Haematology/Blood Transfusion: 173440 Microbiology: 173444 Histology / Cytology / Serology / Public Health / Media /Infection Prevention and Control Department Open 09:00 to 17:00hrs weekdays only. Please note that these departments are not open at weekends or Public Holidays and do not provide an “on call” service. Test Availability Available during routine hours For routine test availability and specimen requirements, please refer to specific departmental guidelines Biochemistry Haematology/ Blood Transfusion Histology/Cytology Microbiology Serology Public Health Oncall service Medical Laboratory Scientists provide an emergency On Call service outside of the routine working hours for in (see above for “on call” working arrangements). This service is intended to respond to urgent test requests and provide results, where there is an immediate clinical requirement for decision making in the patients care. Specimens during On Call hours should be sent on the red PATH-GEN-FRM-12 Laboratory Emergency Request Form. Any other tests required should be completed on blue/green request forms and attached. These tests will be processed during next routine hours. NB all 3 copies of form must have patient information completed Biochemistry Oncall Biochemistry On Call (On Call Telephone number 173450) Blood gases * Total bilirubin (neonates only) Urea & Electrolytes Alcohol ** Cardiac enzymes (weekends only) Paracetamol Amylase Salicylate Magnesium Glucose Calcium CRP *Biochemistry On call MUST be contacted prior to sending blood gas specimen. Failure to do so may result in specimen not being processed. Do not send blood gas specimens in shute system ** Alcohol requests from ED will only be processed upon direct discussion with the consultant. Result cannot be used for medico legal purposes due to collection procedure. OnCall
Primary receptacles should be packed in secondary packagings in such a way that, under normal conditions of carriage, they cannot break, be punctured or leak their contents into the secondary packaging. Secondary packagings should be secured in outer packagings with suitable cushioning material. Any leakage of the contents shall not compromise the integrity of the cushioning material or of the outer packaging. For further details of the packing instructions for UN 3373 refer to European Agreement concerning the International Carriage of Dangerous Goods by Road (ADR 2015) part 4 packing instruction P650. Volume Order of Draw Cap Colour Additive Assays Mixing Instructions Special Instructions 3ml 1 Citrate Solution PT, APTT, Fibrinogen, Thrombophillia Screen, HLA Typing After Blood Collection, Invert tube 4 times Fill tube to Line - Inadequately filled tubes CANNOT be used 9ml 2 Gel General Biochemistry Tests, Immunology & Virology Tests, After Blood Collection, Invert tube 5-10 times Allow 30 Minutes before Centrifuging 9ml 3 Lithium Heparin Gel Biochemistry if specimen is clotting in-vitro, some Biochemistry tests e.g. Amino Acids After Blood Collection, Invert tube 5-10 times 30 Minutes before Centrifuging 3ml 4 EDTA FBC, HBA1c, Malaria Parasites, Sickledex, Reticulocyte Count, ACTH, Renin, Cyclosporins, Haemochromatosis, Ammonia, ESR, PTH, PCR After Blood Collection, Invert tube 8-10 times Ammonia MUST be Transported on ICE PTH must be sent promptly to the lab 6ml 5 EDTA Crossmatch, Group Crossmatch After Blood Collection, Invert tube 8-10 times Handwritten details ONLY - no addressograph (within SUH PDA collect label acceptable) 4ml 6 Fluoride Oxalate Blood Glucose Levels & GTT, Lactate After Blood Collection, Invert tube 5-10 times Specify Collection Time & if sample is RANDOM or D-
Unidentified patients Patients who cannot be identified (unconscious) are provided with a unique PCN. Gender of the patient should also be provided.Once patient identity is LIS and hospital records will be merged/updated accordingly. b) Mandatory Criteria for Request Form completion. Request form MUST match details provided on specimen and should be labelled with Patient Forename & Surname (essential) and Date of birth and/or SUH PCN or Full address* *Address is only accepted when Surname, Forename and DOB is provided All sections of request form should be completed and must be legible. Relevant clinical details and sample type must be provided. Collect Date and Time required for Antibiotic assays, Molecular Serology Invesigations – PCR, Viral Load and Genotype (Refer to specific Microbiology/Serology and Histology acceptance criteria in this manual ) Some referral/specialized require a completed consent form, refer to individual laboratory department sections of this manual or applicable laboratory for guidance Specimens will not be processed where required consent form is not provided. Specimens may be processed upon provision of this information within a reasonable timeframe at discretion of individual laboratory. Specimens with request forms that are not completed properly will not be processed. Please note the following also when completing Request forms All copies of request form should be completed Addressograph may be used Please Use the appropriate request form: -Blue Request form used for routine Blood sciences analysis (Biochemistry/Haematology/Serology) -Red Request form used for urgent on call analysis (Biochemistry/Haematology/Microbiology) -Red Blood Transfusion request form (Blood Transfusion)
Jones Protein Full EMU 24H Container See report form Bicarbonate Blood Serum (Red top tube) 22-29 mmol/L Daily Bilirubin (Total) Blood Serum (Red top tube) < 21 umol/L < 6 days old – <216 umol/L or STAT samples <1hr Bilirubin (Direct) Blood (Red top tube) <5.0 umol/L Daily or STAT samples <1hr Blood Gases Arterial Arterial Blood Balanced Heparinised Syringe. PH: PO2: 4.5-6.1 kPa pCO2: kPa HCO3: 20-26 mmol/L TCO2: 23-27 mmol/L BE: +/- 2 mmol/L Do not transport in chute. Must inform Lab before taking sample Expel any airbubble. Send to the lab immediately on ice. Needle must NOT be left in syringe. sample clearly STAT sample <20mins Calcium Blood Serum (Red top tube) 18-60 Y 2.10 - 2.42 mmol/l 60-90 Y mmol/L >90 y 2.05-2.40 mmol/l See report for paediatric ranges Daily or STAT samples <1hr 24H Acid added to 24H container 2.5 - 8. 0 mmol/d (adult) 24 hr urine required Daily Random Urine ( only for paedriatrics) Universal NB wil only be accepted for paedriatric patients Send to lab immediately after collection. Calcium : Creatinine ratio is calculated. Daily CEA Blood Serum (Red top tube) <5.0 ng/ml Reference for non smokers Should not be used as a screening test. Daily CA-15.3 Blood Serum (Red top tube) 0 – 31.3 U/ml Weekly
CA-19.9 Serum (Red top tube) 0 - 27 U/ml Weekly CA-125 Blood Serum (Red top tube) 0 - 35 U/ml Weekly Carbamazepine Blood Serum (Red top tube) 4 - 12 ug/ml Therapeutic range Weekly Chloride Blood Serum (Red top tube) 96 - 108 mmol/L See report for paediatric ranges Daily or STAT samples <1hr Cholesterol Blood Serum (Red top tube) < 5.2 mmol/L (Fasting) Daily HDL Cholesterol Blood Serum (Red top tube) >1.45 mmol/L (Male) >1.68 mmo/L (Female) Daily LDL Cholesterol Blood Serum (Red top tube) 0 – 2.59 mmol/L Daily Cortisol Blood Timed Serum (Red top tube) Morning 0700-1000hrs 171 – 536 nmol/L Daily Afternoon 1600-2000hrs 64 – 327nmol/L Note: Due to Circadian rhythm of Cortisol levels, in serum and plasma, sample collection time must be noted. Short Synacthen Investigation; investigation of suspected adrenal insufficiency Adrenal insufficiency is excluded by a rise in cortisol >200nmol/L and a 30 min value >600nmol/L. Baseline and post Synacthen cortisol values do not apply to women on oral contraceptives Low dose overnight dexamethasone suppression test; Investigation of suspected Cushing Syndrome: A normal response is suppression of cortisol at 0900hrs to <50nmol/L. Failure to suppress is indicative of Cushing’s syndrome. C-Reactive Protein Blood Serum (Red top tube) < 5 mg/L Daily Creatine Kinase Blood Serum (Red top tube) <190 IU/L (m) <167 IU/L (f) See report for paediatric ranges Daily or STAT samples <1hr
Creatinine (Red top tube) or Plasma (Green top tube) 62-106 umol/L (M) 44-80 umol/L (F) See report for paediatric ranges or STAT samples <1hr Creatinine Clearance Blood and Urine Serum (Red top tube) and Universal or 24H container 80 - 100 mls/min Blood & 24 hr collection of urine. Blood sample should be taken during the urine collection period. Daily CSF Protein CSF Universal 0.2 - 0.4 g/L Contact Laboratory STAT sample <1hr CSF Glucose CSF Universal 2.5 - 4.7 mmol/L Oligoclonal banding CSF and Blood Universal and Serum (Red top tube) tube Unique specimens for Biochemistry. Send Blood sample with CSF. Digoxin Blood Serum (Red top tube) 1.2 - 2.6 nmol/L Specimen should be taken at least 6 hours after lasr oral dose. Weekly Electrophoresis Blood Serum (Red top tube) See report form Fortnightly EMU or 24H 24Hr container EMU- full morning void or complete 24h colledtion Ferritin Blood Serum (Red top tube) 6m – 15yr 7-140 ug/L M 16 -60yr 30-400 ug/L F 16-60yr 15 -150 ug/L M/F 60-90yr 15-650 ug/L Daily Folate Serum (Red top tube) 3.1 – 20.5 ng/ml FSH Serum (Red top tube) Follicular phase 3.0-8.1 mIU/ml Mid-cycle peak 2.6-16.7 mIU/ml Luteal phase 1.4-5.5 mIU/ml Post Menopausal 26.7-133.4 mIU/ml Males 1.0-11.9 mIU/ml Daily
GT Blood Serum (Red top tube) <60 U/L (Male) <40 U/L (Female) Daily or STAT samples <1hr Glucose Blood Fluoride EDTA; Adult grey top or Paediatric yellow top tube. Fasting: Adults,<60y 4.1-5.9mmol/l 60-90y 4.6-6.4mmol/l >90y 1hr PP <7.8mmol/l 2hrPP <6.7mmol/l Criteria for diagnosing DM 1) Incidental glucose >11.1mmol/l or 2) Fasting glucose >7mmol/l or 3) 2hr post oral GTT, glucose conc. Daily or STAT samples <1hr Haemochromotosis Blood EDTA (purple top tube) Presence or absence of mutation Fortnightly Haemoglobin A1c Blood EDTA (purple top tube) or Fluoride EDTA mmol/mol. No diabetic range Weekly IgG IgA IgM Blood (Red top tube) IgG (Adult) 7-16g/L IgA 0.7-4.0 g/L IgM (Adult) 0.4-2.3g/L See report for paediatric ranges Serum protein electrophoresis is done in conjunction with immunoglobulin for technical reasons. Weekly Iron Blood (Red top tube) 11 - 28 umol/L (m) 6.6 - 26 umol/L (f) See report for paediatric ranges Lactate Blood Fluoride EDTA; grey top or Paediatric yellow top tube. 0.5 – 2.2 mmol/L On ice and transported to laboratory immediately Daily LDH Blood Serum (Red top tube) 240 - 480 U/L Daily or STAT samples <1hr
LH Blood Serum (Red top tube) Follicular phase 1.80-11.78 mIU/ml Mid-cycle peak 7.59-89.08 mIU/ml Luteal phase 0.56-14.00 mIU/ml Post Menopausal 5.16-61.99 mIU/ml Males 0.57-12.07 mIU/ml Daily Lithium Blood Serum (Red top tube) Therapeutic ranges 0.6-1.2 mmol/L Potentially Toxic at > 1.5 mmol/L Specimen should be 12 hours post dose Weekly Magnesium Blood Serum (Red top tube) Adults, <60y 0.66 - 1.07 mmol/L 60-90y 0.66-0.99 mmol/L >90y 0.70-0.95 mmol/L See report for paediatric ranges Daily or STAT samples <1hr Microalbumin Creatinine Ratio Random Urine Random < 2.26 g albumin/ mol creatinine Daily Microalbumin Excretion Rate 24hr Urine Plain Bottle < 30 mg / 24hr Daily NT-Pro BNP Serum (Red top tube) Refer to interpretation on report Daily
Oestradiol Blood (Red top tube) Follicular phase 77 – 921 pmol/L Mid-cycle peak 139 - 2382 pmol/L Luteal phase 77- 1145 pmol/L Post Menopausal < 103 pmol/L On HRT < 528 pmol/L 40-161 pmol/L Weekly Osmolality Blood (Red top tube) 280 300 mOsm/Kg (adult) 265-275 mOsm/Kg (neonate) Weekly Urine Random 50 - 1250 mOsm/Kg Weekly Paracetamol Blood Serum (Red top tube) Therapeutic range 10-30 mg/L Daily Phenobarbital Blood Serum (Red top tube) 15 - 40 ug/ml Therapeutic range Weekly Phenytoin Serum (Red top tube) 10 - 20 ug/ml Therapeutic range Weekly Phosphate Blood Serum (Red top tube) 0.87 - 1.45 mmol/L See report for paediatric ranges Daily or STAT samples <1hr 24H Urine 24H Urine Container 10 - 42 mmol/24H Daily Potassium Blood Serum (Red top tube) or Plasma (Green top tube) 3.5 - 5.1 mmol/L < 1 month 3.5 – 5.5 mmol/L or STAT samples <1hr Urine Random / 24hr Refer to report Daily Progesterone (Red top tube) Follicular phase < 0.3 - 0.9 nmol/L Luteal phase 3.8 - 50.6 nmol/L Post Menopausal < 0.3 - 0.6 nmol/L First Trimester 8.9 - 468 nmol/L Second Trimester 71.5 - 303 nmol/L Third Trimester 88.8 - 771 nmol/L Males <0.64 nmol/L Weekly Prolactin Blood Serum (Red top tube) Female ng/ml Male Daily
3.46-19.40 ng/ml Protein Blood Serum (Red top tube) 66 - 87 g/L or STAT samples <1hr 24H Urine 24H Container < 0.14 g/24H Daily Urine Random Protein : Creatinine ratio is calculated Daily PSA (Total) Blood Serum (Red top tube) Age related ng/ml See report form Daily 0 - 50 yrs 50 - 60 yrs 60 - 70 yrs > 70 yrs PTH EDTA (purple top tube) 15 - 65 pg/ml Transport immediately to lab Weekly Rhuematoid factor Blood Serum (Red top tube) 0-14 IU/ML Salicylate Blood Serum (Red top tube) Therapeutic range <300 mg/L Daily Sodium Blood Serum (Red top tube) or Plasma (Green top tube) 133 - 145 mmol/L See report for paediatric ranges Daily or STAT samples <1hr Random 50 - 200 mmol/L Daily Sweat Test Sweat Collected by Medical Scientist, must arrange with Biochemistry Lab ext 4590 in advance. A value below 60 mmol/l is unlikely to be associated with cystic fibrosis. Values above 90mmol/l support a diagnosis of cystic fibrosis. Cystic fibrosis should not be diagnosed based on conductivity measurement alone. Confirmation should be sought using sweat chloride or genotyping. Intermediate values between 60 and 90 mmol/l require Per appointment only, please call Biochemistry on ext 4590 to arrange
further investigation by sweat chloride and/or genotyping. Testosterone Blood Serum (Red top tube) Male: 18-50 yrs 4.94 – 32.0 nmol/L Weekly T4 (Free) Blood (Red top tube) 9.0 - 19.0 pmol/L Daily Total Iron Binding Capacity Blood Serum (Red top tube) 40.8 – 76.6 umol/L Daily Transferrin saturation Blood (Red top tube) 25- 30% Daily Triglyceride Blood Serum (Red top tube) < 2.26 mmol/L Fasting specimen Daily Troponin T Hs Blood (Red top tube) <14 ng/L Analysis on Roche E170 Haemolysed samples unsuitable Daily TSH Blood Serum (Red top tube) 0.35 - 4.94 uU/ml Daily Urate Blood (Red top tube) 0.01 - 0.45 mmol/L (m) 0.01 - 0.34 mmol/L (f) Urine 24 hr Collection 1.48 - 4.43 mmol/24H Daily
Urine - Bence Jones (UPE) Early Morning Random Urine (for screening) / 24hr Urine collection (known cases)- plain bottle Biomnis Creatinine 24hr 24hr Urine collection - plain bottle Biochemistry, SUH Urine Calcium (UCA) 24hr 24hr Urine collection in acidified Calcium bottle Biochemistry, SUH Urine Calcium-Creatinine ratio (UCCR) Paediatrics only – random -send to lab immediately post collection. Biochemistry, SUH Urine Catecholamines / VMA / Metanephrines 24hr collection in acidified Catecholamines bottle (available from Lab) Random sample for Paediatrics only. Beaumont Citrate (CIAU) 24hr 24hr Urine collection - plain bottle –Send to lab immediately post collection Biomnis Urine Copper 24hr 24hr Urine collection - plain bottle Biomnis Urine Cortisol (24UC) 24hr 24hr Urine collection - plain bottle Biomnis Urine Creatinine / Creatinine Clearance (CRCL) 24hr 24hr collection - plain bottle NB. Blood sample must accompany urine for estimation of clearance Biochemistry, SUH Urine Cystine Adult Early morning fasting sample,10mls must be on ice Biomnis Paed Random Urine on ice (add 1 drop 5%thiomercel) Temple St Urine Metabolic screen ( Phos/Uric acid/Calcium) 24hr 24hr Urine collection - plain bottle and 24hr Urine collection in acidified Calcium bottle (available from Lab) Biochemistry, SUH Microalbumin/creatinine ratio MCR Random Biochemistry, SUH Microalbumin Excretion Rate 24hr Urine Collection – plain bottle Biochemistry, SUH Urine Myoglobin (MYUS) 24hr / random 24hr collection - plain bottle / random sample. Biomnis Mucopolysacharides Random urine with 1 drop of 5% Thiomersal added Willink Manchester Urine Organic Acids Urine must be on ice Temple St Urine Oxalate (UOX) 24hr 24hr Urine collection in acidified Calcium bottle Biomnis
Beaumont Hospital P.O. Box 1297 Beaumont Road Dublin 9 Ireland Toxicology (01) 809 2673/5 Telephone enquiries 09:00 - 17:00 GMT Birmingham, City Hospital Biochemistry Dept (TPMT) Dr Jonathan Berg Clinical Biochemistry Department City Hospital Dudley Road Birmingham B18 7QH Tel. No. 0121 507 5353 Fax 0121 507 5290 E Mail Jonathan.Berg@swbh.nhs.uk Eurofins Biomnis Laboratories Ltd. Rock Road, Sandyford Business Estate, Sandyford, Dublin 18, Ireland. Results and Test Enquiries 1800 252966 Telephone enquiries 09:00 - 17:30 GMT Web link; main website CytoGenetics Crumlin Crumlin Molecular Genetics National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children Crumlin Dublin 12 Ireland Cytogenetic enquiries 01-409 6970 Molecular Genetics Crumlin Crumlin Molecular Genetics National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children Crumlin Dublin 12 Ireland Molecular Genetic enquiries 01-409 6733 Genetic Medicine St Mary’s Hospital Floor 6 St Mary’s Hospital Oxford Rd ManchesterM13 9WL Genetic Medicine Tel 0161 276 6506 Southend Hospital (Macroprolactin) Dr Mapplebeck Department of Clinical Chemistry Southend Hospital Prittlewell Close Southend, Westcliffe-on-Sea SS0 0RY Tel. No. +44 (0)1702 435555 ext 5438 Fax 01702 221059 E Mail to mail) sarah.mapplebeck@southend.nhs.uk
Ambiguous Genitalia Contact Biochemistry Laboratory Androgens Serum Refrigerated Biomnis Angelman syndrome Contact Biochemistry Laboratory AntiMullerian Hormone on ice Frozen <4hr Biomnis Acids Lithium Heparin plasma preferable Refrigerated Temple St Amiodarone Serum preferably on ice Frozen <4hr Biomnis Amyloid Serum must be on ice Frozen <1hr Biomnis Azathiopine Lithium Heparin whole blood preferably on ice Do NOT spin Frozen <4hr Biomnis B2M Serum Refrigerated University Hosp, Galway Benzodiazepine (Qualitative) Serum/ urine Refrigerated Beaumont Benzodiazepine (Quantitative) Frozen <4hrs Biomnis Bile acids Serum Refrigerated Biomnis BRCA 1 + 2 Refer to QPulse for detailed bench instructions C- Peptide preferably on ice Frozen <4hrs Biomnis C1 Esterase Serum Serology send out Cadasil Refer to QPulse for detailed bench instructions Caeruloplasmin Serum Refrigerated University Hosp, Galway Caffeine Serum Refrigerated Biomnis Calcitriol Serum preferably on ice Frozen <4hrs Biomnis Calcitonin Serum preferably on ice Frozen <4hrs Biomnis
Erythropoietin Serum Refrigerated Biomnis Ethylene Glycol (antifreeze) Serum Registrar/Consultant MUST arrange directly with Beaumont Tox lab to process test (01) 809 2673/5 Sent immediately to Beaumont hospital Beaumont Fabrys disease Refer to QPulse for detailed bench instructions Facioscapulohumeral muscular dystrophy Refer to QPulse for detailed bench instructions Familial Amyloid Polyneuropathy Refer to QPulse for detailed bench instructions Fatty acids with Very long chains 2 ml EDTA plasma must be on ice Frozen <1hr Biomnis Fatty acids free non esterified serum Lithium Heparin must be on ice Frozen <1hr Biomnis Fecal Elastase ELF Feces Frozen Biomnis Fecal Fats min 24hr max 72hr Fecal collection taken Mon- Tues Refrigerated Biomnis Fecal Reducing Substances Random Fecal sample Frozen Biomnis Lactose Intolerance test Runny fresh (<20mins) Fecal sample min 20g must be on ice Freeze immediately,transport frozen Temple St Felbamate preferably on ice Frozen <4hrs Biomnis FISH Refer to QPulse for detailed bench instructions Flecanide Serum preferably on ice Frozen <4hrs Biomnis Fluoxetine (Prozac) Serum preferably on ice Frozen <4hrs Biomnis Fragile X DO NOT SPIN 2 x EDTA DO NOT SPIN Refrigerated Molecular Genetics, Crumlin Fredreich Ataxia to QPulse for detailed bench instructions Free Light chains Serum Print lastest PE result and attach to FLCR request form Refrigerated University Hosp, Galway Fructosamine Serum Refrigerated Biomnis
Newcastle Screen (refer to protocol in Referral folder in Biochemistry reception for further detail) 5 lithium hep,5 serum,1 Aprotinine,1 EDTA,2 Flouride Oxalate,Urine and Gutherie card Refer to QPulse for detailed bench instructions Biomnis / Temple St Nickel Serum Refrigerated Biomnis Nitrazepam Serum preferably on ice Frozen <4hrs Biomnis Olanzapine preferably on ice Frozen <4hrs Biomnis Oligioclonal band Serum + CSF Refrigerated, include CSF Glucose / CSF protein University Hosp, Galway Oxalate Serum must be on ice Frozen <1hrs Biomnis Oxycarbamezepine Serum must be on ice Frozen <1hrs Biomnis Pancreatic polypeptide 1 EDTA Aprotinin tube (small pink tube in cold rm,do not send in shute) must be on ice Separate into plain tube Frozen <30mins Biomnis Pierrre Robin Syndrome (chromosome analysis) to QPulse for detailed bench instructions Phenyalanine Lithium Heparin,plasma Refrigerated Tem Porphyrin Screen 2 EDTA (DO NOT SPIN), 1 Lit Hep, 1 Fecal sample, 1 24hr urine collection Protect all from light Protect from light,spin Lit Hep,take 100ml aliqout from urine collection St James Pradar Willi Syndrome Molecular genetics Refer to QPulse for detailed bench instructions Primidone Serum preferably on ice Frozen <4hrs Biomnis Pro- Insulin Serum preferably on ice Frozen <4hrs Biomnis Procollagen PPT3 (P3P) Serum preferably on ice Frozen <4hrs Biomnis Protein marker for myeloma) Refer to QPulse for detailed bench instructions Prozac Serum preferably on ice Frozen <4hrs Biomnis PTEN gene Refer to QPulse for detailed bench instructions
Pyruvic acid Refer to QPulse for detailed bench instructions Reducing substances Random Fecal sample Frozen Biomnis Renin EDTA preferably on ice Frozen <4hrs Biomnis Respiradone Serum preferably on ice Frozen <4hrs Biomnis Syndrome Refer to QPulse for detailed bench instructions Rufinamide (Innovlen) Serum preferably on ice Frozen <4hrs Biomnis Selenium Serum -White tube only Separate immediately into white tube, Refrigerated Biomnis Serolimus (Rapumune) DO NOT SPIN Serum Refrigerated Biomnis Serotonin DO NOT SPIN Whole Blood Lith Heparin /10ml 24Hr Urine (dietary restrictions) must be on ice DO NOT SPIN blood Sample Frozen <1hr / (urine) frozen Biomnis SHBG serum Refrigerated Biomnis Spinal Muscular Atrophy to QPulse for detailed bench instructions T3 Serum Refrigerated, include FT4 and TSH results University Hosp, Galway Tacrolimus(prograf) FK506DO NOT SPIN EDTA whole blood Refrigerated Beaumont Testosterone Female / boys <14 Serum Refrigerated Biomnis Theophylline Serum preferably on ice Frozen <4hrs Biomnis Thyroid globulin Serum Refrigerated Biomnis Thyroid binding globulin Serum preferably on ice Frozen <4hrs Biomnis Tiagabine Serum preferably on ice Frozen <4hrs Biomnis Titanium Lithium Hep plasma Refrigerated Biomnis TPMT DO NOT SPIN Refer to QPulse for detailed bench instructions
Topiramate preferably on ice Frozen <4hrs Biomnis Toxicology Screen Refer to QPulse for detailed bench instructions Trileptal Serum preferably on ice Frozen <4hrs Biomnis Triple Test (Downs screen) to QPulse for detailed bench instructions Tryptase Serum Refrigerated Biomnis TTR gene Refer to QPulse for detailed bench instructions Tubersclerosis Refer to QPulse for detailed bench instructions Urobilinogen Not available Vasoactive Intestinal polypeptide (VIP) EDTA Aprotinin tube must be on ice Separate into plain tube Frozen <30mins Biomnis Vigabatrin Serum preferably on ice Frozen <4hrs Biomnis Vitamin A, K1 Serum must be on ice Protect from light and freeze <1hr Biomnis Vitamin B1 Thiamine,B6 DO NOT SPIN EDTA blood, protect from light DO NOT SPIN- freeze <4hrs Biomnis Vitamin C Lithium Heparin only,protect from light must be on ice Protect from and freeze <1hr Biomnis Vit D 1,25 dihydrorxyvit D (Calcitriol) Serum preferably on ice Frozen <4hrs Biomnis Vitamin E Serum preferably on ice, must protect from light protect from light, Frozen <4hrs Biomnis Williams Syndrome Refer to QPulse for detailed bench instructions Zinc White serum tube only Separate immediately into white tube, Refrigerated Biomnis Zonisamide Serum preferably on ice Frozen <4hrs Biomnis Please note that referral tests may take up to 3 weeks before the result is available. Some referral tests require consent form and clinical information forms which are available in Qpulse
Institute of Molecular Medicine John Radcliffe Hospital (JRH) Headington Oxford OX3 9DS United Kingdom Tel: 0044 1865 741166 Biomnis Laboratories Ltd. Three Rock Road, Sandyford Business Estate, Sandyford, Dublin 18, Ireland. Results and Test Enquiries 1800 252966 Telephone enquiries 09:00 - 17:30 GMT Web link; main website Galway University Hospital Galway University Hospital Newcastle Road Galway Telephone enquiries 09:00 - 17:00 GMT Results and Test Enquiries 091 524765 / 524222 ext 4418 Immunology Dept Royal London & St Barts Hospital Immunology, 2nd floor Pathology & Pharmacy building 80 Newark Street, Whitechapel, London, E1 2ES Tel: 0044 2032460279 Immunology Laboratory, St James’s Hospital St James' Hospital James street, Dublin 8 (01) 416 2928 or (01) 416 2034 Exeter Pathology Services: Royal Devon and Exeter NHS Foundation Trust Barrack Rd, Exeter (EX UK) EX2 5DW, UK General Queries 0044 1392 402464 Clinical Queries 0044 1392 402463 Transfusion Laboratory
To arrange tests outside this profile contact the laboratory or medical scientist on call for further information. Haematology Specimen containers: Tube Additive Laboratory use K3EDTA K3EDTA for whole blood haematology determinations. Tube inversions prevent clotting. Invert 8-10 times. Sodium Citrate For coagulation determinations. Tube inversions prevent clotting. MUST be filled to arrow. Serum Clot Activator Tube inversions ensure mixing of clot activator with blood. For Serum specimens Haematology Routine Test Menu Test Specimen type Additional Information Turn-Around-Time * Full Blood Count EDTA x 1 One specimen is sufficient for FBC and ESR when filled to mark. 1 hour stat 3 hrs routine 24hrs GP specimens Erythrocyte Sedimentation Rate EDTA x 1 For ESR analysis on paediatrics- 2 paediatric specimens required. 1 hour stat 3 hrs routine 24hrs GP specimens Reticulocyte Count EDTA x 1 Can be added on to FBC specimen. 1 hour stat 3 hrs routine 24hrs GP specimens Coagulation Screen (on Heparin or Heparin & Warfarin) NaCit x 1 Specimen must be filled to the Black arrow on the tube <1 hour stat 3hrs Routine 8 hrs GP INR (on Warfarin) NaCit x 1 Specimen must be filled to the Black arrow on the tube <1 hour stat 3hrs Routine 24 hrs GP Fibrinogen x 1 Can be added on to Coag specimen. Specimen should be as fresh as possible <4hrs <1 hour stat Dimers NaCit x 1 Can be added on to Coag specimen if specimen is within 4 hrs of phlebotomy <1 hour stat 3hrs Routine 4 hrs GP
Our Lady’s Children’s Hospital, Crumlin. The Division of Pathology and Laboratory Medicine (DPLM), Our Lady’s Children’s Hospital, Crumlin, Dublin Telephone enquiries Monday-Friday from 09:00-17:00 phone (01)-4096251/ 4096432 Saturday-Sunday from 09:30-12:30 phone (01)-4096251/ 4096432 Biomnis Laboratories Ltd. Rock Road, Sandyford Business Estate, Sandyford, Dublin 18, Ireland. Results and Test Enquiries 1800 252966 Telephone enquiries 09:00 - 17:30 GMT Web link; main website University College Hospital, Galway University College Hospital Newcastle Road Galway Telephone enquiries 09:00 - 17:00 GMT Results and Test Enquiries 091 524765 / 524222 ext 4418 Bristol H+I Laboratory NHS BT, 500 North Bristol Park Northway Filton Bristol BS34 7QH Dr Jeff Lucas 00441179217536 Elaine Griffin 00441179217532 Haematology Referral Tests Test name Specimen type Information Referral lab TAT Anticardiolipin antibodies Serum x 1 Immunology UCHG 2-3 weeks Anti Factor Xa Na Citrate plasma x 2 Should be received in lab within 1 hour of phlebotomy. Sample should be taken 4 hours post dose of LMWH. Details and dose of low molecular weight heparin (LMWH) should be stated on request form and time of administration. Haem Lab UCHG (adults), OLCHC (children <16 yrs old) 2 weeks
BCR ABL (Molecular Analysis of Leukaemia) For Chronic Myeloid Leukaemia (CML) or disorders (MPD) EDTA Peripheral blood or BM in RPMI Samples should be in afternoon before 16:00 Ensure sample is accompanied with fully completed and signed PATH-HAEM-EXT-14 Cancer Molecular for molecular analysis Cancer Molecular Diagnostics (CMD)St. James' Hospital 14-21 working days Cytogenetics BM in RPMI with heparin for Leuk/MDS BM in RPMI with Blood in EDTA for CLL BM smears for Multiple Myeloma All samples must be accompanied by a fully completed and signed PATH-HAEM-EXT-5 NCMG Cytogenetics request form. Samples should be in afternoon and received in the laboratory before 16:00 Division of Cytogenetics, National Centre for Medical Genetics, Our Lady's Children's Hospital, Crumlin, Dublin 12.(NCMG) Results available approx 6 months. Urgent referrals may have a preliminary FISH result within 4 days Chimerism testing PB/BM 9ml of peripheral blood in EDTA (3 samples) or 1-3ml of bone marrow in RPMI (1:3 dilution) Samples should be taken in afternoon and received in the laboratory before 16:00 Ensure sample is accompanied with fully completed and signed PATH-HAEM-EXT-14 Cancer Molecular Diagnostics-Request for molecular analysis Cancer Molecular Diagnostics, Central Pathology Laboratory, St James's Hospital, Dublin 8. Usually within 14-21 working days. CD3 CD4 (T Helper), CD8 (T Cytotoxic), CD19 (B cell), CD16/56 (NK cells). 3ml blood in EDTA X 2 Take sample after 2 pm Contact lab prior to sending samples as it must arrive in referral laboratory within 24 hours of phlebotomy. Time and date of collection must be on form. Immunology Lab, St. James Hospital Dublin 8 5 working days
Factor Assays Na citrate x 6 Send samples Mon-Fri. Ensure delivered to laboratory within 4 post phlebotomy and during routine hours St James's Hospital. For patients <16 yrs send to Crumlin 6-8 weeks Factor inhibitor test Na citrate x 2 Send samples Mon-Fri. Ensure delivered to laboratory within 4 post phlebotomy and during routine hours St James's Hospital. For patients <16 yrs send to OLCHC Crumlin 4 weeks Factor V Leiden 1 x EDTA Note: Factor V Leiden testing is only carried out on patients with an abnormally reduced APCR result Biomnis 8 days Hb- electrophoresis 1 X EDTA Advise to request Ferritin test also. Biomnis 5-7 days HIT screen (Heparin Induced Serum x 2 & NA citrate x 2 Must have a pre-test probability of 4 or more & must be accompanied by a clinician completed PATH-HAEM-EXT-1 SJH HIT request form. Send samples Mon-Thurs. Ensure delivered to laboratory within 4 hours post phlebotomy and during routine hours NCHCD SJH Up to 2 weeks HLAB27 (HLA 27 genotype) EDTA x 2 Biomnis 2 weeks Hereditary Spherocytosis (EMA) EDTA sample > 0.5ml Contact laboratory to discuss to taking specimen as must be received by referral laboratory within 18-24 hours Adults- St Special Haematology Lab <16 yrs Crumlin Haematology Lab 1 week (this includes CD19) BM in RPMI specimens Peripheral blood (~3ml EDTA) Must be accompanied by completed PATH-HAEM-EXT-15 UCHG Request for Specialised Haematology Tests Patient details on sample must be HANDWRITTEN Haematology Lab., UCHG/SJH 2-5 days JAK2 EDTA x 2 PB samples / BM in RPMI Send with a fully completed and signed CMD form CMD SJH 14-21 days
Leucocyte Adhesion Deficiency (CD 18/ CD 11) EDTA x1 sample Contact laboratory to discuss prior to taking specimen as must be received by referral laboratory for testing <5 hrs post phlebotomy and requires prior arrangement with referral lab before phlebotomy. (Specialist test not all staff trained) Immunology Lab St James Hospital 5 days Lupus anticoagulant Na citrate x2 samples Ensure delivered to laboratory within 4 post phlebotomy and during routine hours Biomnis 2 weeks gene C677>T mutation EDTA x 1 sample At Haematologist Consutlant request Biomnis 2 Plasma viscosity EDTA x 3 samples Samples must be taken pm, and received in the laboratory before 16:00, Mon-Thurs. Must be received in UCHG<24HRS UCHG 2 days Proxismal Nocturnal (PNH) EDTA x 2 samples Samples must be taken routine hours Mon-Thurs. Sample to arrive in referral lab <48 hrs of phlebotomy. Special Haematology St James Hospital Dublin 2 weeks Prothrombin G20210A 5 ml EDTA At Haematologist Consutlant request Biomnis 8 days Red cell folate 3ml EDTA blood Sample to be early in morning, and received in the laboratory before 10:00 Mon-Thurs. Haematology Lab., UCHG 1 week Thrombophilia screen Na citrate x 6 and Serum x 1 (for ACG) Haematology team must be contacted to taking specimens to discuss clinical details. Ensure samples delivered to laboratory within 4 hours post phlebotomy and during routine hours Biomnis: adults OLCHC: children <16 years old 2 Von Willebrand screen Na citrate x 4 Ensure samples delivered to laboratory within 4 hours post phlebotomy and during routine hours NCHCD, SJH (Adults) OLCHC <16 yrs 6-8 weeks White Cell Antibodies Clotted sample x1 Sample to be sent with completed form PATH-HAEM-EXT-19 Mon/Tues/Wed H+I Laboratory NHS BT 500 North Bristol Park Northway, Filton, Bristol BS34 7QH UK
Microbiology lab for general enquiries 071 9174557 Serology lab for general enquiries 071 9171111 ext. 4159 Consultant Microbiologist Dr. Kenny 071 9171111 ext 4162 Consultant Microbiology Secretary Barbara Moloney 071 9172501 barbara.moloney@hse.ie Chief Medical Scientist (Microbiology) Anne 071 9174563 Senior Medical Scientist (Microbiology) Esther McCormack 071 9174563 Senior Medical Scientist (Microbiology) Karen Hickey 071 9174563 Senior Medical Scientist (Serology) Anne Duffy 071 9171111 ext 4159 Quality Manager Mike Mitchell 071-917 4434 Surveillance Scientist Karen Logan 071 9174140 Infection Prevention and Control Theresa Farrell Ciaran Adams 071 9171111 ext 4161 (Bleep 132) 071 9171111 ext 4161 (Bleep 117) * Internal extensions in bold digits. Introduction This manual is designed to give an overall view of the services available in the Saolta University Health Care Sligo University Hospital, Microbiology Laboratory. It is intended as a quick reference guide for both GPs and Hospital Clinicians. Please note this manual is intended for use as a guide only.
Declaration form for inadequately labelled samples and correct labelling error in person before samples may be processed. Samples from patients details do not correspond with the request form. Sample not processed. Report issued stating that Different names on form and sample(s) or Incorrect PID or Name stated) CSF samples Blood Culture samples Unrepeatable samples The request form and sample should have corresponding details. Unlabelled / Mislabelled samples Sample not processed. Report issued stating that unlabelled sample received and This sample deviated from Pathology Labelling Policy. Requesting clinician was contacted by the laboratory and informed of requirement to rectify labelling error and complete Declaration Form for Inadequately Labelled Specimens. Nature of deviation stated ie Unlabelled samples or Mislabelled samples. CSF samples Blood Culture samples Unrepeatable samples Unrepeatable specimens-refer to sample deviation acceptance policy in Introduction section of this manual. Requesting Clinician is required to complete form: PATH-GEN-FRM-3 Declaration form for inadequately labelled samples and correct labelling in person before samples may be processed. Samples with no clinical details or inappropriate clinical details provided on request form ( including antibiotic assays) Sample not processed. Any samples received without accompanying appropriate clinical details will also be rejected with the following comment “No (or inappropriate)clinical details provided. Sample not processed. Relevant clinical information is necessary in order to allow interpretation of test results. Samples will be held for 48 hours and processed if relevant clinical details are provided” ICU samples NICU RDU samples Haematology/ Oncology patients Diabetic patients Any sample that cannot be easily repeated e.g. tissue, CSF, aspirates, blood cultures, BALs, biopsies. MRSA/VRE screens (including CSU urines from known MRSA carriers) Relevant clinical information is necessary in to allow choice of relevant tests and interpretation of test results. If clinical information is subsequently provided, this is recorded on the report and the sample is processed.
urine samples in this second tube. Please call Microbiology at 071 9174563 to discuss if required. Microscopy: Manual Microscopy WBC <20 x 106/L AND epithelial cells or amorphous deposit present. Automated Cell Count WBC <40 x 106/L AND ≥1+ epithelial cells present. Field obscured by Amorphous Deposit or Epithelial Cells Automated Cell Count WBC <40 x 106/L AND no bacteria present. Sample not cultured. A report will be issued with the microscopy result and a comment stating “Culture not performed on this sample due to low blood cell count and the presence of epithelial cells/amorphous deposit.” Sample not cultured. A report will be issued with the microscopy result and a comment stating “Poor quality sample as evidenced by large amounts of epithelial cells and/or amorphous deposit……Advise repeat specimen if clinically indicated.” Sample not cultured. A report will be issued with the microscopy result and a comment stating “Culture not performed on this sample due to absence/low white cells and absence/low levels of bacterial cells on urine cytometry. Evidence has shown that significant Neutropaenic Haem/Onc patients ICU/NICU/RDU pts Suprapubic aspirates Suprapubic catheter >100 RCC in male patients, elderly females, pregnancy or anybody where there is not a reasonable explanation for a high RCC. Proteinuria in pregnancy Pyelonephritis Majority of such samples cultured yield mixed growth of contaminating organisms (mixed skin flora or mixed enteric organisms) Culture not performed due to high likelihood of contamination Evidence has shown that significant growth does not occur on culture in these instances.
Faecal samples: (C. Difficile) Non-diarrhoeal sample received Previous positive C. Difficile within 6 days Sample not processed Sample not processed. Report issued with comment, This patient tested positive for C. Difficile on: (date) Please send repeat sample 6 days post initiation of therapy N/A N/A In accordance with National Guidelines, non-diarrhoeal samples are not tested for C. diff. toxins Duplication of work. Send repeat sample 6 days post initiation of therapy as per guidelines. Faecal samples: (Norovirus) Norovirus requests received that have not been discussed with Infection Prevention and Control Sample received from a confirmed outbreak Sample received from a specific patient on a particular outbreak that has a known negative or positive result. Sample not processed. Report issued with comment, Norovirus testing not performed. Please discuss Norovirus request with Infection Protection and Control prior to submitting samples. Sample not processed. Report issued with comment, Norovirus outbreak already confirmed in this unit. Further samples from this unit will not be processed for Norovirus detection. Sample not processed. Report issued with comment, indicating that a sample has been received that has been previously positive or indicating that a sample has been received that has been previously negative. Samples received from ED and Assessment Units that have clinical details clearly indicating diarrhoea and vommitting. N/A Infection prevention and control may ask for a repeat of a negative result. Control of Norovirus testing. Two positive norovirus cases obtained from a specific outbreak occurrence are required for confirmation of an outbreak. Control of Norovirus testing. Faecal samples: Control of unnecessary requests
(General) Multiple Requests / Single sample received Report issued with appropriate comment from below Prioritise C. Difficile or Viral screen over routine culture. Sample processed for one test only. At the discretion of Infection prevention and control or a senior scientist. Mutiple requests , separate samples required Multiple requests: (One sample received), SEPARATE samples required. Multiple requests,( Two samples received) SEPARATE samples required. MRSA: Screens from community (including nursing homes) Repeat MRSA screens received within 7 days MRSA: Such samples will not be processed. A report will be issued with the comment “Sample not processed. MRSA screens from the community will only be processed in the following circumstances: if clinical details indicate patient is for admission to hospital, if clinical details indicate screening is required as part of pre-operative assessment, or if requested by Infection Prevention and Control.” Such samples will not be processed. A report will be issued with the comment “Duplicate MRSA screen received within ‘? days.’ Please submit repeat screening swabs at weekly intervals.” If clinical details indicate patient is for admission to hospital If clinical details indicate screening is required as part of assessment If requested by Infection Prevention and Control N/A Recommended by SARI Infection Prevention and Control The Control and Prevention of MRSA in Hospitals and in the Community. Ireland:Health Protection and Surveillance Centre, 2005. MRSA protocol.
folded square of paper preferably fastened with a paper clip, but commercial packs are also available (e.g. ‘Mycotrans’). It is easier to see affected hairs on white paper rather than black. Medical indications and Serology test requesting guide For a serological diagnosis, acute (as early as possible in the illness) and convalescent sera (10-14 weeks after onset) may need to be taken for for demonstrating seroconversion or rising titres. Virus specific Ig M tests may be done on a single specimen of serum for the diagnosis of acute infections for example Hepatitis A. IgM is usually positive 5 days post onset. N.B. A general request for “Viral screen” or “routine virology” or “atypical screen” can NOT be processed without accompanying clinical information. The following “Requesting Guide” may assist in identifying possible viruses/agents involved. This guide is derived from guidelines issued by the National Virus Reference Laboratory (NVRL), Dublin. More detailed information is available on the NVRLwebsite * These specimens/ samples are referred to external laboratory for testing (PTWIP) Phoned to ward if positive and/ or significant ** NOTE: If sample needs to be sent to referral Lab for supplemental/ confirmatory testing Turnaround Time will be longer. Days are expressed as Calendar days. Provisional Diagnosis/ Symptoms Tests to be ordered Specimen Type Possible Virus/ Agent/ Disease Respiratory Infection URTI and LRTI Mycoplasma pneumoniae Coxiella burnetti (Q fever) Chlamydia Group Serum/ Clotted Blood Legionella pneumophilia (Urinary Antigen) Urine Influenza A** Influenza B** Throat swab in viral transport media Respiratory Syncital virus (RSV)* Parainfluenza* Adenovirus* Nasopharyngeal Aspirate (NPA) or sputum Arthralgia Rubella virus* Parvovirus B19* Serum/ Clotted Blood
Mycoplasma pneumoniae Brucella* Borrelia burgdorferi *(Lyme Disease) (if clinically suspected) Exanthem (Skin Rash) Measles virus* Rubella virus* Parovirus B19* Antistreptolysin Titre (ASO) Borrelia burgdorferi *(Lyme Disease) (if clinically suspected) HIV(if risk factors) Hepatitis B (if risk factors) Dengue *(if risk factors) Clotted Blood Saliva Oral Fluid for Measles only Herpes Simplex Virus* (HSV) Varicella Zoster Virus (VZV) Vesicle Fluid/ Scrapings on Slide Enterovirus* Stool/ Viral Throat Swab Central Nervous System Mumps virus* Serum/ Clotted Blood Measles Serum/ Clotted Blood Nasopharyngeal Aspirate CSG Herpes Simplex virus* (HSV) Varicella Zoster (VZV) Clotted Blood or CSF Enterovirus* CSF/ Stool/ Viral Throat Swab/ Pleural Fluid Dengue* (if risk factors) West Nile Virus* (if risk factors) Serum/ Clotted Blood Hepatitis Hepatitis A, B, C, D & E Viruses Cytomegalovirus *(CMV) Epstein-Barr Virus* Serum/ Clotted Blood Genital infection Herpes Simplex *(HSV) Viral swab Chlamydia trachomatis* Urine Male uretheral swab Endocervical swab Eye swab
• For the diagnosis of bacteraemia withdraw blood from a peripheral vein and divide the sample equally among blood culture bottles. If a central line is present, withdraw blood also from the central line following the recommendations in hospital’s Guidelines for Preventing Central Vascular Catheter Related Infection. • Label bottles with patient name and hospital number or use hospital addressograph label. DO NOT COVER THE BOTTLE BARCODE. THIS IS FOR LABORATORY USE. • State on bottles and form if blood is from a peripheral vein or a central line. Complete laboratory request form giving a brief relevant history including antibiotic therapy. Complete Microbiology Specimen Request Form (Green), or On-call request form (Red) to ensure compliance with the Patient Specimen and Request Form Identification Criteria. Please supply relevant clinical and antibiotic therapy details. Send bottles and request form to the laboratory for immediate incubation Volume/Quantity Paediatric/Neonate 1-4 mls of blood in yellow paediatric bottle. Adult 5-10 mls of blood in each bottle (Aerobic and Anaerobic). Endocarditis Three sets (Aerobic and Anaerobic) of blood cultures should be taken from separate venepuncture sites. Safety Requirements Standard precautions should be adhered to when collecting blood or biological material. Inspect the blood culture bottles for damage or defect before use and that they have not exceeded their expiry date. Gloves should be worn at collection. Do not re-sheath needles. Time Between Collection and Processing Blood cultures should be transported to the laboratory as soon as possible after collection, for incubation / loading to the BacT Alert 3D system within 4 hours. Where there is a delay in transport to the laboratory or loading onto the BacT Alert 3D system, blood cultures should be incubated at 36±1°C as soon as possible after inoculation and MUST NOT be refrigerated. Pending transportation, store at room temperature. Sample Quality N/A Special Requirements N/A Turnaround Times Most significant pathogens will be detected within 24-48 hrs; however blood cultures are routinely incubated for 5 days with the exception of endocarditis investigations where incubation is extended to 21 days. Positive blood cultures are notified to the ward staff involved immediately on detection by the microbiology/on call staff therefore there is no need for ward staff to contact the Microbiology laboratory to determine if a blood culture is positive.
spoon. The specimen is unsatisfactory if there remains any residual soap, detergent or disinfectant in the pan. Volume/Quantity 1-2g (spoonful) is sufficient. No more than 3 consecutive negative stools from different days will be tested on a single patient. Safety Requirements Ensure sterile universal containers are leak-proof and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Stool specimens should arrive in the laboratory as soon as possible. Sample Quality Formed will not be tested unless there is an indication that the patient has toxic megacolon. Special Requirements N/A Turnaround Times 24 Comments Sligo University Hospital Infection Prevention and Control will be notified of a positive result. Faeces – Norovirus Testing Specimen Type Faeces Sample Container Sterile Universal Container. Sample collection/ preparation Collect specimen 3-5 days after onset of symptoms. Specimen may be passed into a clean, dry, disposable bedpan or similar container and transferred into a sterile container (see above) using the spoon. The specimen is unsatisfactory if there remains any residual soap, detergent or disinfectant in the pan. Volume/Quantity 1-2g (spoonful) is sufficient. If more than one specimen is received on the same day, only one specimen per patient per day is to be processed. Safety Requirements Ensure sterile universal containers are leak-proof and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Stool specimens should arrive in the laboratory as soon as possible. If a delay is unavoidable, specimen should be refrigerated in a designated refrigerator or in a designated part of a refrigerator not close to medicines or food. Sample Quality N/A Special Requirements N/A Turnaround Times 24
One specimen is sufficient. Safety Requirements Place urine vacutainer in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing ≤ 4 hrs, store at room temperature. Alternatively, specimens may be stored at 2-8oC for up to 14 days or frozen (-20oC) for longer periods before testing Sample Quality Boric acid may be used as a preservative. Special Requirements N/A Turnaround Times Same Day Comments N/A Pregnancy Tests Specimen Type Urine Sample Container Sterile BD Urine collection cup and urine vacutainer NB: Sharp Risk-There is an integrated sharp in the collection cup lid !! Sample collection/ preparation Collect a urine specimen into a Sterile BD Urine collection cup and transfer to the urine vacutainer. Submit vacutainer only to the laboratory. Volume/Quantity Minimum volume ≥ 1 ml. One specimen is sufficient. Safety Requirements Place urine vacutainer in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing ≤ 48 hrs, store at 2-8oC for up to 48 hours or frozen (-20oC) for longer periods before testing Sample Quality n/a Special Requirements A first morning urine specimen is preferred since it generally contains the highest concentrationof hCG; however, urine specimens collected at any time of the day may be used. Turnaround Times Same Day Comments N/A Screening Swabs MRSA screen
Specimen date and collect time NOT provided. Sample received in laboratory > of venepucture. For all of the above: Advise submit repeat specimen Gentamicin Clotted Blood Specimen Collect Time/ Focus of infection/ Dose Schedule/ when last dose was given must be provided on request form Inadequate clinical information provided- Timing of sampling, dose administered, dose frequency and focus of infection must be specified. Results uninterpretable without the above information/ Sample will be held and processed if relevant details are provided. Hepatitis C RNA EDTA Whole Blood or Clotted Blood Specimen collect date and time must be indicated on request form. Specimen must be sent to the Serology Lab Urgently so that it can be centrifuged, aliquoted and frozen within 6 hrs of venepuncture. The Serology laboratory must be contacted before is taken and specimen must reach laboratory before 4pm. Specimen date and collect time NOT provided or or specimen received in laboratory > 6 hours from venepuncture. Sample not received and frozen within 6 hours of venepuncture./ Advise submit repeat specimen HCV genotype * EDTA Blood or Clotted Blood Specimen collect date and time must be indicated on request form. Specimen must be sent to the Serology Lab Urgently so that it can be centrifuged, aliquoted and frozen within 6 hrs of venepuncture. The Serology laboratory must be contacted before is taken and specimen must reach laboratory before 4pm. Specimen date and collect time NOT provided or specimen received in laboratory > 6 hours from venepuncture Sample not received and frozen within 6 hours of venepuncture./ Advise submit repeat specimen HIV Viral load * EDTA whole blood Specimen collect date and time must be indicated on request form. Two EDTA samples must be received centrifuged and frozen within 6 hours of venepuncture. Laboratory must Specimen date and collect time NOT provided or specimen received in laboratory > 6 hours from venepuncture.
Schistosomal antibodies * (Primarily screened on urine in microbiology) Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist. / Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Staphyloccal antibodies * Clotted Blood Test currently suspended Teicoplanin level *(Trough) Clotted Timing of sampling, dose administered, dose frequency and focus of infection must be specified & prior discussion with Consultant Microbiologist required. Inadequate clinical information provided./ Please contact Consultant Microbiologist for test to be processed. Vancomycin Clotted Blood Specimen Collect Time/ Focus of infection/ Dose Schedule/ when last dose was given must be provided on request form Inadequate clinical information provided- Timing of sampling, dose administered, dose frequency and focus of infection must be specified. Results uninterpretable without the above information/ Sample will be held and processed if relevant details are provided. Viral Screen * Clotted Blood ‘Specimens accompanied by forms requesting ‘Viral Studies” are not routinely processed: clinical details are essential to inform appropriate tests are performed’ (NVRL User manual). Clinical team in NVRl can be contacted at 01 7164418 for discussion re the most appropriate test(s) to request. No relevant clinical details provided. Tests analysed by NVRL,based on clinical information supplied on original Laboratory request form. / A serum aliquot of this sample has been stored, but will not be processed unless relevant clinical details are provided. West Nile Virus * Clotted Blood Relevant Clinical Details including history and prior discussion with Consultant Microbiologist. No relevant clinical details provided or no discussion with Consultant Microbiologist/ Please contact Consultant Microbiologist with relevant clinical details for test to be processed.
Amikacin levels * Blood None 5.0 Red top vacuette serum tube Site of infection, Dose schedule, When last dose was given, must be clearly indicated on form. Prior discussion with Consultant Microbiologist required. Amikacin is assayed in Biomnis Laboratory 2 days for phoned report Anti-DNAse B * Blood None 5.0 Red top vacuette serum tube Test No Longer Available titre (ASOT) Blood None 5.0 Red top vacuette serum tube Useful for the investigation of A Beta- haemolytic Streptococcal infection or post- streptococcal disorder e.g. rheumatic fever. 1 – 3 days Aspergillus precipitans * Blood None 5.0 Red top vacuette serum tube 13 – 18 days Avian allergans * Blood None 5.0 Red top vacuette serum tube 13 – 21 days Bartonella henselae antibodies */ Cat Scratch Disease None 5.0 Red top vacuette serum tube Test currently suspended Bordatella pertussis antibodies * Blood None 5.0 Red top vacuette tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Borrellia burgdorferi antibodies (Lyme Disease)* None 5.0 Red top vacuette serum tube 13 – 18 days Brucella screen * Blood None 5.5 Red top vacuette 7-14 days
serum tube Chlamydia trachomatis (CT) PCR * Samples requested for CT investigations will also be tested for Neisseria gonorrhoeae (GC) Urethral Swab Swab Eye Swab Throat swab Rectal Swab specimen None Not relevant Swab/ Urine APTIMA collection device kits Available from Serology Lab Details on specimen collection for combined CT and GC testing are included in the APTIMA collection device kits 7-14 days Chlamydia group CFT assay (Non STD, respiratory) Discontinued, NVRL in conjunction with labs in the UK has been unable to obtain control antigens for Chlamydia for use in the CFT assay. Chloramphenicol levels * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 3 – 7days for phoned result Clostridium tetani antibodies * None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Coeliac Screen Blood None 5.5 Red top vacuette serum tube Supplementary testing sent to Immunology UCHG if Anti tTG is positive on initial screening. 2-5 days for in-house screen Corynebacterium diphtheriae antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Coxiella burnetti (Q fever) antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following consultation with Consultant Microbiologist. 18 - 24 days Cryptococcus Serology * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 24 days
Cytomegalovirus (CMV) antibodies * Blood None 5.5 Red top vacuette serum tube 7-12 days Cytomegalovirus (CMV) DNA CMV PCR * Blood Urine K EDTA None 4.5 Purple top vacuette EDTA tube Sterile Universal Serology Lab must be notified before sending samples. Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hrs of venepuncture. Please send to laboratory immediately as sample must be sent frozen to referral lab 10 – 18 days Dengue Antibodies * Blood None 5.5 Red top vacuette tube Only accepted following consultation with laboratory. Please provide clinical details including comprehensive travel history 18-24 days Echinococcus antibodies (Hydatid Cyst / Cystercercosis Ab) * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Epstein-Barr (EBV) antibodies * Blood None 5.5 Red top vacuette serum tube 7 – 12 days
Epstein-Barr Virus PCR EBV DNA * Blood K EDTA 4.5 Purple top vacuette EDTA tube Serology Lab must be notified before sending samples. Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hrs of venepuncture 10 – 21 days Farmers lung screen * None 5.5 Red top vacuette serum tube 10 – 24 days Assay 5.5 Red top vacuette serum tube Weeks Gentamicin levels *** Blood None 5.5 Red top vacuette serum tube Site of infection, Time was collected, Dose schedule, When last dose was given, must be clearly indicated on request form. See HSE Intranet/ SUH homepage/ hyperlink to ‘Guide to Antimicrobial Use in SRH’ Desirable Levels: Gentamicin (pre-dose): <1mg/L 3-6 hours Results outside therapeutic ranges are phoned to ward during routine day. All tests performed On Call are phoned to ward B streptococcal PCR Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day. Haemophilus influenzae b antibodies (HIB) * Blood None 5.5 Red top vacuette serum tube 15-24 days Haemophilus PCR * K EDTA 4.5 adult 1.5 paed Purple top vacuette Please state on request form if patient was on antibiotic before taking sample, Clinical details, If sample received in referral lab before 11 AM
EDTA tube Date of onset of symptoms preliminary verbal report can be issued same day. Hepatitis A IgM (Acute infection) *** None 5.5 Red top vacuette serum tube 2 – 6 days Hepatitis A IgG (Immunity/ Past infection) * Blood None 5.5 Red top vacuette serum tube 7 – 14 days Hepatitis B surface antigen *** (HBsAg) Acute Infection ** Blood None 5.5 Red top vacuette tube 2 – 6 days (PTWIP) Anti-HBs *** (Hepatitis B Immunity/ Vaccination) Blood None 5.5 Red top vacuette serum tube Please provide vaccination history. For information on HBV vaccine schedule/ post vaccination testing to Immunisation Guidelines at - Chapter 9 Hepatitis B 2 - 6 days Anti-HB core (Evidence of past infection) * None 5.5 Red top vacuette serum tube 7 – 12 days Hep B markers: HBeAg, Anti Hep B core specific IgM Blood None 5.5 Red top vacuette serum tube 7 – 12 days Hepatitis B viral load, HBV DNA * Blood KEDTA 4.5 Purple top Vacuette EDTA tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hours of venepuncture and Serology Lab notified before blood is taken. 10 – 21 days
HIV confirmatory * Blood None 5.5 Red top vacuette serum tube 5 – 12 days HIV Genotypic antiviral resistance testing Blood K EDTA 2 X 4.5 Purple top vacuette EDTA tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hours of venepuncture and Serology Lab notified before blood is taken. 16-24 Days HIV viral load * Blood K EDTA 2 X 4.5 Purple top vacuette EDTA tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hours of venepuncture and Serology Lab notified before blood is taken. 10 – 24 days Influenza virus * aspirate, Viral nasal/ Throat sample None 4.5 Sterile Universal or swab Send to Microbiology Laboratory 5-12 days Leptospiral screen * None 5.5 Red top vacuette serum tube 10 – 18 days Measles antibodies (IgM + IgG) * Blood None 5.5 Red top vacuette tube 10 – 18 days antibodies * None Paed 1.5 (0.2-0.5 ml Red top vacuette serum tube Variable, 2 – 6 months Monospot (Glandular fever) Blood None 5.5 Red top vacuette serum tube 1.-3 days
Mumps antibodies (IgM + IgG) * Blood None 5.5 Red top vacuette serum tube 10 – 18 days Mycoplasma pneumoniae antibodies * None 5.5 Red top vacuette serum tube NVRL will test Mycoplasma IgM for patients the age of 20. For patients >/= 20 years old prior discussion is required with Consultant Microbiologist as these samples are sent, to UK for analysis 10 – 18 days Neisseria meningitidis PCR * Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day. Parvovirus B19 serology * Blood None 5.5 Red top vacuette tube 10 – 18 days Pneumococcal antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist 15-24 days Pneumococcal PCR * Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day Polyomavirus (JC, BK) * Blood CSF Urine None 5.5 Red top vacuette serum tube Sterile Universal Specimen collect date and time must be provided on request form and sample. Blood Sample must be received and frozen within 24 hours of venepuncture. Urine sample must be frozen within 24 hrs of collection 10-24 days
Rubella IgG*** Blood None 5.5 Red top vacuette serum tube 2-6 days Rubella IgM * Blood None 5.5 Red top vacuette serum tube 7-12 days Staphylococcal antibodies * Blood None 5.5 Red top vacuette serum tube Test currently suspended Schistosomal antibodies * (Primarily screened on urine in microbiology) Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist 15-24 days Syphilis *** screen (Treponema pallidum) ** None 5.5 Red top vacuette tube 2-6 days Teicoplanin level (Trough) * None 5.5 Red top vacuette serum tube Site of infection, Dose schedule, When last dose was must be clearly indicated on form. Only accepted following prior consultation with Consultant Microbiologist 3– 7 days for phoned result Tobramycin Level * Blood None 5.5 Red top vacuette serum tube State dose schedule, when last dose was received, Tobramycin is assayed in St Vincent’s Hospital 2 – 4 days for phoned result Toxocaral antibodies * Blood None 5.5 Red top vacuette serum tube 15-24 days Toxoplasma screen * Blood None 5.5 Red top vacuette serum tube 7-12 days Vancomycin levels *** Blood None 5.5 Red top vacuette serum tube Site of infection, Collect time of sample, Dose schedule, When last dose was must be 2 hrs Results outside therapeutic ranges are phoned to ward
Test Specimen (Part) Type Additive and amount required Container type Special requirements biopsies for Histology Endoscopic, skin, core/needle biopsies (prostate breast, lung etc.) curettings etc. 10% Neutral Buffered Formalin (NBF) Prefilled 40 ml containers with lid firmly closed None Larger biopsies or organs for Histology Fixed tissue Resections, larger biopsies, organs etc 10% NBF. Bulk liquid is available from the Histology Laboratory. Ensure specimen is fully immersed in liquid Select appropriately sized Histology container (available from the Pathology Laboratory) with the lid securely closed None Frozen section for Histology Fresh tissue None Do Not Immerse in Fluid Appropriately sized empty Histology container with lid securely closed Prior to procedure- inform Pathologist on-duty and laboratory to advise and ensure appropriate staff are available. Adhere to the standard safety precautions for infectious material. Transport immediately to the laboratory Genetic studies* Paraffin embedded tissue N/A N/A Pathologist selected on request Cytogenetic studies** tissue RPMI transport medium Specific container supplied by Claymon laboratories Claymon request form and Patient consent form must be completed prior to specimen collection * and** These tests are referred to outside laboratories for analysis.