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Archive for the ‘Labs’ Category

Lab Update

Dear Colleagues,

I would like to provide you with general information about ordering laboratory tests and getting results of those tests from our clinical laboratories at Mount Sinai. Here is a list of questions that are most frequently asked of our lab staff, together with our answers. I hope you will find them useful. You can also find this list at our new laboratory website: www.mssm.edu/labmed under ‘FAQs for Practitioners’ – http://www.mssm.edu/research/labs/laboratory-medicine/faqs-for-practitioners

If there are other questions that you think might be appropriate to add to this list, or if you would like us to answer your questions pertaining to labs in general, please do not hesitate to contact us.

Best regards,
Ila Singh

Ila Singh, MD, PhD
Vice Chair, Clinical Pathology
Director of Clinical Laboratories
Professor of Pathology
Mount Sinai Medical Center
(212) 659-8181
www.mssm.edu/labmed

Where is my specimen right now?
Click on Chart Review in EPIC and look at the ‘Status’ column. You will see the following status updates.
Standing = Ordered, but not yet released
Ordered or Needs To Be Collected = ordered and released, but not collected
Collected (Date/Time) = collected, but not in lab yet;
In Process = specimen in the lab system
Final result = test completed and verified
Edited = result updated after going to ‘final’ status
Open an order for more details.
How do I see ALL results in EPIC?
In Chart Review mode, check both LAB and MICRO tabs. Also, deselect ‘hide cancellations’ box.
How do I add-on a test to an existing sample?
Most routine chemistry tests can be added on up to 5 days after receipt of the original sample. BNP, lactate and ammonia are very unstable and cannot be ordered as add-ons. Add-ons for coagulation testing should be requested within 4 hours of original draw. Specimen type of add-on must match specimen type in the lab. Add-ons can be requested in EPIC [new order-priority “add-on”], or faxed to 212-987-0038 (ATTN: ADD-ONS), or phoned in to 4LABS.

Is there a way to figure out the correct tube to collect blood for each test?
For most common tests, go to: http://www.mssm.edu/research/labs/laboratory-medicine/blood-collection/common-test-and-tube-types
For other tests, please check the test directory. For now this is available only on the intranet. But starting early next year, we will roll out a different version that you will be able to access in many different ways.
Why is my test canceled? How do I avoid sample rejection?
Quantity not sufficient (QNS): Always allow tubes to fill completely. Collect a tube for each label generated. If the volume of blood drawn is small, clearly indicate the order of priority for tests, if ordering on paper – otherwise call 4LABS.
Clotted: Draw blood into tube with proper anticoagulant and mix immediately by gently inverting ten times.
Hemolyzed: Increase needle gauge if possible. If transferring from syringe to tube, inject blood slowly into tube.
Contaminated: Draw specimen from arm not used as IV site. Follow correct order of draw (blood culture bottles, gold, blue, green, lavender, pink, pearl, grey). Use correct tube type. Tests results are not valid if sample is drawn in an incorrect tube and switched to the correct tube.
Auto-cancellation: If 72 hours after order-placement, a specimen is not received in the lab, the order is canceled by the lab system.

When and how do I collect blood for culture?
Obtain sample before starting antibiotic therapy, or just before the next scheduled dose. Send two blood culture sets from two separate venipunctures, 15-60 min apart. Standard blood culture bottles will grow bacteria and yeast. If suspecting mycobacteria or dimorphic fungi, use an Isolator™ tube or an SPS containing collection tube. Prior to collecting blood for culture, follow correct skin cleaning procedures using chlorhexidine-swabs; do not repalpate vein after cleaning skin.
Should I send an aspirate/fluid or a swab?
For optimal organism recovery, aspirates and fluids are best. Send swabs for throat, surveillance, nasal, ear & genital specimens ONLY.
When should I order Antibiotic Susceptibility Testing (AST)?
When a culture is positive, AST is performed when feasible. An MIC and interpretation is provided if criteria exist for that organism/antibiotic/body site. Susceptibility tests on yeasts and anaerobes are by request only.
When do I need to order a stool culture?
Stool culture for enteric pathogens is performed only during the first 3 days of admission. Stool specimens for Ova & Parasites are accepted only during the first 3 days of admission, unless the patient is immunocompromised.
How do I order testing for C. difficile?
This test is performed only on loose stools (stools that take shape of container). Testing is not repeated within 7 days of a negative specimen and within 14 days of a positive specimen. Send directly to Microbiology Tube Station 74.
How do I find out more about our labs?
Go to the lab website www.mssm.edu/labmed
Information on this site is updated often.

How do I contact the labs?
Laboratory staff is available 24/7 by phone. Call 4-LABS (212 241-5227). You can also find Email addresses of lab directors on our website: www.mssm.edu/labmed

Written by phil

October 8th, 2012 at 9:16 pm

Posted in Labs

Extra CSF

with one comment

Written by reuben

June 29th, 2012 at 3:42 pm

Posted in Labs