CALL LAB
Prothrombin Time
• Prothrombin Time
• Protime, PT/INR
Monitoring or diagnosing bleeding or clotting disorders
24 hours @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
1 of the following Blue Sodium Citrate:
• 2.7ml
• 1.8ml Number of Inversions: 3-4
Tubes must be filled to line on tube for proper dilution
Sedimentation Rate
• Sedimentation Rate
• Sed Rate
Used to monitoring inflammation
24 hours @ 2-8°C **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT -4 hours
1 of the following Lavender K2 EDTA:
• 4.0ml (min 2ml)
• 2.0ml- must be to the line Number of Inversions: 8-10 * Cannot be collected in a Microtainer
Synovial Fluid Crystals
• Syn Crystal examination
• Crystal Examination Synovial
Looks for the presence of uric acid or CPPD crystals in synovial fluid
Send to Lab STAT • ST - 1 hour
• TS - 1 hour
• RT - 1 hour
1 of the following Lavender K2 EDTA:
• 4.0ml
• 2.0ml Number of Inversions: 8-10
Urinalysis Reflex Microscopic and
Culture, if indicated
• UA Rflx Mic/Clt Detecting urinary tract infections or kidney disease. If certain criteria are met, a culture can be indicated based on microscopic findings. A culture will help identify the type of bacteria that may be the cause of the UTI.
• UA: 8 hours @ 2-8°C
• Culture: 24 hours @ 2-8°C
**For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
• Sterile Container *For best results, collect at least 5ml of urine
6
Cerner Order Name Useful for Specimen Stability
Expected TAT
What to Collect Collection Device
Urinalysis Reflex Microscopic, if
indicated
• UA Microscopic Detecting urinary tract infections or kidney disease
• 8 hours @ 2-8°C
• 1 hour @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
• Sterile Container *For best results, collect at least 5ml of urine
Xa
• Anti-XA (LMWH)
• Anti-Xa (UFH)
• Anti-Xa (UFH)-Heparin
Monitoring heparin therapy. It can be used to monitor unfractionated heparin (UFH) or low molecular weight heparin (LMWH).
1 hour @ Room Temp **For best results, send all samples to lab ASAP**
• ST - 1 hour
• TS - 1 hour
• RT - 1 hour SPECIAL REQUIREMENTS - CALL LAB
7
Transfusion Testing
Cerner Order Name
Orders Needed to Process Request
Specimen Stability
Expected TAT TAT depends on workflow,
e.g. traumas, massive bleeds, and OR patients.
What to Collect Collection Device
ABO/Rh and Antibody Screen
• Type and Screen Gel
• T&S Gel
Type and Screen 72 hours • ST - 1 hour
• TS - 1 hour
• RT - 2 hours
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
ABO/Rh
Confirmatory Type
• ABO/Rh Confirmatory
ABO/Rh Confirmatory
72 hours • ST - 20 minutes
• TS - 20 minutes
• RT - 1 hour SPECIAL REQUIREMENTS - CALL LAB
ABO/Rh Type
• ABO/Rh ABO/Rh 72 hours • ST - 20 minutes
• TS - 20 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Antibody Screen
• Antibody Screen Gel
• ABSCR Gel
Antibody Screen 72 hours • ST - 1 hour
• TS - 1 hour
• RT - 2 hours
*if clinically significant antibodies are identified, workup will be longer.
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Cord Blood Testing
• DAT Cord
• Infant DAT
• ABO/Rh Cord
• Infant ABO/Rh
• Cord Blood Workup
• DAT
• ABO/Rh * Tests may be ordered individually or as a full workup that includes both.
72 hours • ST - 1 hour
• TS - 1 hour
• RT - 2 hours
1 Red Top tube Number of Inversions: 5
and 1 Lavender K2 EDTA:
Number of Inversions: 8-10
Tube must be labeled with infant information
Cryoprecipitate
• Blood Bank Cryoprecipitate
ABO/Rh * Full workup recommended but not required
72 hours • ST - 40 minutes
• TS - 40 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
8
Cerner Order Name
Orders Needed to Process Request
Specimen Stability
Expected TAT • TAT depends on workflow,
e.g. traumas, massive bleeds, and OR patients.
What to Collect Collection Device
Direct Antiglobulin
Testing
• DAT Poly
• Direct Antiglobulin Testing-Polyspecific
DAT Poly 72 hours • ST - 30 minutes
• TS - 30 minutes
• RT - 1 hour
SPECIAL REQUIREMENTS - CALL LAB
Fetal Screen
• Fetal Screen
• ABO/Rh
Fetal Screen and ABO/Rh * Commonly ordered on Rh negative females within 72 hours after birth. Also used for Fetal/Maternal Bleeds.
72 hours • ST - 1 hour
• TS - 1 hour
• RT - 2 hours
1 Pink EDTA Number of Inversions: 8-10 Must be labeled with patient identification and 1 red sticker off Blood Bank Bracelet and placed on tube. Do NOT cut off current Blood Bank Bracelet
Fresh Frozen Plasma
• Blood Bank Plasma
ABO/Rh * Full workup recommended but not required
72 hours • ST - 40 minutes
• TS - 40 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Hold Clot
• Hold Clot Hold Clot 72 hours • Not Applicable 1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
micRhoGAM
• Blood Bank MicRhoGAM
ABO/Rh 72 hours • ST - 30 minutes
• TS - 30 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Platelet
• Blood Bank Platelet
ABO/Rh- if no previous history * Full workup recommended but not required
72 hours • ST - 15 minutes
• TS - 15 minutes
• RT - 30 minutes
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
9
Cerner Order Name
Orders Needed to Process Request
Specimen Stability
Expected TAT • TAT depends on workflow,
e.g. traumas, massive bleeds, and OR patients.
What to Collect Collection Device
Red Blood Cells
• Blood Bank RBC ABO/Rh + Antibody Screen Gel
or Type and Screen Gel
72 hours • ST - 1 hour
• TS - 1 hour
• RT - 1 hours
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Rh Type
• Rh Type
• Rh Only
Rh Type 72 hours • ST - 20 minutes
• TS - 20 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
RhoGAM
• Blood Bank RhoGAM
ABO/Rh 72 hours • ST - 30 minutes
• TS - 30 minutes
• RT - 1 hour
1 Pink EDTA Number of Inversions: 8-10 Patient must be banded with Blood Bank bracelet.
Transfusion Reaction
• Transfusion Reaction Workup
• Trxn Workup
Transfusion Reaction Workup
72 hours All transfusion reactions will be worked up as soon as they are ordered. The length of the workup depends on the type of reaction.
1 Pink EDTA Number of Inversions: 8-10 Must be labeled with patient identification and 1 red sticker off Blood Bank Bracelet and placed on tube. Do NOT cut off current Blood Bank Bracelet
10
Chemistry
Testing
Specimen Stability
Expected TAT
What To Collect Collection Device
Body Fluids
• CSF Glucose
• CSF Protein
Send to Lab STAT
• ST - 1 hour
• TS - 1 hour
• RT - 1 hour
• CSF Collection Tubes
• BF LDH
• BF Glucose
• BF Protein
• BF Albumin
• BF Amylase
• BF BUN
• BF Creatinine
• BF Triglycerides
• BF Uric Acid
Send to Lab STAT
• ST - 1 hour
• TS - 1 hour
• RT - 1 hour
At least 1 full: Light Green Lithium Heparin Tube
Number of Inversions: 8-10 Or
Gold SST Tube Number of Inversions: 5
Or Sterile Container
• BF pH
Send to Lab STAT
• ST - 1 hour
• TS - 1 hour
• RT - 1 hour
1 Dark Green Lithium Heparin Number of Inversions: 8-10
Cardiac Markers
• CK
• CKMB
• hsCRP
• Troponin
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full: Green Lithium Heparin Tube Number of Inversions: 8-10
Or Gold SST Tube
Number of Inversions: 5
* Green Lithium Heparin Tube Preferred
Creatinine Clearance
Creatinine Clearance:
• Must record duration of collection (usually 24 hours)
• Must have creatinine Blood test collected within 24 hours of Creatinine Clearance.
All urine testing should be sent to the lab ASAP. If unable to transport right away, refrigerate sample.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
Call Lab for Instructions
11
Testing
Specimen Stability
Expected TAT
What To Collect Collection Device
Critical Care Markers
• Critical Care Panel
• Ionized Calcium
• Lactate
• pH
• Carboxyhemoglobin
• VBG
• Cord Blood Gas
Specimens must be drawn, placed on ice, and sent
to the lab IMMEDIATLEY
• ST- 30 minutes
• TS- 30 minutes
• RT- 30 minutes
1 Dark Green Lithium Heparin Tube Number of Inversions: 8-10
Or Heparinized Syringe
• Needle must be removed, and end capped before sending the sample to the lab
• ABG
Specimens must be drawn, placed on ice, and sent
to the lab IMMEDIATLEY
• ST- 30 minutes
• TS- 30 minutes
• RT- 30 minutes
1 Heparinized Syringe-needle must be removed, and end capped before sending the sample to the lab *Respiratory usually collects these specimens Lab cannot collect these specimens
*Lab does not provide arterial draw kits.
Contact Respiratory Therapy for arterial kits.
• Capillary Blood Gas
Specimens must be drawn, placed on ice, and sent
to the lab IMMEDIATLEY
• ST- 30 minutes
• TS- 30 minutes
• RT- 30 minutes
1 full capillary tube with flea inside. All items for collection of this test are located within the lab. Call the lab when this test is ordered.
Drug Levels (Serum Only)
• Lithium Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full Gold SST Tube Number of Inversions: 5
Drug Levels (Serum/Plasma)
• Acetaminophen
• Digoxin
• Phenobarbital
• Salicylate
• Carbamazepine
• Ethanol
• Phenytoin
• Valproic Acid
• Gentamicin (Random, Trough, Peak)
• Vancomycin (Random, Trough, Peak)
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full: Green Lithium Heparin Tube Number of Inversions: 8-10
Or Gold SST Tube
Number of Inversions: 5
* Green Lithium Heparin Tube Preferred
Drug Screen (Urine)
• Urine Drug Screen (ordered as a panel) All urine testing should be sent to the lab ASAP. If unable to transport right away, refrigerate sample.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
• Sterile Container
*Lab does not provide
arterial draw kits.
Contact Respiratory
Therapy for arterial kits
12
Testing
Specimen Stability
Expected TAT
What To Collect Collection Device
General Chemistries
• Acetone
• Albumin
• Alk Phos
• Amylase
• ALT
• AST
• Bun
• CO2
• CRP
• GGT
• Magnesium
• Uric Acid
• Sodium
• Protein
• Potassium
• Calcium
• Chloride
• Cholesterol
• Creatinine
• Ferritin
• Phosphorous
• Triglycerides
• LDL
• HDL
• Bilirubin (Direct, Total, Total & Direct)
• Glucose (Fasting, Diabetic Screen, 2hr PP, 2hr GTT, 3GTT)
• Panels: o CMP o BMP o Liver Function o Renal Function, o Lipid Profile
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full: Green Lithium Heparin Tube Number of Inversions: 8-10
Or Gold SST Tube
Number of Inversions: 5
* Green Lithium Heparin Tube Preferred
• C3
• C4
• Folate
• Iron
• Rheumatoid Factor
• IgA
• IgG
• IgM
• TIBC
• Vitamin B12
• Vitamin D
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full Gold SST Tube
Number of Inversions: 5
13
Testing
Specimen Stability
Expected TAT
What To Collect Collection Device
Hormones
• TSH,
• T4, Free
• T4, Total
• T3 Free
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full: Green Lithium Heparin Tube Number of Inversions: 8-10
Or Gold SST Tube
Number of Inversions: 5
* Green Lithium Heparin Tube Preferred
• TSH Cascade
• Cortisol, Random
• Cortisol, Baseline, 30 min., 60min (ACTH)
• FSH
• Prolactin
• T3 Total
• PTH
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full Gold SST Tube Number of Inversions: 5
Infectious Diseases
• Hepatitis A/B/C Panel
• HIV Antibody
• Syphilis
• Lyme
• Measles
• Mumps
• Rubella
• Procalcitonin
• Varicella Zoster
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
Hepatitis, HIV, and Syphilis samples are only run M-F between 8am-1pm.
At least 1 full Gold SST Tube for Syphilis
2 full Gold SST Tubes for Hepatitis Testing
Number of Inversions: 5
Random Urine Testing
• Phosphorous
• Protein
• Urea Nitrogen
• Microalbumin
• Calcium
• Creatinine
• Glucose
• Potassium
• Sodium
• Uric Acid
All urine testing should be sent to the lab ASAP. If unable to transport right away, refrigerate sample.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
• Sterile Container
14
Testing
Specimen Stability
Expected TAT
What To Collect Collection Device
Tumor Marker
• Ca125
• CEA
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full Gold SST Tube Number of Inversions: 5
• PSA, Diagnostic
• PSA, Screening
Specimens must be spun within 2 hours of Draw. For best results send to lab ASAP.
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
At least 1 full: *Green Lithium Heparin Tube
Number of Inversions: 8-10 Or
Gold SST Tube Number of Inversions: 5
* Green Lithium Heparin Tube Preferred
24 Hour Urine
• Phosphorous
• Protein
• Urea Nitrogen
• Uric Acid
• Microalbumin
• Calcium
• Creatinine
• Glucose
• Potassium
• Sodium
All urine testing should be sent to the lab ASAP. If unable to transport right away, refrigerate sample
• ST - 1 hour
• TS - 1 hour
• RT - 4 hours
Call Lab for Instructions * All 24-hour urines MUST be refrigerated on kept on ice during the whole collection process
15
Microbiology
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Abscess, Wound, Routine Culture
• C Abscess
• C Wound
• C Routine
• *Orders require a source.
Identifying bacteria responsible for infections
Sterile Container:
• 2 hours Room Temperature
• 24 hours Refrigerated
Swab:
48 hours Room Temp
**For best results, send all samples to
lab ASAP**
3 days
*Gram stain completed within 1 shift
• Sterile Container
• ESwab-White Cap (Most Common)
• ESwab-Green Cap( small sources)
Collect material from actual infection site with minimal contamination from adjacent areas.
AFB Culture
• C AFB
• AFB Culture *Orders require body fluid type or source
Detect the presence of Acid Fast Bacilli in a specimen
Sterile Container:
• 2 hours Room Temperature
• 24 hours Refrigerated
• Negative: 6 weeks
• Positive: Reported when become positive
• Sterile Container
Anaerobic Culture
• Anaerobic with Aerobic Scr. Culture
• C Anaerobe *Orders require a source.
• *Note difference in collection containers for tissues and body fluids.
Detection of bacteria only capable of surviving in oxygen lacking environments
Send to lab Immediately
3 days
*Gram stain completed within 1 shift
Tissues All anaerobic tissues MUST be collected in the small anaerobic jar and CANNOT be placed in the tall, skinny anaerobic vial for fluids.
Body Fluids
All body fluids for anaerobic testing MUST be collected in the tall, skinny anaerobic vial, and should not be placed in the small anaerobic jar meant for tissues.
*Note: Tissue samples
should be in contact
with the media in the
vial
*Do NOT pierce gel.
***Swabs are
not acceptable
collection devices
for anaerobic
cultures
* Do not remove cap.
Open sterile pack,
then pierce rubber
stopper on cap with
syringe to add fluid.
***Swabs are not
acceptable
collection devices
for anaerobic
cultures
16
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Blood Culture
• Blood Culture Testing for septicemia and bacteremia
Bring to Lab ASAP
• Negative: 5 days
• Positive: Called to floor when bottle becomes positive
• Green BacT Alert Aerobic Bottle
• Orange BacT Alert Aerobic Bottle
• Yellow BacT Alert Pedi Bottle (12 yrs. and under ONLY)
Adult: Aerobic: 8-10ml
Anaerobic: 8-10 ml
Pediatric: 0.5-4 ml
Body Fluid Culture
• C Body Fluid
• Body Fluid Culture *Orders require body fluid type
Detect the presence of bacteria in normally sterile body fluids Send to lab
immediately
3 days *Gram stain completed within 1 shift
• Sterile Container
• Red Top Tube
• Syringe with no needle *Swabs are unacceptable*
C- Diff
• C Diff Toxin
• Clostridium Difficile Toxin
Detection of toxogenic C- Diff DNA in liquid fecal specimens
3 days Refrigerated
**For best results, send all samples to lab ASAP**
1 day
• Sterile Container
• White Para-Pak Vial *Formed stools not accepted
CSF Culture
• CSF Culture
• C CSF
Detect bacterial infection or presence in CSF. Often seen in cases of meningitis
Send to lab immediately.
3 days
*Gram stain completed within 1 hour
• Sterile Container
Cryptococcal Antigen - CSF
• CSF Crypt Ag
• Cryptococcal Antigen Scr
Detection of the capsular polysaccharide antigens of Cryptococcus species in CSF
Send to lab immediately
1 hour • Sterile Container
17
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Fungus Culture
• C Fungus
• Fungus Culture *Orders require body fluid type or source
Detect the presence of fungi in a specimen
Sterile Container:
• 2 hours Room Temperature
• 24 hours Refrigerated
• Negative: 6-8 weeks
• Positive: Reported when become positive
• Sterile Container
Fungus Culture
Skin, Hair, Nails
• Fungus Culture Skin, Hair, Nails
Detect the presence of fungi in a specimen
Sterile Container:
• 2 hours Room Temperature
• 24 hours Refrigerated
• Negative: 6-8 weeks
• Positive: Reported when become positive
• Sterile Container
Gardnerella, Trichomonas
and Yeast Probe
• GTY Probe Useful for the detection of Candida, Gardnerella, and Trichomonas in vaginal fluid specimens
72 hours • 1 day
• STAT: 1 hour
• Affirm GTY Kit
GI Pathogen (Previously Stool Culture)
• GI Pathogen PCR
• Stool Pathogen PCR
Detection of:
• Campylobacter
• Salmonella
• Shigella
• Yersinia Enterocolitica
• Vibrio
• Norovirus
• Rotavirus
• Shiga Toxins
Sterile Container: 1-hour Room Temperature
Orange Para-Pak:
48 hours refrigerated
**For best results, send all samples to lab ASAP**
24 hours
• Sterile Container
Orange Para-Pak Vial (preferred)
Group A Strep Culture
• C Strep A
• Group A Strep
Detect the presence of Group A Step
48 hours Room Temperature
**For best results, send all samples to lab ASAP**
3 days • White Cap (Flocked) ESwab
Collect from inflamed throat and/or tonsil area
18
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Group B Strep Culture
• C Strep B
• Group B Strep
Prenatal Screening for Group B Strep colonization
48 hours Room Temperature
**For best results, send all samples
to lab ASAP**
3 days • Green Star Swab II
Collection from vaginal introitus and anorectum
Lactoferrin
• Lactoferrin Screen for fecal leukocytes
Sterile Container or White Para-Pak: Refrigerated within 1 hour of collection. Acceptable 14 days refrigerated
1 day • Sterile Container
• White Para-Pak Vial
MRSA/Staph Screening
• C MRSA
• C Pre-op Staph Screen
Detection of MRSA from anterior nares, groin, and or axilla. Detection of MRSA or MSSA from pre-op anterior nares specimen only. Not intended to monitor treatments
Swab: 48 hours Room Temperature
**For best results, send all samples to lab ASAP**
3 days • White Cap (Flocked) ESwab Only
Rapid Flu A/B
• Rapid Influenza A/B PCR
• Vir Rapid Flu PCR
Rapid detection of Influenza A & B in respiratory specimens
72 hours Refrigerated
**For best results, send all samples to lab ASAP**
1 hour • NP swab only
Rapid RSV
• Rapid Flu/ RSV PCR
• Rapid Influenza A/B and RSV PCR
Rapid detection of RSV in respiratory specimens
72 hours Refrigerated
**For best results, send all samples to lab ASAP**
1 hour • NP swab only
19
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Rapid Strep
• Rapid Strep Strep A Ag
Rapid detection of the Group A Antigen
48 hours Room Temperature
**For best results, send all samples to lab ASAP**
1 hour
• Green Star Swab II
Sputum Culture
• C Sputum
• Sputum Culture *Required source: Endotrach, Sputum Induced, Sputum, Sputum Aspirate, Trach Aspirate
Identifying bacteria responsible for respiratory tract infections
• 2 hours Room Temperature
• 24 hours Refrigerated
**For best results, send all samples to lab ASAP**
3 days
*Gram stain completed within 1 shift
• Sterile Container Expectorated or induced sputum: Collect a deep, vigorous cough, directly into sterile container
Stool Giardia and Crypto
• Giardia/ Cryptosporidium Ag
Detecting Giardia or
Cryptosporidium antigen in feces
Sterile Container: 1-hour Room Temperature
Black Para-Pak:
96 hours
**For best results, send all samples to lab ASAP**
2-3 days • Sterile Container
• Black Para-Pak Vial *Collection kit available upon request from lab
Stool Occult Blood
• Fecal Occult Blood Diagnostic or Screening
• Occ Bld Fec, Dgn, or Scr
• Detection of Hemoglobin in stool samples.
• Often seen in GI Bleeds.
Sterile Container: 1-hour Room Temperature Occult Card:
14 Days Room Temperature
**For best results, send all samples to lab ASAP**
1 day • Sterile Container
• Occult Card
Stool O&P
• O&P Exam
• Ova and Parasite Exam
• Identifying parasites and/or ova in feces
Sterile Container: Fresh stool in
white top must be transferred to black top within
1 hour of collection
Black Para-Pak:
96 hours
**For best results, send all samples to lab ASAP**
2-3 days • Sterile Container
• Black Para-Pak Vial *Collection kit available upon request from lab
20
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Tissue Culture
• Tissue Culture
• C Tissue *Orders require a source.
Detection of bacteria on or in body tissues
• Send to lab Immediately
• Refrigerate only if there is a delay
**For best results, send all samples to lab ASAP**
3 days
*Gram stain completed within 1 shift
• Sterile Container
* DO NOT SEND SWAB OF TISSUE.
Urine Culture
• C Urine
• Urine Culture *Orders require collection type: Clean Catch, Mid- Stream, Cystoscopy, Kidney, Pedi Bag, Suprapubic Asp, Ureteral, NOS
Detection of UTI 24 hours Refrigerated
**For best results, send all samples to lab ASAP**
3 days • Sterile urine container
Virus Detection
• Virus Adenovirus Detection
• Virus Cytomegalovirus Detection
• Virus Influenza & RSV Detection
• Virus Herpes Simplex Detection
• Virus Metapneumovirus Detection
• Virus Parainfluenza Detection
• Virus Varicella Zoster
• Virus VTDH Flu Detection
*Requires Specimen Type
Rapid (qualitative) detection of viruses through PCR
Return to lab within 24 hours
refrigerated
**For best results, send all samples to lab ASAP**
3-5 Days
• NON-Nasopharyngeal/ Body Fluid sites: Adult Virology FloqSwab Collection Kit
• Nasopharyngeal: Wire shaft, polyester tipped swab in Copan sleeve
• Body Fluids: Sterile Container
21
Anatomic Pathology
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Anal-Rectal Cytology (Anal Pap)
• Pathology NON-GYN Request
Evaluation of HPV related lesions in upper anal-rectal mucosa.
Send to lab in timely manner.
Specimen is stable
at room temperature.
1 Day Swab/brush above the anal transformation zone, and swish or clip the brush into NONGYN PreservCyt vial. Single-use Anal-Rectal kits available through the lab.
Body Fluid Cytology
• Pathology NON-GYN Request
Evaluating the presence or absence of malignant cell populations in effusions.
Send to lab immediately
1 Day NO FIXATIVE. Tap effusion. Submit ALL fluid regardless of volume.
Bone Marrow Specimen Evaluation
• Pathology Bone Marrow Request
• Must contact Cytology Dept for assistance x1786
• One order for the aspirate and one order for the core biopsy
Evaluating disorders involving blood and bone marrow.
24-48 hours refrigerated
1-2 Days
(2)-1 mL Sodium Heparin Green (1)- 1 mL K2 EDTA (1)- Formalin container with clot specimen (1)- Formalin container with filter specimen 6 to 9 prepared slides
Breast Lumpectomy or Resection
• Pathology TISSUE Request
Refer to lab with any questions. Extension 1786.
Transport specimen as soon as possible to the lab. Make sure to directly hand the specimen to a laboratory employee and communicate that it is a "fresh specimen.”
24-48 Hours Fresh specimen. NO FIXATIVE.
22
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Brush/ Scrapping Cytology
• Pathology NON-GYN Request
Evaluating possible malignant cell populations in brush/scraping of bronchial tree, gastric mucosa, oral mucosa, tongue scraping, or other surface lesions.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Submit as 2 fixed slides made by rolling the brush across the slide, and rapidly submersing slides in Coplin Jar with 95% ethanol or fix with spray fix. Vigorously swish then clip the brush tip into the Cytolyt tube. Submit slides and Cytolyt tube containing brush tip.
Chlamydia Gonorrhoeae
Testing - Non-
Urogenital sites
• Misc Mayo
• GOKEY MCTGC
Diagnosing Chlamydia trachomatis & Neisseria gonorrhoeae infections in Throat, Oral, Rectal or Eye specimens
Swab: 30 days at 2-30°C
1-3 Days Blue Swab Only: Discard White Swab. Use Blue Swab Only. Swab site and place in transport tube. Snap off swab at score line to fit inside tube. Securely fasten cap.
Aptima Swab Collection Kit
Chlamydia Gonorrhoeae
Testing - Urogenital
sites
• CT PCR
• NG PCR
• Chlamydia Gonorrhea PCR Panel
Diagnosing urogenital Chlamydia trachomatis & Neisseria gonorrhoeae infections in male and female.
1. Urine: 24 hours refrigerated (male or female) 2.Vaginal swab: 60 days at 2-30°C (female only) 3. PreservCyt Pap Test Co-collection: 60 days at 2-30oC (female only)
1-2 Days 1. Urine: (male or female) Collect first 30 mL of NON-Clean Catch (Dirty) urine, at least 2 hours post previous urination. 2. Vaginal swab: (female only) Use Uni-swab PCR Collection Kit, swab vaginal canal without prior cleaning. Submit swab in the collection tube, snapping it off at the demarcation line. 3. PreservtCyt Pap Test: (female only) Collect as for Pap test with
an endocervical broom/spatula, vigorously swish into ThinPrep vial, discard collection device.
Vaginal Swab Collection Kit
PreservCyt ThinPrep Urine Collection Vial Cup
23
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Core Needle Biopsy:
Breast, Liver, Kidney, etc.
• Pathology TISSUE Request
Routine Pathology. Transport specimen as soon as possible to the
lab
24-48 Hours • Tissue Sample added to container with formalin.
• Record time specimen enters container on patient label.
CSF Cytology
• Pathology NON-GYN Request
Evaluating the presence or absence of malignant cell populations in Cerebrospinal Fluid.
Send to lab immediately
1 Day Tapped CS Fluid. Submit as fresh.
Cytogenetics on Bone Marrow
Specimen
• Bone Marrow Request Must contact Cytology Dept for assistance x1786
Evaluating genetic abnormalities associated with various diseases.
24-48 hours refrigerated
> 5 Days
Testing Performed at Mayo Medical
Labs
(2)-1 mL Sodium Heparin Green
OR
(2)- 2 mL bone marrow OR
Tissue in RPMI (RPMI located
in Histology refrigerator).
Cytogenetics on NON Bone
Marrow Specimen
• Cytogenetics
Evaluating genetic abnormalities associated with various diseases.
24-48 hours refrigerated
> 5 Days
Testing Performed at Mayo Medical
Labs
(1)-1 mL Sodium Heparin Green Peripheral Blood only
Eosinophil Evaluation
• Pathology NON-GYN Request
*Please specify in Order Comments tab whether testing request is for "eosinophils only" or "eosinophils and cytology"
Detection of eosinophils in fluid specimens.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Submit as fresh or with Cytolyt fixative.
24
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Flow Cytometry on Bone Marrow
Specimen
• Bone Marrow Request
• Must contact Cytology Dept for assistance x1786
Evaluating disorders involving blood and bone marrow.
24-48 hours refrigerated
1-2 Days
Testing done at UVMMC.
(2)-1 mL Sodium Heparin Green AND
(2)-2 mL EDTA Lavender
OR
Tissue in RPMI (RPMI located in Histology refrigerator)
Flow Cytometry on
NON Bone Marrow
Specimen
• Flow Cytometry
Evaluating disorders involving blood and bone marrow.
24-48 hours refrigerated
1-2 Days
Testing done at UVMMC.
6 mL Sodium Heparin Green for Peripheral Blood
OR 1.5 mL CSF
OR 5 mm3 or larger tissue biopsy in RPMI
(RPMI located in Histology refrigerator Must call to obtain)
FNA Cytology (Fine Needle Aspiration)
• Pathology FNA Request
Evaluating the presence or absence of malignant cell populations in palpable or imaged lesions.
Send to lab in timely manner.
Specimen is stable
at room temperature.
1 Day Generally, 1-3 needle passes, submitted as fixed material. Cell Blocks can be made from generous sampling for confirmation/typing stains (specimen material should be visible in the Cytolyt tube). Each pass should contain Preferred: 1. One Labeled, direct-smear slide dropped, while wet, into a Coplin Jar filled with 95% alcohol. 2. One labeled, direct smear, spreader slide allowed to air dry. 3. Needle rinse material in CytoLyt collection tube. Acceptable: 1. One Cytolyt tube with contents of each pass expressed directly into media.
Fresh Specimen:
Lymph Node
Suspicious for
Lymphoma
• Pathology TISSUE Request
Anything other than Routine Pathology. Example: lymph nodes, looking for lymphoma.
Transport specimen as soon as possible to the lab. Make sure to directly hand the specimen to a laboratory employee and communicate that it is a "fresh specimen.”
24-48 Hours Fresh specimen. NO FIXATIVE.
25
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Frozen Section
• Pathology TISSUE Request
*Place order in Cerner stating frozen section needed BEFORE the specimen is sent to pathology. * Must Include Form #1275 Intraoperative Consultation Request
Immediate diagnosis.
Transport specimen as soon as possible to the lab. Make sure to directly hand the specimen to a laboratory employee and communicate that it is a "frozen specimen.”
20 Minutes Fresh specimen. NO FIXATIVE.
GYN Pap Test Cytology with HPV Detection
• Pathology GYN Request
HPV reflex testing options include:
• HPV if ASC/LSIL
• HPV Co-testing Reflex Genotype
Screening detection for squamous cancer or precursors and molecular detection of HPV in cervical, endocervical, and vaginal brushings.
60 Days from collection at Room
Temperature
3 to 5 Days Endocervical brush/spatula, vigorously swished into ThinPrep PAP Test vial, discard brush/spatula. Single-use collection kits available through the lab.
Hemosiderin Evaluation
• Pathology NON-GYN Request
*Please specify in Order Comments tab whether testing request is for "hemosiderin-macrophages only" or "hemosiderin- macrophages and cytology".
Detection of hemosiderin-laden macrophages in fluid specimens.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Submit as fresh or with Cytolyt fixative.
HPV Detection with Reflex to
Pap Test Cytology
• HPV Primary Screen Alternative screening algorithm for detection of squamous cancer or precursors and molecular detection of HPV. For women >25 yr. Cytology is performed only if HPV result is HPV HR Other Positive.
60 days from collection at 2-
30oC
1-3 days Endocervical brush/spatula in a ThinPep Vial, discard brush/spatula.
26
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Nasal Cytogram
• Pathology NON-GYN Request
Differentiation of allergic, non-allergic, infectious, inflammatory, and non-inflammatory forms of rhinitis
Send to lab in timely manner.
Specimen is stable
at room temperature.
1 Day 1 air-dried slide in a slide holder and 1 CytoLyt tube containing the Rhino-probe.
PJP (Pneumocystis
Jiroveci Evaluation)
• Pathology NON-GYN Request
*Please specify in Order Comments tab whether testing request is for "PCP only" or "PCP and cytology".
Detection of PJP (formerly PCP) in respiratory specimens.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Submit as fresh or with Cytolyt fixative
Sputum Cytology
• Pathology NON-GYN Request
Evaluating the presence or absence of malignant cell populations in sputum.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Deep cough expectorate. Do not have patient spit. Submitted as fresh or with Cytolyt fixative.
Tissue Specimen:
• Temporal artery
• Wound biopsy
• Skin Biopsy
• Vasectomy
• Pathology TISSUE Request
Routine Pathology.
Transport specimen as soon as possible to the
lab
24-48 Hours • Tissue Sample added to
container with formalin.
• Record time specimen enters container on patient label.
27
Cerner Order Name Useful For
Specimen Stability
Expected TAT
What to Collect Collection Device
Tzanck Prep or Varicella
Zoster
• Pathology NON-GYN Request
Detection of cellular change associated with varicella virus in surface lesions/blisters.
Send to lab in timely manner.
Specimen is stable
at room temperature.
1 Day Directly scrape the blister/lesion base, spread onto 1 air dried slide, vigorously swish the collection device in the PreservCyt vial, discard collection device. Submitted slides AND PreservCyt vial. Single-use Tzanck Prep kits available through the lab.
Urine Cytology
• Pathology NON-GYN Request
*Must Specify voided urine, catheterized urine or bladder wash
Evaluating the presence or absence of malignant cell populations in voided urine, catheterized urine, and bladder washes.
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Clean-catch midstream urine, or catheterized-urine, or wash collection. Make sure to specify the collection type on the label. Can be submitted as fresh or with up to 30mL of Cytolyt fixative.
Wash Cytology
• Pathology NON-GYN Request
Evaluating the presence or absence of malignant cell populations in washes (bronchial, abdominal, etc.).
Transport as soon as possible or
refrigerate with Cytolyt.
1 Day Submit as fresh wash collection or mixed with Cytolyt fixative.
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