Endocrinology Submission Guidelines

July 4, 2024, 9:00 pm

Is it necessary to include a comment on the patient report indicating that a test result was obtained after dilution? January 2014—I read a question and answer in the April 2001 CAP TODAY about platelet clumping on EDTA and whether vortexing is an acceptable procedure. 10) If blood gases analysis cannot be analyzed within 30 minutes, why should the health care worker use an airtight container with icy water to transport the arterial specimen? What is the substitute test for HbA1c for a patient with homozygous variant hemoglobin? Are there any FDA-approved laboratory-developed assays or point-of-care assays for detecting oxycodone or fentanyl in urine or blood? Assays that require a chilled specimen include the following. This log book format can be used to monitor delayed or missing information and track turnaround times. How do you calculate the correction factor for blood drawn in an ACD tube? Many medications have been shown to have long-term residual effects that interfere with testing. Does this protocol fulfill CAP checklist requirements? If the specimen is hot or cold to the touch but not obviously hemolyzed or frozen, it should be noted on the log and report forms, but the specimen should still be tested. A misidentified or mislabeled specimen should not be tested, and the cause of misidentification should be determined so that corrective actions can be implemented to prevent future problems.

Assays That Require A Chilled Specimen Include Different

However, staff do not have a way to document that a result was read back. Students also viewed. Fasting or diet restrictions, such as low-fat diets, should be explained in detail, particularly to aged or overanxious patients or their caregivers. Provide a 24-hour urine volume when an aliquot from the 24-hour collection is submitted. Specifically, glycerol containing tubes should not be used when measuring triglycerides because most assays require triglycerides hydrolysis to glycerol and contamination from the lubricant will falsely elevate triglyceride levels. Collection and Submission of Laboratory Samples from Animals - Clinical Pathology and Procedures. Smears of fluid can be prepared using a traditional blood smearing technique. ALK gene rearrangements (the most common of which results in expression of the EML4-ALK fusion protein) are found in approximately five percent of lung adenocarcinomas, and these ALK-rearranged tumors show marked clinical response to the tyrosine kinase inhibitor More ».

Assays That Require A Chilled Specimen Include All Except

Slicing the brain into widths suitable for rapid fixation introduces considerable fixation artifact and should be avoided if possible; fixing the intact/halved brain in a large volume of formalin for >24 hours is preferred. Standard operating procedures (SOPs) should be developed for instrument use and maintenance at each level of laboratory according to the manufacturer's protocol, with adaptations based on the specific situation in the testing facility. This requirement is important in order to achieve the proper blood-to-additive ratio; otherwise, the specimen may be found to be QNS. Slide 7: Separator gels are made from viscous liquids that contain gelling agents such as dibenzylidene sorbitol. Quality Management Systems Approach for CD4 Testing in Resource-Poor Settings | American Journal of Clinical Pathology | Oxford Academic. Whole blood specimens used in CD4 assays have a tendency to clog or partially block the tubing of the instrument. The improvements in HIV diagnosis, care, and treatment result in a continual rise of the absolute number of people living with HIV who must be monitored. What specific regulations regarding the use of this test, quality control, and proficiency testing apply when performing this test on patient specimens? As an example, a scant growth of Micrococcus was isolated and reported from a cerebrospinal fluid culture; it was not seen in the Gram stain and was negative for leukocytes. If there is doubt about sample submission procedures, the laboratory should be contacted. The patient is directed to form a fist and the needle is introduced at a 30 degree angle or less.

Assays That Require A Chilled Specimen Include Path

Blood gases, pH, electrolytes, and ionized calcium should be measured on heparinized sample but not sodium if sodium heparin is the additive, as this would result in false elevation of sodium. However, depending on the method of staining used, some laboratories prefer alcohol-fixed smears. Do we need to stick with a single PT provider for one year before switching? Is a tube containing EDTA suitable? A system should be in place to rapidly transport or communicate CD4 results to the health care provider, through a courier service that could transport hard copies of the results or through a networked electronic or telephone-based system. 30100 relate to point-of-care testing? In addition, complete clotting of blood typically takes 30 minutes, which impacts test turn-around time. First, a blood specimen is drawn from a fasting patient. What is the clinical significance of increased lymphocytes in esophageal biopsy? Air bubble introduction during sample draw is another preanalytical issue to consider. Two Refrigerant Bottles. Assays that require a chilled specimen include path. November 2021 Q. I am a nurse in a cardiac cath lab that performs point-of-care testing, including for activated clotting time.

Assays That Require A Chilled Specimen Include Espn

When performing reagent lot-to-lot correlation studies, some staff believe it is better to perform instrument calibration before a new reagent lot check while others believe calibration is not necessary. If CD4 testing is new to the laboratory, precision could be estimated by replicate testing of patient specimens and accuracy assessed by comparison of samples from a more experienced laboratory or those from quality control (QC) material and proficiency test panels. Use of this relatively rapid and inexpensive diagnostic technique can often result in substantial savings in time, money, and animal life. Is documenting a read-back necessary when critical results are communicated verbally? 2) Blood clots are visible. The draw site is cleaned with a cotton swab saturated with 70% alcohol and the tourniquet is tied 4-6 inches above the draw site. Assays that require a chilled specimen include different. Unstable power supplies can damage or compromise the components of the CD4 instruments. Avoid fist clenching as this causes an increase in plasma potassium. Since the tumor is in the mediastinal fat around the bronchi and had to invade the viscera pleura to invade the peribronchial adipose tissue, would the tumor stage be ypT2a? Can you clarify the PT requirement, if any, for this situation? There are 2 important caveats concerning use of reagents: (1) reagents that are past their expiration date must never be used for testing patient specimens, and (2) reagents are specific for each instrument and, therefore, must never be used for testing on a different instrument. Are you aware of any reference that would list absurd or invalid values for such analytes, i. e. the endpoint that would determine the most dilutions we would have to do for the highest possible value for that analyte? Slide 10: Lavender tops contain potassium EDTA coated onto the tube wall.

Assays That Require A Chilled Specimen Include The Following

Is there a resource that provides a list of tissue-related quality metrics that we can evaluate? September 2017— I received a sample with very high hemoglobin grossly. Ectoparasites or nematodes being submitted for identification should be submitted in vials containing 70% alcohol. CD4 specimens are not often retested because of the time constraints required to accurately test whole blood specimens. What are the consensus recommendations for the diagnosis of eosinophilic esophagitis, eosinophilic gastroenteritis, and eosinophilic colitis? This policy has been difficult for hospital staff, and I feel terrible for patients who get stuck numerous times. As with most molecular techniques, aseptic collection and the prevention of cross-contamination between samples is critical for reliable test results. Bilirubin and B6What Specimens other than blood need to be transported by health care workers? These samples should be shipped chilled but not frozen. This applies to both the last tube collected during a routine venipuncture and to tubes collected during a difficult procedure. For example, if TAE for platelets (based on reading control material 20 times) is less than 25 percent (a CLSI recommended value), we accept the target range; otherwise, we reject it. We are hesitant to evaluate these biopsies for transplantation purposes due to frozen section artifacts and because we send all of our kidney biopsies performed by local nephrologists to a reference laboratory and do not evaluate kidney biopsies. A second sample should be collected into a serum (red-top) tube if any biochemical analyses (eg, triglyceride, cholesterol, lipase for chylous effusions) are to be performed or if a bacterial culture is desired (eg, joint fluid). Causes and prevention are discussed under the section on hemolysis.

Assays That Require A Chilled Specimen Include Three

Slide 4: A number of other preanalytical collection, transport, and processing errors exist that I have listed on this slide. To establish in-laboratory ranges, at least 20 measurements of the QC materials should be performed over a period of time. Our lab has an old procedure for ACD correction, and it is to divide the RBC of the EDTA tube by the RBC count of the ACD tube. Because lipemia can interfere with a number of chemistry tests, dogs and cats should be fasted for 12 hours before samples are collected. June 2014—Treatment with rasburicase seems to affect the uric acid analysis. Avoid lipemia: cloudy or milky serum sometimes due to the patient's diet (discussed under the section on lipemia).

February 2018—I come from a core (hematology/chemistry) background, and I would like practical, how-to guidance in developing an effective QC strategy for HIV viral load testing. In the scar there is residual carcinoma (0. In our hospital, respiratory therapy runs most of the blood gas tests on instruments in centralized locations. At what level or time is aPTT considered incorrect? Alternatively, several representative samples (7 mm wide, including the interface of normal and abnormal) may be collected. Slide 17: Disclosures. Then, the patient is given glucose orally and blood specimens are drawn at fixed intervals. Too much pressure in drawing blood into a syringe or forcefully ejecting blood into a collection tube from a syringe may damage red cells. 1 after counting tube No. Serology generally requires serum, but plasma is often satisfactory. To this end, the Clinical and Laboratory Standards Institute (CLSI) has developed guidelines to standardize the order of blood draw. Blood glucose determinations may be ordered at a specific time to check the effect of insulin treatment. Not all QC materials can be used on all instruments, so QC materials should be selected on the basis of compatibility with the equipment in use in the testing laboratory.

If a syringe is used, whole blood must be immediately placed in the EDTA tube to avoid clotting. It should also be noted that EDTA containing tubes should be avoided if the assay requires divalent cations. This log should be reviewed periodically to check for trends, and any technical errors that are identified should be immediately addressed. Specifically, should immunohistochemical stains for the mismatch repair enzymes be performed on all colorectal adenocarcinomas regardless of the clinical or pathological findings? Blood drawn into a collection device continue to undergo metabolism, thereby consuming glucose, and continue to pump K+ into the cells and Na+ out of the cells. Whole blood should not be frozen because this causes cell lysis and gross hemolysis, which interfere with testing. For therapeutic drug monitoring, samples are generally drawn at trough but peak or random draw may be indicated for some drugs. Clean water is required for hand washing and maintaining a sanitary workplace. Add the preservative (as specified in the test requirements) to the urine collection container prior to collection of the specimen if the preservative is not already in the container. The activated partial thromboplastin time (APTT) clot-based assay is a global test used to detect factor deficiencies in patients with a bleeding diathesis or as a preoperative screen to ensure normal coagulation laboratory parameters before an invasive More ». The gel-barrier tube is an additive tube and should be inverted five to six times after collection. In the gray top tube, lactate is stable for up to 8 hours at room temperature.

The guidelines list requirements essential for providing accurate and reliable CD4 test results in the areas of laboratory environment; human resources; equipment and equipment maintenance; reagent procurement, storage, and inventory; specimen collection and transport; quality monitoring; CD4 testing and reporting; and EQA.