D.6 PALMS Collection Manual_508.pdf

John D. Dingell VAMC GEN023 Detroit, MI

Pathology and Laboratory Medicine Service

Specimen

Collection Manual

What’s Inside:

Laboratory Department Contact Phone

Numbers

Specimen Submission Requirements

Lab Test Turn Around Time

Specimen Collection Information

Nabiha Khoury, M.D.

ACOS, Pathology and Laboratory Medicine

Service

LABORATORY COVERAGE

Monday Thru Friday

8:00 AM TO 4:30 PM Full Coverage, All Departments

4:30 PM TO 8:00 AM Limited STATS and Selected Tests

Saturday, Sunday, and Holidays

8:00 AM TO 4:30 PM Limited STATS, Pre-Op and Selected Tests

4:30 PM TO 8:00AM Limited to STATS, and Selected Tests

GOT A QUESTION?

Please call us!

General Information - ext. 63411 ( 8:00 a.m. -4:30 p.m.)

ext. 65066 (after 4:30 p.m. - 8:00 a.m.)

Clinical Laboratory Information - ext. 63411, or 63861

Anatomical Pathology Patient Information - ext. 63414

(8:00 AM to 4:30 PM Monday-Friday)

Routing Symbol - (11LAB)

Section I. General Laboratory Information Page

A. Staff Listings 5 - 6

B. STAT Test List 7 - 8

C. Out-Patient Drawing Room 9

D. Collection of In-Patient Specimens 10

E. Phlebotomy Techniques 11

F. Specimen Containers 12 - 15

G. Specimen Labels 16 - 17

H. Therapeutic Drug Levels 18 - 20

Section II. Specific Test Information

Alphabetical listing of all in-house tests and most commonly requested send-out 21 - 57 tests with submission requirements, laboratory contact phone numbers, and normal values.

Section III. Appendices

Appendix A - Collection of Microbiology Specimens 58

a. AFB Blood Cultures 59

b. AFB Smears & Cultures (Other than Blood) 60

c. Anaerobic Cultures 61 - 62

d. Blood Cultures 63 - 64

e. Bronchoscopy Protocol 65

f. Chlamydia, EIA 65 - 66

g. Culture and Susceptibility 67 - 69

h. Fungal Cultures 70 - 72

i. Gonococcal Cultures 72 - 73

j. Parasite Examinations 74

k. Viral Cultures 74

l. MRSA Specimen Collection Protocol 75

TABLE OF CONTENTS

Section III. Appendices (continued) Page

Appendix B - Collection of Surgical and Cytology Specimens for Anatomic Pathology 76

a. General Specimen Submission Guidelines 77

b. Histology 78 - 79

c. Ordering Cytology Consults 79

d. Cytology 79-80

e. Fine Needle Aspirate 81

f. Specimen Submission Guidelines for Specific Procedures 81

1) Muscle Biopsy 81 - 82

2) Nerve Biopsy 82

3) Renal Biopsy 82-83

4) Bullets and Other Legal Evidence 83

Appendix C - Autopsy 84 - 85

Appendix D - Glucose Tolerance Test 86- 87

Appendix E - Critical Test Results 88 - 92

TABLE OF CONTENTS (continued)

Pathology and Laboratory Medicine Service Staff

ACOS – Nabiha Khoury, M.D.

Laboratory Manager - Susie Seeley, MT(ASCP)

Secretary - Alison Tilles

Michele Pier

ADPAC –Joseph Masson, MT(ASCP)

Ancillary Testing/ Edu. Coord. - Askar S. Askar, MT(ASCP)

Quality Assurance/Safety Coord. – Teri Caine, MT(ASCP)

Staff Pathologists:

Paula Sochacki, M.D.

Edi Levi, M.D.

Luzette Habib, M.D.

Kinda Hayek, M.D.

Anatomical Pathology (Surgical, Cytology, Autopsy)

Director – Kinda Hayek, M.D.

Autopsy Room

Histopathology Lab

Blood Bank

Director - Paula Sochacki, M.D.

Supervisor – Nita Bhagat, MT(ASCP)cm

Blood Drawing Room (Open Monday - Friday only)

7:30 AM to 4:30 PM

Supervisor - Nita Bhagat, MT(ASCP)cm

PHONE

64403

63900

63400

63487

65070

63693

65050

65049

63428

63407

64403

65203

63414

65049

65030

63675/ 65083

65030

ROOM

C4465

C4459

C4464

C4464

C4423

C4456

C4452

C4451

C4466

C4461

C4465

LL274

C4445

C4453

C4530

C1849

C4530

Pathology and Laboratory Medicine Service Staff

Chemistry/Serology

Director - Paula Sochacki, M.D.

Supervisor - Maria Bonot

Lead Technologist - Parul Patel, MT(ASCP)

Send-Out Testing

Hematology

Director - Luzette Habib, M.D.

Supervisor - Francina Knall, MT (ASCP)

Lead Technologist– Nicole Johnson CLS (ASCP)cm

Microbiology

Director - Nabiha Khoury, M.D.

Supervisor - Tracey Resendez-Clavon, MT(ASCP)

Lead Technologist - Markita Meeks, MT(ASCP)

Flow Cytometry/ Molecular Pathology

Director - Luzette Habib, M.D.

Technologist - John Frank, MT(ASCP)

Uncommon Tours

Supervisor - Brenda O. Jordan, MT(ASCP)

PHONE

64025/ 65218

65049

65080

65079

63415

65066

65065

63423

63691/ 63692

64403

63146

65678

ROOM

C4420

C4451

C4420

C4420

C4401

C4426

C4426

C4426

C4500

C4465

C4500

C4498

STAT TESTING LIST

NOTE: Tests not on this list that are requested as “STAT” must be approved by a pathologist

BLOOD BANK

▪ Crossmatch and Blood Typing

MICROBIOLOGY

▪ Gram Stain for G.C. and Normally Sterile Sites (24 hours/day)

COAGULATION

▪ Prothrombin Time (PT) ▪ Activated Partial Thromboplastin Time (PTT) ▪ Fibrinogen ▪ D-Dimer

▪ Fibrin Split Products (FDP or FSP)

HEMATOLOGY

▪ CBC ▪ Fluids for Cell Count and Differential

▪ Cryptococcal Antigen Test ▪ HCG (Pregnancy Test)

STAT TESTING LIST

CHEMISTRY

▪Albumin ▪ Alkaline Phosphatase (ALKP) ▪ ALT/ SGPT) ▪ Ammonia ▪ Amylase ▪ AST/ SGOT ▪ Basic Meta-bolic Panel ▪ Blood Gases ▪ Blood Urea Nitrogen (BUN) ▪ BOHB ▪ Calcium ▪ Chloride ▪ Carbon Dioxide (CO2)

▪ C. Bili ▪ CKMB Panel ▪ Creatinine ▪ Creatine Kinase (CK) ▪ CSF Protein

▪ D. Bili ▪ Glucose ▪ Inorganic Phosphate (PO 4) ▪ Lactic Acid ▪ Lactate Dehydro-genase (LD) ▪ Lipase ▪ Lithium ▪ Magnesium ▪ Potassium ▪ Sodium ▪ T. Bili

▪ Troponin-T, High Sensitivity ▪ Uric Acid

CHEMISTRY/TOXICOLOGY

▪ Ethyl Alcohol ▪ Carbamazepine ▪ Phenytoin

▪ Digoxin ▪ Valproic Acid ▪Vancomycin

▪ Urine Drug Screen

URINALYSIS

▪ Urinalysis

▪ Fecal Occult Blood

OUT-PATIENT BLOOD DRAWING ROOM

I. HOURS OF OPERATION

A. 7:30 a.m. to 4:30 p.m. Monday through Friday

II. PATIENT PROCEDURE

A. Each patient MUST have a card supplied by the ward/clinic containing his/her name, social security #, order #, and test (s) requested for blood draw.

B. Patients will report to the BLOOD DRAWING ROOM C1849 and take a number from the dis-penser.

C. Each patient will be taken according to his/her number from the dispenser.

D. Patients will be rejected if:

1. Patient arrives too late to complete a timed test.

2. Doctor must collect specimen (specimen must be obtain from area other than the arm or hand).

3. It is impossible to resolve an unclear request via the telephone with ward/clinic.

III. THE DOCTOR MUST COLLECT THE FOLLOWING SPECIMENS:

A. Swabs, throat or wound

B. Sperm counts

C. Dark field for syphilis

D. Blood specimens from amputees without arms

E. Urine, fecal or sputum specimens from paralyzed patients

F. Blood specimens that cannot be drawn from the arm

COLLECTION OF IN-PATIENT SPECIMENS

I. VIA COLLECTION LIST: ONLY BLOOD COLLECTED !!

A. Unit orders for collection list must be entered into the computer by:

1. 5:00 a.m. on the day of collection for the 7:00 a.m. draw

2. 11:30 a.m. on the day of collection for the 1:00 p.m. draw

B. Sunday through Saturday between 7:00 - 8:00 a.m. and 12:30 - 1:30 p.m. blood will be collected on the units by laboratory personnel. Any other blood collection after these two draw times will be drawn by the unit staff.

C. On Saturday, Sunday & holidays, only those tests indicated on the STAT test list should be requested because ward collection personnel are extremely limited and the blood drawing room is closed.

II. AFTER 7:30 AM

A. Monday through Friday ambulatory patients may be sent to the drawing room (C1849) until 4:30 PM.

B. Saturday, Sunday, & Holidays -- must be drawn by unit.

III. OTHER

A. Pre-operative specimens and requests should be in the lab by:

1. Day PRIOR to surgery

2. 9:00 p.m. Monday through Friday except Blood Bank (always 1:00 p.m.)

3. 1:00 p.m. Saturday and Sunday

B. Biopsy and cytology specimens must be in Histology by 3:00 PM Monday through Friday for processing.

C. Autopsy permits with appropriate patient charts must be in the Pathology Office (C4464) before 1:00 PM Monday - Friday in order for the autopsy to be performed that day.

PHLEBOTOMY TECHNIQUES

Supplies needed:

A. Gloves MUST be worn while drawing patient (change between each patient) B. Clean tourniquet C. Sterile alcohol swab, cotton balls and/or gauze, tape D. Proper gauge needles E. Vacutainer tube holder or syringe F. Correct vacuum tubes for the test(s) ordered

1. Verify each patient using two forms of identification prior to collection:

A. Have patient state his/her full name and compare to lab requests and hospital identification band. Do NOT prompt the patient by stating his/her name first.

B. Have the patient state his/her full social security number and compare to lab requests and hos-pital identification band.

C. Other forms of identification are: verification of patient’s identity by Nursing staff.

2. Attach needle to syringe or vacutainer tube holder.

3. If using a syringe, pull back gently on the plunger in order to insure proper function. If using a vacutainer tube holder, push the collection tube into the holder until it reaches the guide mark.

4. Examine both arms of the patient.

5. Apply tourniquet to arm and select vein by palpation.

6. Clean area with a sterile alcohol swab. Let it dry. Do not touch the area again.

7. While holding the skin tight, insert the needle bevel side up into the vein. (A small amount of resistance is felt).

8. After entering the vein, carefully push tube all the way onto the needle. (Tube will automatically fill). As each vacuum tube is filled, gently twist off each tube and replace with another until all samples have been collected. Gently invert 4 to 5 times all collected tubes with an anticoagulant.

9. Release tourniquet and lightly cover area with a sterile dressing while withdrawing the needle.

10. Ask patient to apply pressure to the dressing.

11. Transfer blood from syringe to appropriate vacuum tubes by inserting needle through the cap and touching it to the sidewall of vacuum tube. DO NOT FORCE BLOOD INTO TUBE BY DEPRESS- ING THE SYRINGE PLUNGER!!!! Allow the vacuum in the tube to draw in the blood.

12. Label all tubes in front of the patient. Make sure that each label has the patient’s full name, full social security number, order #, and signature and date , if required.

13. Re-examine patient’s arm for trauma and ask how he/she feels. If patient feels faint or ill, notify a nurse or doctor. If patient is fine and not bleeding from the site, apply gauze to the site and tape.

Order of Draw for Blood Collections

Blood Cultures—Blood Cultures should be collected before any other la-boratory tests that may have been requested by a provider. It should be a separate venipuncture from the other tests to ensure adequate sample in each bottle. There should be a minimum of 5 ml and no more than 10 mL of blood in each bottle. The second set of blood cultures should be drawn in a different venipuncture site and submitted to the lab within 24 hours of the first set.

Light Blue Top Tube –3.2% Sodium Citrate; Plasma collection; Coagula-tion tests. Gently invert after collection 4-6 times.

Red Top Tube— No additives; Serum collections and various Send Out tests. If a light blue top tube is the only tube requested and a but-terfly is used for the collection, a red top tube must be collected first in order to clear the air from the tubing of the collection set.

Gold Top Tube - Gel Separator; No additive; Serum collection.

Green Top Tube - Sodium Heparin; Plasma collection; and Lactic Acid;

Gently invert after collection 4-6 times.

Light Green Top Tube– Lithium Heparin; Troponin-T, High Sensitivity;

Gently invert after collection 4—6 times..

Lavender Top Tube - EDTA; Plasma collection; CBC, HbA1C, and Ammonia; Gently invert after collection 4—6 times..

SPECIMEN CONTAINERS

Pink Top Tube - K2EDTA; Plasma collection; Blood Bank only. Gently invert after collection.

Royal Blue Top Tube - K2EDTA; Plasma collection; Heavy metals. Gen-tly invert after collection.

Pearl/White Top Tube - Gel EDTA; Plasma collection; HCV and HIV Viral Load. Gently invert after collection.

Yellow Top Tube - Acid-Citrate-Dextrose Solution B; Plasma collection;

T & B Lymphocytes. Gently invert after collection.

Gray Top Tube - Sodium Fluoride/ Potassium Oxalate; Plasma collec-tion; Serum Drug Screen and volatiles.

Collection Tubes - Vacuum

Tubes Only Available in the Laboratory

QuantiFERON-TB Gold Tube— Blood test that aids in the detec-tion of Mycobacterium tuberculosis.

PPD Tube– Used for Glucagon, PTHRP , and Vascular Intestinal

Peptide

Urine Containers

Two types of urine containers available; 4 - 8 oz. plas-tic cup with screw-cap lid for routine urinalysis, or random drug screen.

Sterile; Individually packaged 4 - 8 oz. plastic cup with screw-cap lid and/or the transport tube for urine cultures.

Large; Heavy plastic containers for 24 hour urine col-lections; Preservatives vary with test and are obtained from Chemistry Dept. ext. 63415.

Microbiology Containers

Urine Transport System - Kit contains a urine cup and a gray top tube with preservatives in it.

Aerobic Culture - “Culturette” used for routine culturing of material.

Anaerobic Culture Tube - “Anaerobic Speci-men Collector” used for the culturing of anaero-bic organisms.

Aerobic Anaerobic

Blood Culture Bottles - For blood cultures and other body fluids obtained from sterile sites.

Fecal Occult Blood —Immunoassay detects blood in the stool. Kits are available in the Chemistry de-partment.

Special Transport Media (obtained only from Microbiology Lab at Ext. 63691)

Yellow Isolator Tube - Used for blood fungal culture samples.

Viral Culture - Used for Herpes, mycoplasma, ureaplasma, general viral cultures, and H1N1. Not used for HPV.

MRSA Transport Swab - Nasal swab used for MRSA collec-tion only.

NOTE: Please contact the laboratory at extension 63411 if you cannot find a particular transport media that you may require. We will be more than happy to direct your inquiry to the appropriate department.

Special Transport Media (obtained only from Microbiology ext. 63691)

Endocervical swab– Chlamydia trachomatis (CT)/Niesseria gonorrhoeae (NG)

BD Affirm— Molecular test for the detection of vaginitis.

(Candida species, Gardnerella vaginalis, and Trichomonas).

Female collection only.

SPECIMEN LABELING

1. Every specimen must be labeled individually.

2. Each label must contain:

a. Patient’s full name

b. Patient’s entire social security number

c. Order number ( if computer is down, send a completed lab downtime form with each specimen).

d. For Blood Bank - Paperwork must include Doctor’s name and diagnosis, and the tube must be signed & dated by the person drawing the specimen and a witness. (See example below). Note: Signatures on tube must match signatures on the Blood Bank Specimen Collection Form.

3. Mislabeled or unlabeled specimens will NOT be processed, the ward/clinic will be contact-ed in an effort to clarify or correct the problem.

4. A new specimen must be obtained if there is any unresolved discrepancy in the infor-mation on the label and the computer/lab slip, or if there is any doubt as to the identity of the patient.

5. No one in the lab may correct an incorrectly labeled specimen. The person who collected the specimen is responsible for completing an affidavit that attests to the validity of the sample and any re-labeling of specimens.

Patient’s Full Name

Patient’s Social Security Number

Order Number Two signatures and date required for Blood Bank requests

Doe, John

123-45-6789 Nurse Rachett

24567 Dr. Doolittle 1/1/2011

LABEL PLACEMENT

The placement of patient labels on various laboratory specimen containers is very im-portant. Due to modern technology and the use of bar codes, the location of labels on specimen containers can be crucial as to how efficient our instrumentation can function

(i.e. read barcodes). Below you will find a few examples of how we require sample con-tainers to be labeled in order for our instruments to be able to access the barcodes.

Incorrect Way

PLEASE NOTE: When labeling aerobic and anaerobic blood culture bottles, DO NOT obscure the barcode on the bottle with the patient label.

THERAPEUTIC DRUG LEVELS**

DRUG NAME THERAPEUTIC RANGE COMMENTS

Carbamazepine 4 - 12 mcg/mL Half-life: 10 - 26 hours in adults

Toxic Level: > 12 mcg/mL

Steady state: 2- 10 days (Possibly 2-4 weeks due to autoinduction)

Monitoring: Draw trough immediately prior to next dose.

Digoxin 0.8 -2.0 ng/mL Half-life: 33 - 51 hours

Steady state: 7-10 days (possibly longer)

Toxic Level: > 2.4 ng/mL

Obtaining Levels: Determine serum digoxin levels at least 4 hours after an IV dose or 6 hours after an oral dose in order to allow sufficient time for drug distribution.

Lithium 0.5 - 1.3 mEq/L Half-life: 17 - 36 hours

Potentially toxic level: >1.5 mEq/L

Drawing levels: Just prior to next dose or at least 6 - 12 hours after the last dose.

Phenytoin 10 - 20 mcg/mL Half-life: 7 - 42 hours (average: 24 hours)

Steady state: 7 - 10 days

Toxic level: > 40 mcg/mL

Drawing levels:

IV: 2 - 4 hours after loading dose

Oral: (peak): 3 - 9 hours after dose (not critical). Trough: immediately prior to next dose.

THERAPEUTIC DRUG LEVELS** Cont’d

DRUG NAME THERAPEUTIC RANGE COMMENTS

Valproic Acid 40 - 100 mcg/mL Half-life: 9 - 18 hours in adults

4 - 14 hours in children

Steady state: 2 - 4 days

Toxic level: > 100 mcg/mL

Vancomycin Peak: 20 - 40 mcg/mL

Trough: 10 - 20 mcg/mL*^

*Minimum trough levels should be maintained above 10 mcg/mL in order to avoid the development of resistance.

^Trough concentrations of 15 - 20 mcg/mL should be reserved for compli-cations or deep-seated infections in-cluding: bacteremia, endocarditis, hos-pital-acquired pneumonia, meningitis, and osteomyelitis.

Half-life: 6 hours (average)

Drawing levels: Draw trough imme-diately prior to the 4th dose. Peak level monitoring is not recommended ( not a reliable indicator of potential ne-phrotoxicity).

** All therapeutic drug level data taken from http://www.globalrph.com

The therapeutic levels listed above are only in-house testing that is performed in our laboratory. Send- out therapeutic drug testing will publish their own therapeutic ranges .

Alphabetical Listing of

Laboratory Tests

Lab Tests

TEST NAME SUBMISSION REQUIRMENTS CONTACT NORMAL VALUES

ABO/RH TYPING Orders must be entered into

CPRS. Fill out Blood Bank Spec-imen Collection Form and sub-mit with 6 mL pink top tube

(plasma). Form must be signed by blood drawer and witness.

Signatures on tube must match signatures on collection form.

Blood Bank - X 63419

ACETAMINOPHEN

(TYLENOL)

6 mL red top tube. Do not use gel- barrier tube.

Chemistry Send Out -

X 63415

See Laboratory Report

ACETONE See BETA-HYDROXY–

BUYTRATE (BOHB)

Chemistry - X64025

ACETYLCHOLINE

RECPTOR ANTIBODY

(AChR)

6 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ACTIVATED PARTIAL

THROMBOPLASTIN TIME

(aPTT)

See PARTIAL

THROMBOPLASTIN TIME

(PTT)

Hematology -

X63423

ADRENOCORTICOTROPIC

HORMONE (ACTH)

4 mL lavender top tube.

Transport to lab immediately.

Chemistry Send Out -

X 63415

See Laboratory Report

AFB BLOOD CULTURE See APPENDIX A Microbiology Send

Out - X 63691

See Laboratory Report

AFB SMEAR & CULTURE

( Other than Blood)

See TUBERCULOSIS (TB) Microbiology Send

Out— X63691

See Laboratory Report

ALANINE

AMINOTRANSFERASE

(ALT/SGPT)

5 mL gold or light green top tube.

Chemistry—X 64025 9.0—72.0 U/L

ALBUMIN 5 mL gold top tube. Chemistry—X64025 3.4—4.8 g/dL

ALDOLASE 5 mL gold or light green top tube.

Chemistry Send Out-

X 63415

See Laboratory Report

ALDOSTERONE, Serum 6 mL gold top tube. Indicate if patient was upright or supine when specimen was collected.

Chemistry Send Out -

X 63415

See Laboratory Report

ALDOSTERONE, Urine 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

ALKALINE PHOS-

PHATASE, LEUKO-

CYTE

See LEUKOCYTE ALKALINE

PHOSPHATASE

Hematology—X63423

ALKALINE

PHOSPHATASE, FRAC-

TIONATED (Heat Inac-tivated)

5 mL gold top tube. only Chemistry—X 64025 Liver: > 25% of total

Bone: </= 20% of total

ALKALINE PHOSPHATASE,

Serum

5 mL gold or light green top tube.

Chemistry—X 64025 25.0— 100.0 U/L

AALLERGENS– Formerly knon as RAST Testing

10 mL gold top tube. Contact lab for tube. If more than 5 aller

-gens are requested, submit an additional red top tube for each

8 additional allergens.

Transport to lab immediately.

Chemistry Send Out -

X 63415

See Laboratory Report

ALPHA—1– ANTITRYPSIN 6 mL gold top tube. Chemistry Send Out—

X 63415

See Laboratory Report

17– ALPHA– HYDROXY PRO-

GESTERONE

6 mL red top tube. Chemistry Send Out—

X 63415

See Laboratory Report

ALPHA FETOPROTEIN, AFP

(Tumor Marker)

5 mL gold top tube. Chemistry—X 64025 0—8.4 ng/dL

ALPHA SUBUNITS of GLYCO-

PROPTEINS (Includes: FSH, LH, HCG, and TSH)

6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ALUMINUM 6 mL royal blue top tube. Chemistry Send Out -

X 63415

See Laboratory Report

AMIKACIN 6mL red or 6 mL green top tube. Do not use gel-barrier tubes.

Chemistry Send Out—

X 63415

See Laboratory Report

AMINO ACIDS, Plasma 6 mL green top tube. Chemistry Send Out -

X 63415

See Laboratory Report

AMINOLEVULINIC ACID,

DELTA (Urine)

24 hr urine specimen. Must obtain 24 hr container fro m lab.

Chemistry Send Out -

ADENOSINE DEAMINASE,

Fluid

1 mL pleural or peritoneal fluid;

Submit to lab immediately.

Chemistry Send Out -

X 63415

See Laboratory Report

AMEBIASIS ANTIBODY/

(ENTAMOEBA histolytica An-tibody)

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

AMIODARONE /

(CORDARONE)

6 mL red, or 6 mL lanvender top tube. Do not use gel-barrier tube.

Chemistry Send Out -

X 63415

See Laboratory Report

AMITRIPTYLINE (ELAVIL) 6 mL red, or 6 mL green top tube. Do not use gel-barrier tube.

See Laboratory Report

AMMONIA (NH3) 4 mL lavender top tube on ice! Chemistry—X 64025 11.2—35.4 ug/dL

AMPHETAMINES/ METAM-

PHETAMINES (Urine)

See URINE DRUG SCREEN Chemistry - X 64025

AMYLASE ISOENZYME, Se-rum

6 mL gold top tube. Pre approv-al by pathologist required.

Chemistry Send Out -

X 63415

See Laboratory Report

AMYLASE, Serum 5 mL gold top tube. Chemistry—X 64025 20.0—104.0 U/L

AMYLASE, Urine 30 mL random urine Chemistry—X 64025 < 650 U/L

ANAEROBIC CULTURES See APPENDIX A for specimen collection types and instruc-tions.

Microbiology Send

Out— X 63691

See Laboratory Report

ANATOMIC PATHOLOGY See APPENDIX B Histology—X 63414

Reports—X 63400

ANDROSTENEDIONE 5 mL gold top tube. Chemistry Send Out—

See Laboratory Report

ANGIOTENSIN –1 CON-

VERTING ENZYME (ACE)

5 mL gold top tube. Chemistry Send Out—

X 63415

See Laboratory Report

ANTICARDIOLIPIN

ANTIBODIES

5 mL gold top tube. Hematology Send Out

– X 63423

See Laboratory Report

ANTI-DIURETIC

HORMONE

(ADH, Vasopressin)

4 mL lavender top tube Chemistry Send Out -

TEST NAME SUBMISSION REQUIREMENTS CONTACT NORMAL VALUES

ANTI-DNA

(Double—stranded)

ANTIBODIES

5 mL gold or top tube. Serology - X 64025 None Detected

ANTI– DNA ( Single-stranded) ANTIBODIES

5 mL gold or 6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ANTI– Hu ANTIBODIES 6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

Lab Tests

ANTIMICROSOMAL

ANTIBODY

See THYROID PEROXIDASE

(TPO) ANTIBODIES

Chemistry Send Out -

X 63415

See Laboratory Report

ANTIMYOCARDIAL ANTI-

BODIES,

5 mL gold or 6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ANTINEUTROPHIL

CYTOPLASMIC ANTIBODY

(ANCA)

5 mL gold or 6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ANTINUCLEAR

ANTIBODIES (ANA)

5 mL goldtop tube. Serology - X 64025 None Detected

ANTIPARIETAL CELL

ANTIBODY

5 mL gold or 6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ANTIPLATELET

ANTIBODY

See PLATELET ANTIBODY Chemistry Send Out -

X 63415

See Laboratory Report

ANTI—RNP ANTIBODY See EXTRACTABLE NUCLEAR

ANTIGEN

Serology - X 64025

ANTI– SCL70 ANTI-

BODY(SCLERODERMA

Ab)

See EXTRACTABLE NUCLEAR

ANTIGEN

Serology - X 64025

ANTI– SSA/SSB ANTI-

BODY

(SJOGREN’S Ab)

See EXTRACTABLE NUCLEAR

ANTIGEN

Serology - X 64025

ANTI– Sm ANTIBODY See EXTRACTABLE NUCLEAR

ANTIGEN

Serology - X 64025

ANTI-SMOOTH MUSCLE

ANTIBODY

6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ANTISTREPTOLYSIN-O

(ASO)

5 mL gold or 6 mL red top tube. Chemistry Send Out -

ANTISTRIATED MUSCLE

ANTIBODY

6 mL red or 5 mL gold top tube.

Chemistry Send Out—

X 63415

See Laboratory Report

ANTITHROMBIN III AC-

TIVITY

3 mL light blue top tube. Hematology—

X 65066

88—144%

ANTITHYROGLOBULIN ANTI-

BODY

6 mL red or 5 mL gold top tube.

Chemistry Send Out—

X 63415

See Laboratory Report

ARSENIC 6 mL royal blue top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ASO See ANTISTREPTOLYSIN—O Chemistry Send Out -

X 63415

See Laboratory Report

ASPARTATE AMI-

NOTRANSFERASE (AST/

SGOT)

5 mL gold or light green top tube.

Chemistry— X 64025 14 - 59 u/L

ASPERGILLUS

GALACTOMANNAN ANTIGEN

6 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

AUTOPSY See APPENDIX C Pathology—X 3400

BARBITURATES See URINE DRUG SCREEN Chemistry—X 64025 None Detected

BARTONELLA ANTIBODY

PROFILE

5 mL gold top tube. Profile includes: Bartonella henselae, IgG; Bartonella henselae, IgM;

Bartonella Quintana, IgG; and

Bartonella Quintana, IgM.

Chemistry Send Out—

X 63415

See Laboratory Report

BASIC METABOLIC PANEL

(Includes: Na+, K+, Cl-, CO2, Ca++, Glucose, BUN, and Creat-inine)

5 mL gold or light greentop tube.

Chemistry—X 64025 Sodium:

136—145 mEq/L

Potassium: 3.4

-5.1 mEq/L

Chloride:

98-107 mEq/L

CO2: 20—31 mEq/L

Calcium:

8.7—10.4 mg/dL

Glucose:

74– 106 mg/dL

BUN: 6.0—20.0 mg/dL

Creatinine:

0.3—1.2 mg/dL

BCR-ABL I KINASE

DOMAIN MUTATION ANALY-

SIS

5 mL whole blood from a lavender top tube or 1-2 mL bone marrow.

Chemistry Send Out—

BCR-ABL I TRANSCRIPT DE-

TECTION FOR CML AND ACL,

Quantitative

5 mL whole blood from laven-der, green, or yellow top tube or 1-2 mL bone marrow.

Chemistry Send Out X

63415

See Laboratory Report

BENCE JONES PROTEIN 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry—X 64025 No monoclonal immunoglobulins de-tected.

BENZODIAZEPINES, Whole

Blood (Valium, Librium)

2- 4 mL gray top tubes. Chemistry Send Out—

X 63415

See Laboratory Report

BENZODIAZEPINES, Urine

(Valium, Librium)

See URINE DRUG SCREEN Chemistry—X 64025 None Detected

BETA-HYDROXYBUTYRATE

(BOHB)

5 mL gold top tube. Chemistry—X 64025 0—0.3 mM

Ketosis: >0.3mM

Ketoacidosis: >4.9 mM

BETA 2 GLYCOPROTEIN 1

ANTIBODIES, IgA, IgG, IgM

5 mL gold top tube. Not to be used alone as a screening test for antiphospholipid syn-drome.

Chemistry Send Out—

X 63415

See Laboratory Report

BETA-2-MICROGLOBULIN 6 mL gold or 5 mL dark green top tube.

Chemistry Send Out—

X 63415

See Laboratory Report

BETA 2 TRANSFERRIN 2mL aural or nasal fluid in sterile container.

Chemistry Send Out—

X 63415

See Laboratory Report

BILIRUBIN, DIRECT (D.BILI) 5 mL gold or light green top tube.

Chemistry—X 64025 0—0.4 mg/dL

BILIRUBIN, TOTAL (T.BILI) 5 mL gold or light green top tube.

Chemistry—X 64025 0.3—1.2 mg/dL

BIOPSY See APPENDIX B Histology—X 63414 See Laboratory Report

BLEEDING TIME Schedule with Hematology.

Done 8:00 a.m.— 4:00 p.m.

Monday—Friday only.

Hematology —

X 63423

1—3 minutes

BLOOD or BLOOD PROD-

UCTS

See CROSSMATCH Blood Bank—X 63419

BLOOD CULTURES See APPENDIX A Microbiology —

X 63691

BLOOD GASES, Arterial or Ve-nous

3—5 mL of blood drawn into a heparinized syringe. REMOVE needle and cap end of syringe.

Label barrel of syringe and put in a plastic bag containing a mix of water and ice. Indicate if specimen is arterial or venous blood. Must be sent to the lab immediately for testing.

Chemistry—X 64025 Arterial Blood:

pH: 7.35—7.45

PCO2: 34—36 mm Hg

PO2: 75—100 mm Hg

Venous Blood:

pH: 7.35 –7.45

PCO2: 42—45 mm Hg

PO2: 30—50 mm Hg

BLOOD UREA NITROGEN

(BUN)

See UREA NITROGEN–

BLOOD and URINE

Chemistry—X 64025

BONE MARROW and/or BONE

BIOPSY

Collect PRIOR TO TRANS-

FUSION, if possible. Scheduled by Staff Hematologist after con-sultation.

Hematology—

X 65066

See Pathology Report

BUPRENORPHINE, URINE

(SCREEN)

Provide a random urine specimen .

Chemistry—X 64025 See Laboratory Report

BRAIN NATRIURETIC PEP-

TIDE (BNP)

4 mL lavender top tube. Must be ordered by designated Cardiolo-gy providers. Transfer to lab immediately.

Chemistry Send Out -

X 64025

See Laboratory Report

BRONCHOSCOPY PRO-

TOCOL

See APPENDIX A Microbiology—

C-1-q ANTIBODY IgG 6 mL red or 5mL gold top tube. Chemistry Send Out—

See Laboratory Report

CA 15-3 See CANCER ANTIGEN (CA)

15-3

Chemistry Send Out—

X 63415

See Laboratory Report

CA 19-9 See CARBOHYDRATE ANTI-

GEN (CA) 19-9

Chemistry Send Out—

X 63415

See Laboratory Report

CALCITRIOL, ( 1,25 di-OH VIT-

AMIN D)

6 mL red or 5 mL gold top tube. Chemistry Send Out—

X 63415

CALCIUM, Ionized 5 mL gold top tube. Chemistry—X 64025 1.19—1.29 mmol/L

CA 27.29 ANTIGEN See CANCER ANTIGEN (CA)

27.29

Chemistry Send Out—

X 63415

See Laboratory Report

CA 125 See CANCER ANTIGEN (CA)

Chemistry Send Out—

X 63415

See Laboratory Report

CALCITONIN 5mL gold or gark green top tube.

Chemistry Send Out—

X 63415

See Laboratory Report

CALCIUM, Serum 5 mL gold or light green top tube.

Chemistry—X 64025 8.7 –10.2 mg/dL

CALCIUM, Urine 24 hr urine specimen. Must obtain 24 hr container from lab.

Chemistry—64025 100– 300 mg/ 24 hrs

CANCER ANTIGEN 15-3 5 mL gold top tube. Chemistry Send Out—

X 63415

See Laboratory Report

CANCER ANTIGEN 27.29 5 mL gold top tube. Chemistry Send Out—

CANCER ANTIGEN 125 5 mL gold top tube. Chemistry Send Out—

X 63415

See Laboratory Report

CANNABINOID (THC,

Marijuana, or Pot)

See URINE DRUG SCREEN Chemistry—X 64025

CARBAMAZEPINE

(Tegretol)

6 mL gold top tube. Chemistry—X 64025 4.0—10.0 ug/mL

CARBOHYDRATE AN-

TIGEN (CA 19-9)

5 mL gold top tube. Chemistry Send Out-

X 63415

See Laboratory Report

CARBON DIOXIDE (CO2) 5 mL gold or light green top tube.

Chemistry—X 64025 20—31 mEq/L

CARCINOEMBRYONIC

ANTIGEN (CEA)

5 mL gold top tube. Chemistry—X 64025 0—5.0 ng/mL

CARDIAC ISOENZYMES See CKMB PANEL Chemistry—X 64025

CAROTENE, BETA 5 mL gold top tube. Chemistry Send Out–

X63415

See Laboratory Report

CATECHOLAMINE, Fractionat-ed and Total Plasma

4 mL dark green top tube on ice. Immediately transport to lab on ice. Patient should be fasting for 4 or more hours without smoking prior to collec-tion. Walnuts, bananas, and alpha– methyldopa should be avoided.

Chemistry Send Out-

X 63415

See Laboratory Report

CATECHOLAMINE, Fractionat-ed, Urinary Free

24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry Send Out—

CBC– ( Complete Blood Count) 4 mL lavender top tube. Col-lect 2 hours post– transfusion.

Hematology—

X 63423

WBC:

4.8- 10.8 x 103/mm3

RBC:

Male:

4.6 - 6.2 x 106/mm3

Female:

3.8 - 4.8 x 106/mm3

Hgb:

Male: 16 g/dL±2

Female: 13.5 g/dL±2

Hct:

Male: 45%±7

Female: 39.5%±5

MCV: 80 fl±7

MCH: 29ug±2

MCHC: 34%±2

CD4, CD8 See T & B LYMPHOCYTES Flow Cytometry -

X 65678

CEA See CARICINOEMBRYONIC

ANTIGEN

Chemistry - X 64025

CELL COUNT & DIFF

(CSF)

1 mL in Tube #3 from spinal tap kit supplied by SPD. DO NOT

PUT ENTIRE SPECIMEN IN

ONE TUBE FOR ALL TESTS!

Hematology -

X 63423

See Laboratory Report

CELL COUNT & DIFF

(Other Fluids)

1 mL in lavender top tube. Hematology -

X 63423

See Laboratory Report

CERULOPLASMIN 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CHLAMYDIA, EIA See APPENDIX A. Microbiology -

X 63691

See Laboratory Report

CHLAMYDIA/GONOCOCCUS,

MOLECULAR

1 endocervical, vaginal, or male urethral swab; 20-30 mL first voided urine collection; or cer-vical cells from an entire liquid cytology vial.

Microbiology -

X 63691

See Laboratory Report

CHLORIDE, Serum ( Included in Basic Metabolic Panel and

Serum Electrolytes)

5 mL gold or light green top tube.

Chemistry - X 64025 98 - 107 mEq/L

CHLORIDE, Urine Random urine or 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry - X64025 Random urine: No ref-erence range for ran-dom urine specimens.

24 hr urine: 110 - 250 mmol/24hr

CHOLESTEROL, HDL 5 mL gold or light green top tube. Must fast for 9 -12 hours prior to collection.

Chemistry - X64025 > 40 mg/dL

CHOLESTEROL, LDL (Direct), LDLc (Calculated)

5 mL gold or light green top tube. Must fast for 9 -12 hours prior to collection for LDLc.

Chemistry - X64025 < 130 mg/dL

CHOLESTEROL, TOTAL 5 mL gold or light green top tube. Must fast for 9 -12 hours prior to collection.

Chemistry - X 64025 < 200 mg/dL

CHOLINESTERASE, PSEUDO

(Plasma)

4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CHOLINESTERASE, ACE-

TYL (RBC)

4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CHROMOGRANIN A 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CIRCULATING IMMUNE

COMPLEXES, C1q Binding

See C-1-q Immune Complex Chemistry Send Out -

X 63415

See Laboratory Report

CK See CREATINE KINASE Chemistry - X 64025

CKMB PANEL 5 mL gold or light green top tube.

Chemistry - X 64025 0 - 6 ng/mL

CLOSTRIDIUM DIFFICILE

TOXIN (C. difficile)

Diarrheal sample in a leak-proof container. Submit to lab imme-diately. May be refrigerated.

Microbiology Send

Out—X 63691

See Laboratory Report

CO2 See CARBON DIOXIDE Chemistry - X 64025

COCAINE, URINE See URINE DRUG SCREEN Chemistry - X 64025 None Detected

COMPLEMENT, C3 5 mL gold top tube. Chemistry - X 64025 70 - 170 mg/dL

COMPLEMENT, C4 5 mL gold top tube. Chemistry - X 64025 12 - 36 mg/dL

COMPLEMENT, TOTAL

(CH50)

5 mL red top tube. Chemistry Send Out -

X 63415

See Laboratory Report

COMPREHENSIVE META-

BOLIC PANEL (Includes:

Na+, K+, Cl-, CO2, Glucose, BUN, Creatinine, Albumin, Alk. Phos., T.Bili, AST, Calci-um, and Total Protein)

5 mL gold top tube. Chemistry - X 64025 Sodium:

136- 145 mEq/L

Potassium:

3.4 - 5.1 mEq/L

Chloride:

98 - 107 mEq/L

CO2:

20 - 31 mEq/L

Glucose:

74 - 106 mg/dL

BUN:

6.0 - 20.0 mg/dL

Creatinine:

0.6 - 1.5 mg/dL

Albumin:

3.4 - 4.8 g/dL

Alk. Phos.:

25.0 - 100.0 U/L

T.Bili:

0.3 - 1.2 mg/dL

AST:

14 - 59 u/L

Calcium:

8.7 - 10.4 mg/dL

Total Protein:

6.4 - 8.3 g/dL

COOMBS, DIRECT &

INDIRECT

Order must be entered into

CPRS. Fill out Blood Bank

Specimen Collection Form and submit with 6 mL pink top tube

(plasma). Form must be signed by blood drawer and witness.

Signatures on tube must match signatures on collection form.

Blood Bank - X 63419 Non- Reactive

COPPER, Serum 6 mL royal blue top tube. Chemistry Send Out-

X 63415

See Laboratory Report

COPPER, Urine 24 hr urine specimen. Must obtain 24 hr container from lab.

Chemistry Send Out-

COPROPORPHYRIN, Urine See PORPHYRINS Chemistry Send Out -

X 63415

See Laboratory Report

CORTICOSTERONE 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CORTISOL, Serum 5 mL gold top tube. Chemistry - X 64025 3.09 - 22.4 ug/dL

CORTISOL, URINARY FREE 24 hr urine specimen. Must obtain 24 hr container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

CORTISOL, SALIVA Obtain special swab kit from

Sendouts.

Sendouts—X63415

COVID, ANTIBODY TEST

(SEROLOGY)

SEE VIRAL TESTING Microbiology X 63691

COVID, DIAGNOSTIC, PCR

(Nasal Swab)

See VIRAL TESTING Microbiology X 63691

COVID, SCREENING SEE VIRAL TESTING Microbiology X 63691

COVID, SURVEILLANCE/

MONITORING

See VIRAL TESTING Microbiology X 63691

C-REACTIVE PROTEIN

(CRP)

5 mL gold top tube. Chemistry - X 64025 0 - 4.9 mg/dL

C-REACTIVE PROTEIN, (CRP) 5 mL gold top tube. Sendout—X 63415 See Laboratory Report

CREATINE KINASE (CK, CPK) 5 mL gold top tube. Chemistry - X 64025 38 - 174 U/L

CREATININE CLEARANCE Must have both: 5 mL gold top tube and 24 hr urine specimen.

Must obtain 24 hr urine con-tainer from lab.

Chemistry - X 64025 >90 mL/min

CREATININE, Serum 5 mL gold or light green top tube.

Chemistry - X 64025 0.3 - 1.2 mg/ dL

CREATININE, Urine (Random) Random urine specimen. Chemistry - X 64025 No reference range for random urines.

CREATININE, Urine (24 hr) 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry - X 64025 7 - 20 mg/24 hrs

CROSSMATCH Orders must be entered into

CPRS. Fill out Blood Bank Spec-imen Collection Form and sub-mit with 6 mL pink top tube

(plasma). Form must be signed by blood drawer and witness.

Signatures on tube must match signatures on collection form.

One form and caution tag for each unit of blood requested.

Blood Bank - X 63419

CRYOGLOBULIN, Serum Must contact lab prior to collec-tion. Monday - Friday only

(8:00 a.m. - 3:00 p.m.)

Chemistry Send Out-

X 64025

CRYPTOCOCCUS ANTI-

GEN, (CSF or Serum)

5 mL red top tube and/or

2 mL CSF.

Hematology -

X 63423

Negative

CRYPTOSPORIDIUM AND

ISOSPORA SMEAR (Stool)

Diarrheal specimen in leak-proof container. Collect speci-men prior to antidiarrheal ther-apy or antiparasitic therapy.

Microbiology -

X 63691

Negative

CRYSTALS, FLUID (Synovial/

Joint)

1 mL fluid in a green or lavender top tube.

Hematology -

X 63423

See Laboratory Report

CRYSTALS, URINE See URINALYSIS Urinalysis - X 65074 See Laboratory Report

CSF IMMUNOFIXATION

ELECTROPHORESIS (IFE)

See OLIGOCLONAL BANDS Chemistry - X 64025 See Laboratory Report

CULTURE & SUSECPTI-

BILITY

See APPENDIX A for specimen collection types and instruc-tions.

Microbiology -

X 63691

See Laboratory Report

CYCLIC CITRULLINATED

PEPTIDE (CCP) ANTI-

BODIES, (IgG/IgA)

5 mL gold top tube . Chemistry Send Out -

X 63415

See Laboratory Report

CYCLOSPORINE, BLOOD 4 mL lavender or 6 mL green top tube.

Chemistry Send Out -

See Laboratory Report

CYTOLOGY See APPENDIX B Histology- X 63414

Reports - X 63400

See Laboratory Report

CYTOMEGALOVIRUS (CMV) 6 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

CYTOMEGALOVIRUS, PCR 5 mL lavender top tube Chemistry Send Out

X 63415

See Laboratory Report

DARVON, Serum See PROPOXYPHENE, Serum Chemistry Send Out -

X 63415

See Laboratory Report

DARVON, Urine See URINE DRUG SCREEN Chemistry Send Out -

X 63415

See Laboratory Report

D-DIMER 3 mL light blue top tube Hematology -

X 63423

Negative = ≤ 230 ng/ mL

DEHYDROEPIANDROS-

TERONE (DHEA)

5 mL gold top tube. Chemistry Send Out -

DEHYDROEPIANDROS-

TERONE SULFATE

(DHEA-S)

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

11-DEOXYCORTISOL/ COM-

POUND S

6 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

DEOXYCORTICOSTERONE

(DOC)

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

DIFFERENTIAL COUNT

(DIFF)

Differential

NEUTRO SEGS

NEURTO BANDS

LYMPHOCYTES

EOSINOPHILS

BASOPHILS

MONOCYTES

PLATELETS

4 mL lavender top tube.

Cannot be ordered without a

CBC.

X 65066

Normal Values

Absolute No.

3,000 - 5,800

150 - 400

1,500 - 3,000

50 - 250

25 - 50

280 - 500

DIFFERENTIAL COUNT,

(FLUID)

See CELL COUNT & DIFF, (FLUID)

X 63423

DIGOXIN 5 mL gold top tube. Chemistry - X 64025 0.8 - 2.0 ng/mL

DIHYDROTESTOSTERONE

(DHT)

6 mL red or 5 mL gold top tube. Chemistry Send Out

X 63415

See Laboratory Report

DILANTIN See PHENYTOIN Chemistry - X 64025

DNA ANTIBODIES - Double Stranded

5 mL gold top tube. Serology - X 64025 Negative

DNA ANTIBODIES - Single

Stranded

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

DRUG SCREEN, SERUM (2) - 4 mL gray top tubes or (1)

6 mL red top tube.

Chemistry Send Out -

ELECTROLYTES, SERUM

(Includes: Na+, K+, Cl-, and

CO2)

5 mL gold or light green top tube.

Chemistry - X 64025 Sodium: 136—145 mEq/L

Potassium: 3.4-5.1 mEq/L

Chloride: 98-107 mEq/L

CO2: 20—31 mEq/L

ELECTROLYTES, URINE

(Na+, K+, and Cl-)

30 mL random urine specimen or 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Urinalysis - X 65074 Random: No normal values established for random urine.

24 hr:

Na+:

40-220 mmol/ 24hr K+:

25-125 mmol/24hr Cl-:

110-250 mmol/24hr

EMERGENCY DRUG SCREEN See URINE DRUG SCREEN Chemistry - X 64025

ENA See EXTRACTABLE NUCLEAR

ANTIGEN

Serology - X 64025

EOSINOPHIL COUNT, URINE 30 mL random urine specimen. Hematology -

None Seen

EPSTEIN-BARR VIRUS (EBV) 5 mL gold top tube. Chemistry Send Out -

See Laboratory Report

EPSTEIN-BARR VIRUS, PCR 5 mL lavender top tube. Chemistry Send Out—

X 63415

See Laboratory Report

ERYTHROPOIETIN (EPO) 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ESTRADIOL 5 mL gold or dark green top tube.

Chemistry Send Out -

X 63415

See Laboratory Report

ESTRIOL 5 mL gold top tube. State weeks of gestation on tube.

Chemistry Send Out -

X 63415

See Laboratory Report

ESTROGENS, FRAC-

TIONATED

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ESTRONE 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

ETHANOL (ETOH,

ALCOHOL)

5 mL gold top tube. Chemistry - X 64025 None Detected

EXTRACTABLE NUCLEAR

ANTIGEN (ENA) Includes:

Anti-SSA(RO); Anti- SSB(LA);

Anti- Sm; Anti-RNP; and Anti-

SCL-70

5 mL gold top tube. Performed only after a positive ANA with a titer of ≥ 1:160

Serology - X 64025 Negative

FACTOR ASSAYS: II, VII, VIII

ACTIVITY, VIII ANTIGEN, IX,

X, XI, XII, XIII

3 mL light blue top tube. Direc-tor of Hematology reviews each request to determine if request is clinically relevant .

Hematology Send Out

- X 63423

See Laboratory Report

FACTOR V (LEIDEN) 4 mL lavender top tubes. Hematology Send Out

- X 63423

See Laboratory Report

FECAL FAT, QUALITATIVE Random fresh stool. Approx. 3 g in a sterile leak-proof container.

Refrigerate.

Hematology Send Out

- X 63423

See Laboratory Report

FECAL FAT,

QUANTITATIVE

24-72 hour stool specimen. Col-lect stool directly into can. Ob-tain can from lab. Patient should be on a standard diet containing 50-150 g of fat per day for at least three days before test is started and during the 24

-72 hour collection.

Chemistry Send Out-

X 63415

See Laboratory Report

FECAL LEUKOCYTES Stool specimen in leak-proof container.

Hematology -

X 63423

None Seen

FECAL OCCULT BLOOD Collect stool specimen per in-structions included with Fit-

Chek collection kit. Label sam-ple container with patient’s full name and full SSN and order number. Submit to lab upon completion.

Urinalysis - X 65074 Negative

FERRITIN 5 mL gold top tube. Chemistry - X 64025 10.2 - 464.0 ng/mL

FIBRIN MONOMERS 3 mL light blue top tube. Hematology -

X 63423

Negative

FIBRIN SPLIT or DEGRADA-

TION PRODUCTS (FSP or FDP)

Obtain special collection tube from Hematology department.

Hematology -

X 63423

Negative/ < 10 ug/mL

FIBRINOGEN 3 mL light blue top tube. Hematology -

287 - 575 mg/dL

FINE NEEDLE ASPIRATE

(FNA)

See APPENDIX B Pathology - X63414 See Laboratory Report

FIT-CHEK See FECAL OCCULT BLOOD Urinalysis X65074

FLOURESCENT

TREPONEMAL ANTIBODY

ABSORPTION TEST

(FTA-ABS)

See TREPONEMA PALLIDUM-

PASSIVE AGGLUTINATION

Serology - X 64025

FOLATE (FOLIC ACID) 5 mL gold top tube. Chemistry - X 64025 2.76 - 20.0 ng/mL

FOLATE, RBC 4 mL lavender top tube. Chemistry Send Out-

X 64025

See Laboratory Report

FOLLICLE STIMULATING

HORMONE (FSH)

5 mL gold top tube. Chemistry - X 64025 2.0 - 138 mIU/mL

FREE DILANTIN See FREE PHENYTOIN Chemistry Send Out -

FREE PHENYTOIN 6 mL red top tube. Do not use gel-barrier tube.

Chemistry Send Out-

X 63415

See Laboratory Report

FREET4 See THYROXINE, FREE, DIRECT

Chemistry - X 64025

FUNGAL ANTIBODIES 6 mL red or 5 mL gold top tube. Chemistry Send Out-

X 63415

See Laboratory Report

FUNGAL CULTURE See APPENDIX A. Microbiology -

X 63691

See Laboratory Report

G-6-PD See GLUCOSE-6-PHOSPHATE

DEHYDROGENASE

X 63711

GAMMA GLUTAMYL TRANS-

FERASE (GGT)

5 mL gold top tube. Chemistry - X 64025 12 - 73 U/L

GASTRIN 5 mL gold top tube. Chemistry Send Out-

X 63415

See Laboratory Report

G.C. CULTURE See GONOCOCCAL CULTURES Microbiology -

GENTAMICIN 6 mL red top tube. Chemistry - X 64025 See Laboratory Report

GLUCAGON 1 Protease Inhibitor Tube (PPT) Chemistry Send Out - X 63415

See Laboratory Report

GLUCOSE-6-PHOSPHATE DE-

HYDROGENASE (G-6-

PD)

4 mL lavender top tube. Hematology - X 63711

Negative

GLUCOSE, CSF 1 mL CSF in Tube # 1 from spi-nal tap kit.

Chemistry - X 64025 40 - 70 mg/dL

GLUCOSE, FLUIDS - (CSF,

Pleural, and Peritoneal)

1 mL of fluid submitted in a red top tube.

Chemistry - X 64025 No normal ranges established for fluids.

GLUCOSE, SERUM (Included in Basic and Comprehensive

Metabolic Panels)

5 mL gold or light greentop tube.

Chemistry - X 64025 74 - 106 mg/dL

GLUCOSE TOLERANCE TEST

(3 Hour Duration)

See APPENDIX F Chemistry - X 64025

GLUCOSE, URINE 24 hour urine specimen. Obtain

24 hr urine container from lab.

Chemistry - X 64025 < 500 mg/24 hrs

GLYCOHEMOGLOBIN, TOTAL

(GHB)

4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

GLYCOSYLATED HEMOGLO-

BIN

See HEMOGLOBIN A1C

(HbA1C)

Chemistry - X 64025

GONOCOCCAL CULTURE

(G.C.)

See APPENDIX A Microbiology -

X 63691

See Laboratory Report

GONORRHEA SCREEN See APPENDIX A Microbiology -

X 63691

See Laboratory Report

GRAM STAIN See APPENDIX A Microbiology -

X 63691

See Laboratory Report

GROWTH HORMONE 4 mL lavender or 5 mL gold top tube.

Chemistry Send Out-

X 63415

See Laboratory Report

HALOPERIDOL

(HALDOL)

6 mL red or 4 mL lavender top tube.

Chemistry Send Out -

X 63415

See Laboratory Report

HAPTOGLOBIN 5 mL gold top tube. Chemistry - X 64025 40 - 240 mg/dL

HEAVY METALS, BLOOD

(Includes: Arsenic, Lead, & Mercury)

6 mL royal blue top tube. Chemistry Send Out -

X 63415

See Laboratory Report

HEAVY METALS, URINE 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

HELICOBACTER PYLORI 5 mL gold top tube. Chemistry - X 64025 Negative

HELPER/SUPPRESSOR

LYMPHOCYTES

See T & B LYMPHOCYTES Flow Cytometry -

HEMATOXYLIN & EOSIN

STAIN (H & E STAIN)

See APPENDIX B Histology -

X 63414

HEMOGLOBIN (Hgb) See CBC - COMPLETE BLOOD

COUNT

Hematology - X 63423

Male: 16 gm ±2 Female: 13.5 gm± 2

HEMOGLOBIN A1C (HbA1C) 4 mL lavender top tube. Chemistry - X 64025 Non-Diabetic: < 5.7%

Diabetic Good Control:

5.7—6.4% Diabetic Poor Control:

≥ 6.5%

HEMOGLOBIN

ELECTROPHORESIS, QUAN-

TITATIVE (Includes: A1, A2, C, F, and S)

4 mL lavender top tube. Hematology Send Out

- X 63711

See Laboratory Report

HEMOGLOBIN, FREE

(Plasma)

See PLASMA FREE

HEMOGLOBIN

Chemistry - X 64025

HEPARIN-INDUCED PLATE-

LET ANTIBODY

5 mL gold top tube. Do not use gel-barrier tube.

Chemistry Send Out -

X 63415

See Laboratory Report

HEPATITIS A ANTIBODY, IgM

(HAIgM)

5 mL gold top tube. Chemistry - X 64025 Non-Reactive

HEPATITIS A ANTIBODY, TO-

TAL

5 mL gold top tube. Chemistry - X 64025 Non-Reactive

If Reactive, do HAIgM

HEPATITIS B CORE ANTI-

BODY (Anti-HBc, IgM)

5 mL gold top tube. Chemistry - X 64025 Non-Reactive

HEPATITIS Be ANTIBODY

(ANTI-HBe)

5 mL gold or 4 mL lavender top tube.

Chemistry Send Out-

X 63415

See Laboratory Report

HEPATITIS Be ANTIGEN

(HBsAg)

5 mL gold or 4 mL lavender top tube.

Chemistry Send Out-

X 63415

See Laboratory Report

HEPATITIS B SURFACE ANTI-

BODY (HBsAB)

5 mL gold top tube. Chemistry - X 64025 See Laboratory Report

HEPATITIS B SURFACE ANTI-

GEN (HBsAg)

5 mL gold top tube. Chemistry - X 64025 Non-Reactive

HEPATITIS B VIRAL LOAD

(DNA)

4 mL lavender top tube. Chemistry Send Out -

HEPATITIS C ANTIBODY

(HCAb)

5 mL gold top tube. Chemistry - X 64025 See Laboratory Report

HEAPTITIS C GENOTYPE 5 mL lavender top tube. Chemistry Send Out—

X63415

See Laboratory Report

HEPATITIS C VIRAL LOAD,

RNA

5 mL pearl white top tube. Flow Cytometry -

X 65678

See Laboratory Report

HEROIN (OPIATES), Urine See URINE DRUG SCREEN Chemistry - X 64025

HERPES CULTURE See APPENDIX A Microbiology Send

Out - X 63691

See Laboratory Report

HERPES SIMPLEX VIRUS

TYPE I &II (IgG or IgM)

5 mL gold top tube. Microbiology Send

Out - X 63691

See Laboratory Report

HISTOLOGY See APPENDIX B. Histology - X 63414 See Laboratory Report

HISTOPLASMA ANTIBODY 6 mL red or 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

HISTOPLLASMA

ANTIGEN, URINE

2 mL random urine sample Chemistry Send Out—

X 63415

See Laboratory Report

HIV ANTIBODY (HIV-1/2 Anti-body)

See HUMAN IMMUNODEFI-

CIENCY VIRUS, HIV-1/-2

ANTTIBODY

Chemistry - X 64025

HLA-B27 DISEASE

ASSOCIATION

4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

HLA-B5701 (Abacavir

Hypersensitivity)

(2) - 4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

HLA-DRB DQB DISEASE

ASSOCIATION

4 mL lavender top tube. Chemistry Send Out -

X 63415

See Laboratory Report

HOMOCYSTEINE, PLASMA 4 mL lavender top tube. Chemistry - X 64025 4.7 - 14.1 umol/L

HOMOVANILLIC ACID,

(Urine)

30 mL random urine or 24 hr urine collection. Must obtain 24 hr urine container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

HUMAN CHORIONIC GON-

ADOTROPIN (hCG), β-

Subunit (Qualitative)

5 mL gold top tube or 20 mL random urine.

Hematology -

X 63423

Negative or Positive

HUMAN CHORIONIC GON-

ADOTROPIN (hCG), β- Subunit (Quantitative)

5 mL gold top tube. Chemistry - X 64025 Males and non-pregnant females = <

10mIU/mL. See lab report for detailed reference ranges.

HUMAN

IMMUNODEFICIENCY

VIRUS, HIV-1/-2 ANTIBODY

5 mL gold top tube. Chemistry - X 64025 Negative. Screening Method only. All incon-clusive screen results must be confirmed by Western Blot before results are reported.

HUMAN

IMMUNODEFICIENCY

VIRUS, HIV GENOTYPE

(2) 4 mL lavender top tubes. Chemistry Send Out–

X 63415

See Laboratory Send

Out

HUMAN

IMMUNODEFICIENCY

VIRUS, HIV RNA

5 mL white pearl top tube. Flow Cytometry -

X 65678

See Laboratory Report

HUMAN PAPILLOMAVIRUS

(HPV)

Contact the Microbiology lab for instructions and obtain appro-priate transport media.

Microbiology -

X 63691

See Laboratory Report

17– HYDROXYCORTICO -

STEROID (Urine)

24 hr urine specimen. Must obtain 24hr urine container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

IgA, (Quantitative) See IMMUNOGLOBULINS Chemistry - X 64025

IgE, (Quantitative) See IMMUNOGLOBULIN E, TOTAL

Chemistry Send Out -

X 63415

See Laboratory Report

IgG, (Quantitative) See IMMUNOGLOBULINS Chemistry - X 64025

IgG SYNTHESIS & INDEX 5 mL gold top tube and 1 mL

CSF in sterile container.

Chemistry Send Out -

X 63415

See Laboratory Report

IgM, (Quantitative) See IMMUNOGLOBULINS Chemistry - X 64025 See Laboratory Report

IMMUNOELECTROPHORE-

SIS , (IFE) CSF

5 mL CSF in sterile tube. Chemistry Send Out—

X63415

No monoclonal immunoglobulins detected.

IMMUNOELECTROPHORESIS

(IFE) Serum

5 mL gold top tube . Chemistry - X 64025 No monoclonal immunoglobulins detected.

IMMUNOELECTROPHORE-

SIS, (IFE) Urine

See BENCE JONES PROTEIN Chemistry - X 64025

IMMUNOGLOBULINS

(IgA, IgG, AND IgM)

5 mL gold top tube . Chemistry - X 64025 IgA: 70 - 400 mg/dL

IgG: 650 - 1600 mg/dL

IgM: 50 - 300 mg/dL

INFECTIOUS MON-

ONUCLEOSIS

6 mL red or 5 mL gold top tube. Hematology Send Out

- X 63423

INFLUENZA A & B , ANTIBOD-

IES IgG and IgM

5 mL gold top tube. Chemistry Send Out—

X 63415

See Laboratory Report

INFLUENZA A, H1N1 Reflex test. Only performed if positive for Influenza A.

Microbiology Send

Out - X 63691

See Laboratory Report

INSULIN 5 mL gold or 4 mL lavender top tube.

Chemistry Send Out - X 63415

See Laboratory Report

INSULIN AUTO-

ANTIBODIES (IAA)

6 mL red or 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

INSULIN-LIKE GROWTH FAC-

TOR 1 (IGF-1)

5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

IONIZED CALCIUM See CALCIUM, IONIZED Chemistry - X 64025

IRON 5 mL gold top tube . Chemistry - X 64025 50 - 181 mg/dL

IRON STAIN Contact Hematology for instruc-tions.

Hematology -

X 63423

See Laboratory Report

17-KETOGENIC STEROIDS 24 hr urine specimen. Must obtain 24hr urine container from lab.

Chemistry Send Out - X 63415

See Laboratory Report

KETONES See BETA- HYDROXYBUTYR-

ATE (BOHB)

Chemistry - X 64025

LACTATE

DEHYDROGENASE (LD)

5 mL gold top tube. Chemistry - X 64025 100 - 190 U/L

LACTATE DE-

HYDROGENASE ISO-

ENZYMES

6 mL red or 5 mL gold top tube. Chemistry Send Out -

X 63415

See Laboratory Report

LACTIC ACID 6 mL green top tube on ice! Chemistry - X 64025 0.7 -2.1 mmol/L

LDL CHOLESTEROL See CHOLESTEROL, LDL. Chemistry - X 64025

LEAD, BLOOD 6 mL royal blue top tube. With a completed State of Michigan

Form.

Chemistry Send Out -

LEAD, URINE 24 hr urine specimen. Must obtain 24 hr urine container from lab.

Chemistry Send Out -

X 63415

See Laboratory Report

LEGAL EVIDENCE See APPENDIX B. Pathology - X 63400

LEGIONELLA

ANTIBODIES

5 mL…