Emergency On Call Medical Scientist On Call Bleep: 101 : 086 3853277 Virology Dispatch Ext. 3178 Virology Results Ext: 3178/3179/3533 Location of Pathology Departments Figure : Department Location Department Location POD Station No. Anatomic Pathology Above the outpatient clinic in the main hospital building. 11 Biochemistry Blood Sciences laboratory on the ground floor in the new wing of the hospital. 14 Blood Transfusion Blood Sciences laboratory on the ground floor in the new wing of the hospital 14 Haematology Blood Sciences laboratory on the ground floor in the new wing of the hospital 14 Microbiology The Microbiology Laboratory is located in the basement of the new wing of the hospital 13 Specimen Reception Ground floor of the new wing of the hospital. Beside Blood Sciences laboratory 14 Pathology Department Opening Figure : Department Hours Department/Activity Opening Routine Service Monday to Friday All Departments with the exception of Anatomic Pathology 08:00 - 18:00 08:00 - 17:00 Saturday (Biochemistry, Blood Transfusion, Haematology and Microbiology) 09:30 -13:00 A reduced service is provided on Saturday (Specimens should reach the laboratory before 12.00) Emergency out of hours service (Biochemistry, Blood Transfusion, Haematology and Microbiology only) (On call emergency diagnostic service) Pod station 12 Monday to Thursday 18:00 – 08:00 the following day Friday 18:00 – 09.30 Saturday Saturday 13.00 –9.30 Sunday Sunday + Bank Holiday: 09.30 - 08.00 the following day Sunday of Bank Holiday Weekend 09.30 - 09.30 the following day
Osmolality (Plasma) Heparin 4ml Heparin 1.3ml Same Day Accredited Phosphate Heparin 4ml Heparin 1.3ml Same Day Accredited Potassium Heparin 4ml Heparin 1.3ml Same Day Accredited Sodium Heparin 4ml Heparin 1.3ml Same Day Accredited Total Protein Heparin 4ml Heparin 1.3ml Same Day Accredited Triglyceride Heparin 4ml Heparin 1.3ml Same Day Fasting Venipuncture immediately after or during the administration of Metamizole (Dipyrone) may lead to falsely low results for Triglyceride. Venipuncture should be performed prior to the administration of Metamizole. Accredited Uric Acid Heparin 4ml Heparin 1.3ml Same Day NAC interference may lead to falsely low results. Venipuncture immediately after or during the administration of Metamizole (Dipyrone) may lead to falsely low results for Uric Acid. Venipuncture should be performed prior to the administration of Metamizole. Accredited Anti Mullerian Hormone Plain 7ml 3 Days Mon – Fri Accredited CA 125 Plain 7ml 3 Days Mon – Fri Accredited Free bHCG and PAPP-A 7ml 1 week Clinical details must include gestation. Samples are only suitable for analysis between 10 weeks 0 days and 13 weeks 6 days. Accredited HCG Heparin 4ml 24 hrs Mon – Fri except by special request. Sat a.m. only if sample received in lab before 11.30a.m. Accredited Oestradiol Plain 7ml 24 hrs Mon – Fri except by special request. The Oestradiol assay used in the NMH should NOT be used when monitoring Oestradiol levels in patients being treated with fulvestrant. Accredited
Crossmatch LF-BTR-XREQ Rev 3 Red cells NMH or Red Cells NMH EDTA 9ml Routine crossmatch requests = 3 hours. Urgent 1 Hour* BT lab / on-call scientist to be phoned if the crossmatch is deemed urgent. *The presence of a positive antibody screen will increase turnaround A current valid inpatient group and antibodies sample is required prior to crossmatch requests with ID armband in place Blood Product Requests created in MN-CMS must be printed and sent to the lab Accredited Uncrossmatched blood group specific RCC NMH or O Neg Red NMH EDTA 9ml Group Specific = approx 15 minutes O Negative = STAT* The request for uncrossmatched blood must be authorised by a member of the medical staff Accredited Neonatal Crossmatch Paed Pack (1-5 NMH) EDTA 9ml from mother EDTA 3ml from Neonate Up to 3 hrs (depending on blood stock arrival from IBTS) Crossmatched against maternal specimen (correctly labelled with maternal details). Please check if a current valid sample is available on the mother prior to maternal sample collection Accredited Transfusion Reaction Investigation Transfusion Reaction Adult / Paed NMH See section 14.9 below Preliminary 2 hrs Final 7 days See Section 14.9 Accredited Antenatal Booking Booking Visit EDTA 9ml 1 routine working Day If patient is not wearing an ID armband an Outpatient Group and antibodies must be selected or if handwriting the sample use form 3 Accredited 28 week Antibody Outpatient group and antibody EDTA 9ml 1 routine working Day It is policy for all RhD negative and women with antibodies to have a 28 week antibody check Accredited
Test/Profile Container Type(Vol) Turnaround Times from time of specimen receipt in laboratory Special Requirements All specimens must be handwritten with Hospital Number, patient name and date of Birth Referral Laboratory Accreditation Status Anti D/ Anti-c Quantitation Anti- D or Anti- c blood level, NMH 9ml EDTA x2 1 week for verbal report 2 weeks for written report Please provide EDD when requesting quantitation. IBTS Reference Laboratory HLA typing Group and Antibodies Inpatient / Outpatient 9ml EDTA 2 weeks Test request must be accompanied by associated referral form. Contact the Blood Bank to request form IBTS Reference Laboratory HLA antibodies Group and Antibodies Inpatient / Outpatient 9ml serum sample (clotted) 2 Test request must be accompanied by associated referral form. Contact the Blood Bank to request form IBTS Reference Laboratory Platelet Alloantibodies and Antibodies Inpatient / Outpatient 9ml serum sample (clotted) 2 weeks Test request must be accompanied by associated referral form. Contact the Blood Bank to request this form IBTS Reference Laboratory NAITP NAITP Maternal / Paed / Paternal blood NMH Mother: 9ml EDTA 2X9ml Serum (clotted) Father: 2 x9ml EDTA Neonate: 1ml Paediatric EDTA 2-3 weeks Request must be authorised by Consultant / Haematologist Test request must be accompanied by associated referral form. Contact the Bank to request this form IBTS Reference Laboratory Foetal Genotyping in Maternal Samples must be handwritten and N/A 9mlx2 EDTA 2-3 weeks Test request must be accompanied by associated referral form. NHS BLOOD AND TRANSPLANT Reference Laboratory
and sent to the Blood Bank Anti-D (RAADP) Outpatient Group and Antibodies 3 Anti-D Immunoglobulin NMH 9ml EDTA 1 routine Day Indicate sample is a 28 week / sample Accredited Anti-D (Post and Antibodies (Type and Screen) Rev 3 Post Natal Anti-D Immunoglobulin NMH 9ml EDTA 1 routine Day If requesting using MN-CMS the Anti-D must be ordered, the requisition printed and sent to the Blood Bank Accredited Blood Products (non red cells) Refer to Fig 21 for red cells Refer to figure below for blood products available from the blood bank Group and Antibodies (Type and Screen) Rev 3 Sample may already be available – contact lab Blood Products Order /Prescribe Adults and Neonates 9ml EDTA TAT is dependent on product required and availability – contact lab for approximate estimation When requesting blood products using MN-CMS the blood product must be ordered, print the requisition and sent to the Blood Bank. Accredited
Factor Five (Factor V Leiden mutation, Genetic for thrombophilia) 2 x 3mlSodium Citrate (for aPC) 1 x 2.7ml EDTA (for FvL) 1 month St. James’s Special Coagulation Laboratory (NCHCD) Gate SEND STRAIGHT AWAY Samples must be received by Coag Lab, NCHCD by 4pm Mon-Fri. Requests for Factor V Leiden must be accompanied by either samples for APCR analysis or an APCR result from an external source. NB: Send confirmation of patient consent to the lab Factor Five (Factor V Leiden mutation, Genetic tests for thrombophilia) 1 x Sodium Citrate 1.3ml 1 X 1.3 ml EDTA 2 weeks Crumlin Haematology NCHCD St James’s for FVL SEND STRAIGHT AWAY Factor 8 ADULT 2 x 3ml Sodium Citrate 6 hours St. James’s Special Coagulation Laboratory (NCHCD) Gate SEND STRAIGHT AWAY (only send to SVUH under the instruction of the Consultant Haematologist F8V) Factor 8 (PAED) 1 x Sodium Citrate 1.3ml 2 weeks Crumlin Haematology SEND STRAIGHT AWAY Factor 9 2 x 3ml Sodium Citrate 6 hours St. James’s Special Coagulation Laboratory (NCHCD) Gate SEND STRAIGHT AWAY (only send to SVUH under the instruction of the Consultant Haematologist F9V) Factor 9 (PAED) 1 x Sodium Citrate 1.3ml 2 weeks Crumlin Haematology SEND STRAIGHT AWAY Ferritin ADULT 1 x 4ml Heparin 2 days ’s Biochemistry Ferritin (PAED) 1 x 7 ml plain 1 week Crumlin Haematology Send on same day as received. If this is not possible: The sample to be spun down and plasma removed from the cells. A vial is labelled with the patients’ hospital number, patient’s name, D.O.B., lab number sticker and today’s date. Flow (for Leukaemia) 3 x EDTA ’s Haematology
Folate 1 x 4ml Heparin 2 days ’s Biochemistry Glucose-6-phosphate dehydrogenase deficiency 2 x 2.7ml EDTA 2 days St. James’s Haemolytic Laboratory Available during routine hours (Mon- Fri). Glucose-6-phosphate dehydrogenase deficiency (PAED) 1 x 1.3ml EDTA 2 – 3 weeks Crumlin Haematology Haptoglobin Hp) 1 x 7 ml plain 2 days St. Haemolytic Laboratory Consult with a Haematologist before taking the sample for haptoglobin. Available during routine hours (Mon-Fri). = 0.45 - 2.05 g/l Children: Adult levels are not reached until 3 – 12 months. Do not measure levels in children < 1 yr old. Haemoglobin S Levels 1 x 2.7ml EDTA 1 week St. James’s Haemolytic Laboratory Samples referred to SJH. Sample must be received before 12:00 with FBC result and 2 unstained slides. Haemoglobinopathy Screen ADULT 1 x 2.7ml EDTA 1 week St. James’s Haemolytic Laboratory Requires Haematologist approval Haemoglobinopathy Screen (PAED) 1 x 1.3ml EDTA 1 x 1.3 ml plain 1 – 2 weeks Crumlin Haematology Heparin Induced Thrombocytopenia (HIT Screen) 2 x 3ml Sodium Citrate 1 x 7 ml plain 2 weeks St. Special Coagulation Laboratory (NCHCD) Gate 1 Vial of patients Heparin to be included with samples. The Coagulation Lab NCHCD James’s Hospital must receive the samples by 4pm Mon-Fri. Routine hours Mon-Fri or out of hours only by authorisation by Coagulation Consultant. HHT Genetic Testing (Hereditary Hemorrhagic Telangiectasia) 2x 6ml EDTA or 4 x 3ml EDTA (>10mls EDTA samples required) 8 weeks Molecular Genetic Service EH42XU Tel: 0044 1315 371116
Intrinsic Factor Antibody 1 x 7 ml plain >14days post B12 injection) 7 days St. James’s Haematology Available during routine hours (Mon-Fri). Urgent analysis available on request. Iron Studies ADULT includes Serum Iron, Serum Transferrin, TIBC (calculated), % Iron Binding Saturation and Ferritin. 1 x 4ml Heparin ’s Biochemistry Send on same day as received. If this is not possible centrifuge and remove from red cells. A vial is labelled with the patients’ hospital number, patient’s name, D.O.B., small lab number sticker and today’s date. Iron Studies (PAED) 1 x 7 ml plain Crumlin Haematology Send on same day as received. If this is not possible centrifuge and remove serum from red cells. A vial is labelled with the patients’ hospital number, patient’s name, D.O.B., small lab number sticker and today’s date. Jak 2 Mutation (JAK V617F) 2 x EDTA 14-21 days St. James’s Cancer Molecular Diagnostics Available Mon-Fri 9.30a.m. - 5.00p.m. Screen (includes Anticoagulant and Anti Cardiolipin Antibodies) And beta 2 glycoprotein 2 x 3ml Sodium Citrate 1 x 7 ml plain 1 x 7 ml plain 3-4 weeks (Batched) ’s Coagulation Laboratory St James Immunology SEND STRAIGHT AWAY The screen must arrive into the lab before 3pm as it will not be processed in ’s if it arrives in the Coagulation lab after 4pm. The beta 2 glycoprotein is sent to SJH Lymphocyte Subsets ADULT and PAED (Lymphocyte subsets B Cell% / BNK cell Subsets) 1 x 2.7ml EDTA 2 days St. James’s Immunology Fresh sample required (<24hrs). Must be received before 2.30pm on Fridays. Gene 2 x 2.7ml EDTA St. James’s Special Coagulation Laboratory (NCHCD) Gate Note; Not Currently available in St James’s. Contact Haematologist on where to send.
Microbiology Specimens and Tests Follow the instructions in section 2.2 above for labelling of specimen and form (paper or electronic). Please note: Samples for Blood Culture investigation must be drawn first to avoid contamination. See SI-NOT-GEN1 and SI-NOT-GEN2 for Order of Draw charts on Q-Pulse. Blood cultures, C.S.F. samples and any sample requiring urgent testing whether during routine hours or on-call must be transported to the laboratory without delay. Routine specimens for culture must be stored at 4°C if there is any delay in transport to the laboratory (excludes blood cultures and CSF, keep at room temperature and transport to laboratory without delay). Inoculated agar plates from corneal scrapings, cultures, ocular fluid inoculated into paediatric blood culture bottle and inoculated chocolate agar plates for N. gonorrhoeae culture are processed immediately. Any remaining sample from ocular fluids (vitreous tap, AC tap, aqueous fluid) is then stored at 4°C. Other specimens transferred from RVEEH are stored at 4°C in NMH Microbiology Laboratory upon receipt until such time as they are processed. See also document PP-CS-MIC-64 available in Q-Pulse. Figure : Blood Cultures Culture Container Volume Turnaround Times Special Requirements Accreditation Status Referred Test Adult Aerobic and anaerobic vials 8-10 mls per bottle Interim negative to date results at 24 and 48 hours for adults and 36 and 48 hrs for paeds. Full negative results after 5 days. Positive results available 48-96 hours from time bottle flagged positive. Specimens should be taken before commencement of antimicrobial therapy. Send to laboratory immediately. Accredited No Neonate vial ≥ 1 ml Accredited No Figure : CSF Microbiology Examination CSF Container Turnaround Times Special Requirements Accreditation Status Referred Test Culture 3 X Sterile CSF Minimum: ≤48hrs. Maximum: 96 hrs. Specimens should be taken before commencement of antimicrobial therapy. Send to laboratory immediately. Accredited No Microscopy, Gram ≤2hrs Accredited GBS, E.Coli and Listeria PCR 1 day Accredited Yes: IMSRL Viral studies ≤1 week Accredited Yes: NVRL
Figure : Sputum Microbiology Examination Sputum Container Specimen Volume Turnaround Times Special Requirements Accreditation Status Referred Test Culture Sterile container Deep cough purulent specimen. 1 ml Minimum: 48hrs Maximum: Specimens should be before antimicrobial therapy started. Saliva and perinasal secretions unsuitable Accredited No Legionella 1 ml 1 week Accredited Yes: Microbiology, ’s Hospital Auramine phenol Stain morning specimen on 3 consecutive days 1 week Accredited T.B Culture 6 - 8 Accredited Bloodstained 1 ml Routine Culture: 10 days. TB: 6 - 8 weeks Any bloodstained sputa are referred to SVUH for ZN stain, TB culture and routine culture if required Accredited Figure : Routine Swabs Microbiology Examination Swabs Container Turnaround Times Special Requirements Accreditation Status Referred Test HVS: Microscopy Plain (red top) swab if taken during working day. Black charcoal swab if delay. Gram stain - same day Accredited No All swabs (see for all swabs processed in NMH) Vary depending on swab type, see individual procedures for reporting times Accredited No Neisseria gonorrhoeae Culture Swab Minimum: 48 hrs Maximum: 96 hrs Endocervical swab, send immediately to Microbiology and Contact Micro Laboratory. Available during routine hours only Accredited No: Culture Yes: For susceptibility testing when isolated. Referred to Microbiology, SJH Rapid GBS Screen - HVS/Rectal Red Copan collection devices (double swab) Same day As per guidelines and/or as per Consultant Microbiologist. Not accredited No PCR test for Chlamydia and N. gonorrhoeae Aptima swab 7 - 10 Days Accredited Yes: NVRL
Figure : Surveillance Screens Screen Container Specimen Turnaround Times Special Requirements Accreditation Status Referred Test MRSA: Adults swab throat and perineal / groin Minimum: Maximum: 96 hrs Accredited No MRSA: Neonatal Screen Nasal, Groin and Umbilical All babies in the unit are screened every Monday. All new admissions and re-admissions to the unit should be screened on arrival. Accredited No MRSA: Occupational Health Screen* Nasal, Accredited No Gentamicin Resistant Enterobacterales Sterile container or Plain swab Stool or Rectal Swab Minimum: 24hrs Maximum: 72 hrs All babies in the unit are screened every Tuesday. Faecal matter required on swab. Accredited No VRE Adults/ Neonates Minimum: Maximum: 96 days All patient transfers or recent hospital admissions screened for VRE and CRE Accredited No CPE Adults/ Neonates Minimum: 24hrs Maximum: 72 hrs Not accredited No *Note: Occupational health screen results are not available to view on ward enquiry.
MEASLES AND MUMPS 4-5 Working Days Y MEASLES SCREEN 4 Working Days Y MOLECULAR GENETICS EDTA 14 - 21 days If not sent out that day, keep in fridge and send the following day. Retain a scanned copy of request form If sent over the weekend, in fridge as it is delivered to the lab. It will be sent on Monday morning. National Centre for Medical Genetics, Crumlin, 12. Tel : 01 4096970 Y* MUMPS SCREEN Adult : Serum gel 5 Working Days NVRL, Tel 01 7164415 Y NEEDLE STICK SOURCE 3 Working Days URGENT!! Send to NVRL ASAP and phone to inform them it’s en route. If needle stick recipient comes at the same time order a HOLD on the recipient sample and send with source sample. Y NEEDLE STICK RECIPIENT (HOLD) If it down with a needle stick send it with the needle stick blood. If there is no needle stick blood it can wait to the next routine day as it’s not urgent. Y NOROVIRUS / WINTER VOMITING Faeces 3 working days (in season)/5 working days (not in season) Do not send vomitus Y OHD SCREEN Adult : Serum gel Paed : Serum / plasma 5 Working Days Y IVS Must be written on OHD forms only PARVOVIRUS SCREEN 3 Working Days If requested urgent by phone send ASAP. Otherwise send with next courier. NVRL, Tel 01 7164415 Y QUANTIFERON TB Special blood tubes (x4) from Biomnis 5 Working Days Keep sample at RT. Must be incubated 16hours after infection. Must be centrifuged within 3 days. Biomnis Y QF PCR CVS / Amniotic Fluid /EDTA 14 - 21 days Change sample type on request screen to suit specimen. If sent over the weekend date and time form and store at room temperature. Leave a note to Specimen reception staff to inform them that the sample is in the fridge. It will be sent on Monday morning. Retain a scanned copy of request form. West of Regional Genetic Service. Level 2 B Laboratory Medicine, Southern , , G514TF Tel : CPA number: 2157
*Denotes a laboratory that had achieved CPD accreditation until December 2013. CPD accreditation is no longer available in , and the above laboratories are in transition to ISO15189 accreditation with INAB. They currently work towards a quality management system. NOTE: For testing Paediatric samples for hepatitis B and C PCR, serum samples are also accepted by the NVRL. For other virology requests please consult WI-CS-SR-2 or The NVRL User Manual at the following link Retrospective Requesting/Additional Requests Samples are sent to NVRL and not retained in specimen reception. Additional may be requested within a year period by completion of a serology request. Highlight on the form that it is add on request to a previous sample sent to the laboratory and send form to specimen reception. Samples are stored in the NVRL for 12 months. All add on requests are entered in the laboratory information system. Molecular Genetics Specimens for cytogenetics are handled by specimen reception and enquiries should be directed to this extension (3178/3545). Specimen reception must be informed in advance of any amniotic fluid or CVS specimen. Samples are sent to the referral centre the same day (Monday – Thursday) if received in the laboratory before 12.00 hrs. On Friday samples can be received up until 2.15 pm. Samples received after this will be sent the following routine working day. Our courier provides a next day delivery to the referral centres. No samples for molecular genetics should be sent outside of routine hours (Monday – Friday 8am – 5pm) Figure : Genetic Testing Test/Profile Adult: Sample Type (Vol) Paediatric: Sample Type (Vol) Referral Centre Turnaround Special Requirements Prenatal Diagnosis QF PCR Amniotic Fluid Or CVS N/A Genetics OLHSCC and / or 3 Working Days Please do not take samples after 2.15pm on a Friday as specimens must be transported to overnight Prenatal Diagnosis Culture CVS Genetics OLHSCC and / or 3 Working Days Please do not take samples 2.15pm on a Friday as specimens must be transported to overnight Molecular Genetics EDTA 3ml EDTA 1.3ml Genetics OLHSCC 14-21 Working Days Monday to Friday only Karyotyping Lithium Heparin 3ml TDL 14-21 Working Days Please do not take samples 2.15pm on a Friday as specimens must be transported to overnight
St James Hospital Dublin 8 Cytogenetics: specimens to Dept of Medical Genetics, York Hill Hospital, NHS Glasgow Phone: 00441412010377 National Reference Laboratory(NVRL) University College Dublin, Belfield, Dublin 4 Phone: 01 7164414 Web: TDL The Doctors Laboratory, 60 Whitfield Street, London W1T 4EU Phone: 00442073077409 00442073077373 Temple Street Biochemistry: (Lactate, Organic Acids, Amino Acids) Temple Street Children’s Hospital Dublin 1 Phone: 01 878 4272 / 4273 / 4458 Biominis Laboratories Sandyford Industrial Estate Foxrock Phone: 01 - 2944108 Appendix : Uncertainty of Measurement Performance specifications and indications of uncertainty of measurement for internal tests are recorded in RF-CS-LM-90 [Calculated Uncertainty of Measurement for Laboratory Procedures] and are available from the individual laboratories (where appropriate) on request.