user manual ed 6 july 09

7/23/2019 User Manual Ed 6 July 09

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Department of Pathology and Laboratory Medicine

User Reference Manual

St Vincent’s University Hospital,lm Par!,Dublin "#

dition $

%uly &''(

Valid Until )'th %une &'*'#

MP-GEN-USERMAN Author: M.O’Leary Approved By :D.Murphy Effective Date !t "u#y $%%& S'U( PD NS RE' %)*%& %+,,

+able of ontents

1.0 INTRODUCTION................................................................................................................................................ .......4

2.0 QUALITY POLICY........................................................................................................................................... .........4

3.0 LOCATION..................................................................................................................................................................4

. P A(OLOG/ RE0EP1ON AND P(LEBOOM/...................................................................................................+.$ L ABORAOR/................................................................................................................................................ +

4.0 LABORATORY OPENING HOURS........................................................................................................................5

5.0 TESTS AVAILABLE OUT OF HOURS................................................................................................................. ...5

,. B1O0(EM1SR/............................................................................................................................................. 2,.$ ( AEMAOLOG/............................................................................................................................................. 2,. BLOOD RANS3US1ON................................................................................................................................... 2,.+ M10ROB1OLOG/............................................................................................................................................. 2,., (1SOLOG/.................................................................................................................................................. 2,.2 NU0LEAR MED101NE...................................................................................................................................... 2,.) 1MMUNOLOG/............................................................................................................................................... 2

6.0 CONTACT DETAILS FOR KEY LABORATORY PERSONNEL........................................................................

.0 USER SATISFACTION! CO""ENTS AND CO"PLAINTS...............................................................................#

$.0 CO"PLETION OF REQUEST FOR".................................................................................................................. ..#

4. GP RE5UES 3ORMS................................................................................................................................... &

#.0 SPECI"EN LABELLING..........................................................................................................................................#

10.0 BLOOD TRANSFUSION REQUEST FOR" AND SPECI"ENS.................................................................. ....10

%. BLOOD RANS3US1ON RE5UES 3ORM........................................................................................................%%.$ P A1EN 1DEN1310A1ON 6(EN A71NG BLOOD RANS3US1ON S AMPLES........................................................%%. L ABELL1NG BLOOD RANS3US1ON S AMPLES..................................................................................................%.+ 1N0ORRE0L/ L ABELLED SPE01MENS 1N BLOOD RANS3US1ON......................................................................

%., 5UAL1/ O3 BLOOD RANS3US1ON S AMPLES................................................................................................

11.0 SPECI"EN CONTAINERS.....................................................................................................................................12

. ARER1AL BLOOD G AS S/R1NGES................................................................................................................ $.$ BLOOD 0ONA1NERS: UBE GU1DE PLA0ED 1N ORDER O3 DRA6..................................................................... (1SOLOG/ SPE01MEN 0ONA1NERS............................................................................................................+.+ UR1NE SPE01MEN 0ONA1NERS.................................................................................................................... +., O(ER SPE01MEN 0ONA1NERS................................................................................................................... +

12.0 PHLEBOTO"Y SERVICE.................................................................................................................................... ..15

$. P(LEBOOM/ OPEN1NG (OURS................................................................................................................... ,

13.0 SPECI"EN TRANSPORT.......................................................................................................................................15

. SPE01MENS 3ROM 61(1N (E (OSP1AL......................................................................................................,.$ PNEUMA10 UBE S/SEM 8POD9............................................................................................................... 2. RANSPOR O3 (1SOLOG10AL SAMPLES......................................................................................................2.+ RANSPOR O3 SEN1NEL NODES PROO0OL...............................................................................................2., P A07AG1NG O3 D1AGNOS10 SPE01MENS 3ROM GP SURGER1ES E;ERNAL (OSP1ALS AND 0L1N10S..............2

14.0 TURNAROUND TI"E.............................................................................................................................................1

+. RE5UES1NG ADD11ONAL E;AM1NA1ONS.....................................................................................................)+.$ 1ME L1M1 3OR RE5UES1NG ADD11ONAL E;AM1NA1ONS.............................................................................)

15.0 REPORTING OF RESULTS! CLINICAL ADVICE AND INTERPRETATION....................................... ........1$

16.0 INSTRUCTIONS FOR %ARD ENQUIRY FOR VIE%ING LABORATORY RESULTS............................... .1$

1.0 INFECTION CONTROL..........................................................................................................................................1#

Pa<e $ of +

'i!itor! to the depart?e>t !hou#d report to the Patho#o<y Receptio> o> the <rou>d f#oor to otai> te?porary!@ipe card. he po!ta# addre!! of the #aoratory i!:Patho#o<y Depart?e>tSt. 'i>ce>t’! U>iver!ity (o!pita#E#? ParCDu#i> +.e#epho>e: H , $$+,&% 8Patho#o<y Receptio>93a: H , $2&$4,

"#' Laboratory /pening Hours

Department /pening Hours

Patho#o<y Receptio> Mo>day – 3riday %4:%%- ):%%

Bioche?i!try

B#ood ra>!fu!io>

(ae?ato#o<y

(i!to#o<y

Microio#o<y

Mo>day – 3riday %&:% – ):%%.

Saturday &:% – $:+, 8Ur<e>t !a?p#e! o>#y9

Metao#i!?

Nuc#ear Medici>e Laoratory

Mo>day – 3riday &:%% – ):%%

E>docri>o#o<y

1??u>o#o<y

Mo>day – 3riday &:% – ):%%

0#' +ests 1vailable /ut of Hours

A> o>-ca## !y!te? operate! out!ide >or?a# @orCi>< hour! for e?er<e>cy @orC i.e. >o>-deferra#e te!t! >ece!!aryfor deci!io>! re<ardi>< patie>t ?a>a<e?e>t.

/n2all Personnel1f !peci?e>! are de#ivered u!i>< the p>eu?atic tue or if the !cie>ti!t o> ca## i! >ot i> the #aoratory @he>!peci?e>! are de#ivered it i! e!!e>tia# that they e co>tacted u!i>< the co>tact >u?er! e#o@:

ontact

Bioche?i!try Scie>ti!t O>-0a## B#eep ,&

Et. +2,+ * 4$4 8Laoratory9

Et $+ 8Se>ior Roo?9

Et. +)8Med Re!9.

(ae?ato#o<y *B#ood ra>!fu!io>*

Microio#o<i!t Scie>ti!t O>-0a##

B#eep +2,

Et. +)4, * +++& 8Laoratory9

Et. +$+& 8Med Re!9

Pa<e , of +

0#* 3iochemistry

he fo##o@i>< ioche?i!try te!t! are avai#a#e out of hour!: Arteria# #ood <a!e! 8a>d acid-a!e9 0o-Oi?etry 8i>c#udi>< 0O( Met(9 LactateUrea 0reati>i>e = E#ectro#yte!G#uco!e 0a#ciu? A?y#a!ePho!phate Ma<>e!iu? UrateLiver 3u>ctio> e!t! 0RP07 ropo>i>Lithiu? Phe>ytoi> heophy##i>e 0ara?aIepi>e 'a#proic Acid

Etha>o#Paraceta?o#Sa#icy#ate!0S3 G#uco!e = Protei>P#eura# 3#uid p( Protei> = LD(3#uid G#uco!e = 3#uid LD(Uri>ary Sodiu? Pota!!iu? = 0reati>i>e.

0#& Haematology

he fo##o@i>< (ae?ato#o<y te!t! are avai#a#e out of hour!:3B0P 1NR APD-Di?er!3iri>o<e>

A>y !pecia# te!t! reuired ur<e>t#y @i## >eed to e !a>ctio>ed y the 0o>!u#ta>t (ae?ato#o<i!t 8e.<. (epari> A!!ay! Protei> 0 A!!ay! etc.9.Pre<>a>cy e!ti><he 0o>!u#ta>t Microio#o<i!t !a>ctio>! ?a#aria !cree>!.

0#) 3lood +ransfusion

1t i! ho!pita# po#icy to avoid routi>e tra>!fu!io>! out of hour!. he out of hour ’! tra>!fu!io> !ervice provided o>#yapp#ie! to e?er<e>cie! a>d to !ituatio>! @here the patie>t! ca>>ot @ait u>ti# the >et routi>e period. Reue!t!for #ood for e#ective !ur<ica# procedure! are >ot proce!!ed out of hour!.

0#" Microbiology

he (ae?ato#o<y Scie>ti!t O>-0a## provide! a !ervice for ur<e>t 0S3 a>d A!cetic 3#uid !a?p#e!. Mo!t other

?icroio#o<ica# !peci?e>! >eed >ot e ea?i>ed ur<e>t#y. P#ea!e co>tact the 0o>!u#ta>t Microio#o<i!t foradvice if i> dout.

0#0 Histology

Ur<e>t #iver iop!ie! ca> e arra><ed y co>tacti>< the 0o>!u#ta>t Patho#o<i!t throu<h the !@itch.

0#$ 4uclear Medicine

he out of hour ’! !ervice for Di<oi> app#ie! to e?er<e>cie! @here the reue!t ca>>ot @ait u>ti# the >et routi>eperiod. A 0o>!u#ta>t ?u!t !a>ctio> reue!t! for out of hour! Di<oi>. 1f the 0o>!u#ta>t dee?! the reue!t ur<e>tthe !@itch @i## co>tact Prof. "oe Duffy or a ?e?er of the >uc#ear ?edici>e !taff.

0#5 -mmunologyPre<>a>cy e!t! are avai#a#e out of hour! co>tact the (ae?ato#o<y Scie>ti!t O>-0a##.

Pa<e 2 of +

$#' ontact details for 6ey Laboratory Personnel

he Cey #aoratory per!o>>e# are #i!ted e#o@. 1f pho>i>< fro? out!ide the ho!pita# p#ea!e prefi the ete>!io>>u?er @ith % $$.

Haematology

0o>!u#ta>t (ae?ato#o<i!t*

0#i>ica# Advice *1>terpretatio>

Dr. Do>a#d Mc0arthy

Dr. 7are> Murphy

Dr. Gerry 0o>>a<ha>

$,

$,

+$4%

(ae?ato#o<y Re<i!trar B#eep )*22,

0hief Medica# Scie>ti!t Mr. 1va> Shir#ey +$4%

A>ticoa<u#a>t Nur!e Specia#i!t

A>ticoa<u#a>t Mo>itori>< Service Secretary

B#eep 22

+,

Laoratory E>uire! +$4%

(ae?ato#o<y 3a % $$&24

Histopathology

0o>!u#ta>t (i!topatho#o<i!t!0#i>ica# Advice*1>terpretatio>

0o>!u#ta>t Neuropatho#o<i!t

Dr. o?. 0rottyProf. 7iera> Sheaha>

Dr. 0eci#y 5ui>>

Dr. David. Gio>!

Dr. Su!a>. 7e>>edy

Dr. Eo<ha>. Moo>ey

Dr. Nia?h No#a>

Prof. Michae#. 3arre##

+$)% 8#eep )9+)

+2,4

4,

+)$,

4,

+)44 8Pa<er $%4,)&9

4%&$2

N0(D’! +$&*+)&&

0hief Medica# Scie>ti!t M!. Ber>ie 0urra> 4,,

Laoratory E>uire! +%

-mmunology

0o>!u#ta>t (i!topatho#o<i!t Dr. o? 0rotty +&,

0hief Medica# Scie>ti!t M! Eve#y> (a>>i<a> +$)%

Laoratory E>uire! +,&4

Metabolism

Pri>cipa# Bioche?i!t

0#i>ica# Advice*1>terpretatio>

M! Barara Murray +,

Laoratory E>uirie! +2)$*++%2

Microbiology

0o>!u#ta>t Microio#o<i!t!

0#i>ica# Advice *1>terpretatio>

Dr. Ly>da 3e>e#o>

Dr. 7ir!te> Schaffer

Prof. 6i##ia? (a##

Dr. Li##ia> RaFa>

Dr. SuIie 3itI<era#d

++)%

+4,

+4,

++)%

++)%

Microio#o<y Re<i!trar! +&+&*+%44*&2*&)

0hief Medica# Scie>ti!t Mr. Eu<e>e 0ru??y +)&+

1>fectio> 0o>tro# Si!ter! +&+4*+%44*&2*&)

Pa<e ) of +

Position 4ame 7tension

Director of Patho#o<y a>d LaoratoryMedici>e

Dr. Do>a#d Mc0arthy +$4%

Laoratory Ma>a<er Mr. Do>a# Murphy +,%

Patho#o<y 5ua#ity Ma>a<er M! Mairead O’Leary 2&,

Patho#o<y Ad?i>i!trator Mr! Sa>dra Dev#i> +2)

3iochemistry

0o>!u#ta>t Bioche?i!t* 0#i>ica# Advice*1>terpretatio>

Dr. Sea> 0u>>i><ha? ++%

0hief Medica# Scie>ti!t M!. 0o#ette (atto> ++&%

Pri>cipa# Bioche?i!t Mr. Ro@#a>d Reece

M! Or#a Ma<uire

+)4&

+,,%

Ge>era# E>uirie! +,,%

Bioche?i!try Scie>ti!t O>-0a## B#eep ,&

+2,+ 4$4 8La9

$+ 8Se>ior Roo?9

+) 8Med Re! Et9

3lood +ransfusion

0o>!u#ta>t (ae?ato#o<i!t


Dr. Do>a#d Mc0arthy

Dr. 7are> Murphy

Dr. "oa> 3itI<era#d

$,

$,

+&2

0hief Medica# Scie>ti!t Mr. Pau# O’Brie> +4+

Laoratory E>uirie! +++&*+)%2

Ste? 0e## Proce!!i>< Laoratory ++$2

B#ood ra>!fu!io>*(ae?ato#o<y *Microio#o<y Medica# Scie>ti!t O>-0a##

B#eep +2,

ndocrinology

Pri>cipa# Bioche?i!t


Dr. ho?a! S?ith +2$&

Laoratory E>uirie! ++%2

4uclear Medicine

Pri>cipa# Bioche?i!t *0#i>ica# Advice*1>terpretatio> Prof. "oe Duffy +2%)

Laoratory E>uire! +)4*$)

Phlebotomy

Se>ior Ph#eoto?i!t M! Bre>da LarCi> +2,$ B#eep ,+

Mortuary

Se>ior Patho#o<y ech>icia> Mr. 0o#i> (o@e +$4

5#' User Satisfaction, omments and omplaints

Our ?ai> <oa# i! to e>!ure that our u!er! receive accurate re#ia#e ?ea>i><fu# a>d ti?e#y #aoratory re!u#t! @ith?i>i?a# reuire?e>t! for repeat te!ti>< 8e.<. for i?proper !peci?e> co##ectio>9. 1f u!er! e>cou>ter a>y pro#e?!@ith the !ervice! or have !u<<e!tio>! for !ervice i?prove?e>t p#ea!e co>tact the appropriate !ectio> or e?ai#the Laoratory Ma>a<er Do>a# Murphy at d.?urphyJ!vuh.ie.

8#' ompletion of Re9uest :orm

3or accurate ide>tificatio> of patie>t! a>d !peci?e>! it i! e!!e>tia# that reue!t! for?! e co?p#eted fu##y #e<i#ya>d accurate#y.

+he essential information on the re9uest form;

• Patie>t’! Sur>a?e a>d 3ore>a?e

• MRN 8Medica# Record Nu?er9. 1f a MRN i! >ot avai#a#e or re#eva>t 8i.e. GP patie>t!9 a date of irth a>d

addre!! ?u!t e !upp#ied o> the for? a>d !peci?e> #ae#.

• Date of Birth

• Ge>der a>d it#e

• Date a>d ti?e of !peci?e> co##ectio>

• Na?e of the Reue!ti>< 0o>!u#ta>t

• Locatio> to @here the re!u#t! !hou#d e reported

• ype of !peci?e> co##ected a>d if appropriate the a>ato?ica# !ite of ori or ticC the re#eva>t o

• Na?e a>d #eep >u?er of reue!ti>< doctor

• A>a#y!i! reuired

0#i>ica# detai#! a>d re#eva>t treat?e>t i>for?atio> are etre?e#y u!efu# to the #aoratory i> i>terpreti>< re!u#t!.he u!e of patie>t addre!!o<raph #ae#! o> reue!t for?! i! reco??e>ded. Mu#tip#e te!t! for o>e depart?e>tca> e !e>t of o>e reue!t for? ut !eparate !peci?e>! a>d reue!t for?! are reuired if te!t! are ei>< !e>t to?ore tha> o>e depart?e>t.

-f specimen is urgent please indicate on re9uest form and the re9uest <ill be prioritised#Please remember that inade9uate information on your re9uest form ma!es it impossible to issue a

report or contact the doctor in case of urgent or une7pected results#

8#* =P Re9uest :orms

GP’! are reue!ted to !e>d !peci?e>! @ith the !pecia##y de!i<>ed GP reue!t for?. 0o?p#eti>< the top copy ofthe GP reue!t for? produce! ?u#tip#e caro> copie! u>der>eath. P#ea!e u!e a##poi>t pe> a>d e>!ure that thei>for?atio> provided i! #e<i#e o> a## copie! of thi! for?.

(#' Specimen Labelling

A## #aoratory !peci?e>! must e #ae##ed @ith a ?i>i?u? of t@o accepta#e ide>tifier!. he accepta#e

ide>tifier! are Patient’s :ull 4ame and either MR4 or Date of 3irth oth ide>tifier! ?u!t e correct a>d

Pa<e 4 of +

mailto:[email protected]

mailto:[email protected]

co?p#ete. A## @riti>< ?u!t e c#ear a>d #e<i#e a>d addre!!o<raph #ae#! should not e u!ed o> !peci?e>! @iththe eceptio> of (i!to#o<y a>d 0yto#o<y !peci?e> @here the u!e of addre!!o<raph #ae# o> !peci?e>! i!reco??e>ded.

he ?i>i?u? #ae##i>< reuire?e>t! for B#ood ra>!fu!io> !peci?e>! are Patie>t ’! 3u## Na?e MRN Date ofBirth a>d the !i<>ature of the per!o> taCi>< the !a?p#e.

he!e criterio>! for !a?p#e accepta>ce are e!!e>tia# for patie>t !afety a>d are i> p#ace to decrea!e the ri!C ofpote>tia# har? cau!ed y #ae##i>< error!. he po#icy i! !trict#y e>forced a>d !peci?e>! >ot ?eeti>< the ?i>i?u?

criteria @i## e reFected.

Speci?e>! of $+ hr uri>e co##ectio>! ?u!t e c#ear#y #ae##ed @ith the patie>t’! >a?e ho!pita# >u?er date a>dti?e co##ectio> co??e>ced date a>d ti?e co##ectio> fi>i!hed a>d te!t reuired. 1t i! >ot !ufficie>t to !ticC thereue!t for? o> the ott#e. he uri>e co##ectio> !hou#d e Cept refri<erated duri>< co##ectio> a>d rou<ht to the#a o> the !a?e day that the co##ectio> fi>i!he!.

A## $+ hr uri>e co##ectio> ott#e! @hich have acid added a! pre!ervative ?u!t a#!o e #ae##ed @ith a corro!ive!ticCer.

i?ed uri>e co##ectio>! !hou#d have oth the !tarti>< ti?e a>d fi>i!hi>< ti?e of uri>e co##ectio>.

B#ood Ga! !peci?e>! ?u!t >ever e !e>t to the #aoratory @ith a >eed#e attached.Specimen containers that are e7ternally contaminated <ith body fluids should not be sent to the

laboratory#

*'#' 3lood +ransfusion Re9uest :orm and Specimens

*'#* 3lood +ransfusion Re9uest :orm

0o?p#ete the B#ood ra>!fu!io> Reue!t 3or? @ith the fo##o@i>for?atio>:. Patie>t’! Sur>a?e 8i> #ocC capita#!9$. Patie>t’! 3ore>a?e 8i> #ocC capita#! i>itia#! are >ot accepta#e9. Patie>t’! MRN+. Patie>t’! Date of Birth,. Date a>d i?e !peci?e> @a! taCe> – thi! i! vita# i> e!ta#i!hi>< the va#idity of the !a?p#e for te!ti><!tora<e a>d reu!e

2. Patie>t’! Locatio> a>d 0o>!u#ta>t). Product reuired a>d date a>d ti?e reuired4. Na?e a>d !i<>ature of the reue!ti>< doctor &. Patie>t’! tra>!fu!io> hi!tory%. Rea!o> for tra>!fu!io>* - 0 above are minimum re9uirements for acceptance# Re9uest forms not meeting minimumre9uirements <ill be returned for correction and unnecessary delays <ill result#

*'#& Patient -dentification <hen ta!ing 3lood +ransfusion Samples

Go to the patie>t a>d if he*!he i! co>!ciou!: -

• A!C the patie>t to !ay their >a?e a>d date of irth.

• 0hecC thi! >a?e @ith the >a?e o> the reue!t for?.

• 0hecC the >a?e a>d (o!pita# Nu?er o> the patie>t ’! @ri!ta>d a<ai>!t the for?. 1f the patie>t doe! >ot

have a @ri!ta>d co>tact the >ur!e i> char<e.-f patient has no <ristband do not ta!e sample#O>#y @he> you are !ati!fied that the patie>t ha! ee> fu##y ide>tified taCe the #ood !a?p#e.

Pa<e & of +

*'#) Labelling 3lood +ransfusion Samples

Addre!!o<raph #ae#! ?u!t >ot e u!ed o> tra>!fu!io> !a?p#e!. After #eedi>< the patie>t @rite the fo##o@i>for?atio> fro? the patie>t’! @ri!ta>d #e<i#y o> the !a?p#e tuebefore leaving the bedside#

• Patie>t’! Sur>a?e 8i> #ocC capita#!9.

• Patie>t’! 3ore>a?e 8i> #ocC capita#! i>itia#! are >ot accepta#e9.

• Patie>t’! (o!pita# >u?er.

• Patie>t’! date of irth

• Si<>ature of per!o> taCi>< the !a?p#e.• Date the !a?p#e @a! taCe>

*'#" -ncorrectly Labelled Specimens in 3lood +ransfusion

1>correct#y #ae##ed !a?p#e! @i## e reFected. he per!o> @ho tooC the !a?p#e @i## e i>for?ed of thi! deci!io>a>d the rea!o> @hy. he!e po#icie! are i> p#ace to e>!ure co?p#ia>ce @ith EU Directive $%%$*&4*E0.he ho!pita##ood a>C !taff have ee> i>!tructed y the (o!pita# ra>!fu!io> 0o??ittee to e>force the!e po#icie!.

*'#0 .uality of 3lood +ransfusion Samples

Sa?p#e! ?u!t e !e>t to the #aoratory i??ediate#y. Sa?p#e! ?u!t e tra>!ported et@ee> +o0 a>d $, o0.Sa?p#e! arrivi>< #ater tha> )$ hour! after the ti?e taCe> are >ot !uita#e for proce!!i>< a>d @i## e reFected8i>c#udi>< GP !a?p#e!9 a>d the reue!ti>< doctor @i## e i>for?ed.

GP’! a>d eter>a# ho!pita#! !e>di>< !a?p#e! to the #aoratory ?u!t e>!ure patie>t co>fide>tia#ity i! protectedduri>< tra>!portatio>.

A## !a?p#e! are i>!pected o> arriva# i>to the #aoratory. Sa?p#e! @hich are <ro!!#y hae?o#y!ed #ipae?ic or!ho@i>< other !i<>! of deterioratio> ?ay >ot e !uita#e for proce!!i>< a>d @i## e reFected. he deci!io> toreFect a !a?p#e @i## e ?ade y a !e>ior !cie>ti!t a>d the reue!ti>< doctor @i## e i>for?ed of thi! deci!io> a>dthe rea!o> @hy.

he #aoratory doe! >ot provide a> a>te->ata# #ood <roupi>< a>d a>tiody !cree>i>< !ervice. he!e !a?p#e!!hou#d e !e>t direct#y to the patie>t’! ?ater>ity ho!pita# #ood a>C.

3or further i>for?atio> o> !a?p#e taCi>< ide>tificatio> or tra>!portatio> p#ea!e co>tact the ho!pita# #ood a>C

direct#y.

Pa<e % of +

**#' Specimen ontainers

he correct !peci?e> co>tai>er ?u!t e u!ed @he> co##ecti>< !peci?e>!. Be#o@ i! a uicC <uide to the co>tai>er type that !hou#d e u!ed. A ?ore co?prehe>!ive #i!t of the te!t! co>tai>er type reuired a>d !pecia#precautio>! @he> taCi>< particu#ar te!t! i! avai#a#e i> the e!t Reuire?e>t Ma>ua#.

B#ood ue! are avai#a#e @ith differe>t a>ticoa<u#a>t! the a>ticoa<u#a>t i> the #ood tue i! @ritte> o> the #ae#a>d the cap co#our i! i>dicative of the a>ticoa<u#a>t pre!e>t. Be#o@ i! a uicC <uide for the co>tai>er reuired fora particu#ar te!t.

1f ?ore tha> o>e #ood !peci?e> i! taCe> !peci?e> ?u!t e taCe> i> a particu#ar order. he <uide e#o@ <ive>the correct dra@ order.

**#* 1rterial 3lood =as Syringes

Pre hepari>i!ed !yri><e! are avai#a#e for #ood <a! a>a#y!i!. A !peci?e> cap i! provided @ith each!yri><e a>d !hou#d e p#aced o> !peci?e> prior to ri>< to the #aoratory. Speci?e>! must >ot e !e>t @ith>eed#e! attached. Sa?p#e! for B#ood Ga! a>a#y!i! !hou#d >ot e !e>t o> the p>eu?atic tue.

B#ood Ga! !peci?e> for #actate a>a#y!i! !hou#d e p#aced o> ice a>d rou<ht to the #aoratory i??ediate#y.

**#& 3lood ontainers; +ube =uide placed in /rder of Dra<

0o#or 0ode ue ype Deter?i>atio>!

B#ood0u#ture

A>aeroic fo##o@ed y aeroic – if i>!ufficie>t #ood for oth cu#ture ott#e! u!eaeroic ott#e o>#y.B#ood 0u#ture ott#e! !hou#d e avai#a#e o> a## @ard!. A !upp#y i! avai#a#e fro?Microio#o<y Receptio> 8Mo> – 3ri9 duri>< ope>i>< hour!.

Li<ht B#ue

Sodiu?

0itrate

Li<ht #ue capped vacutai>er @ith !odiu? citrate a>ticoa<u#a>t.

Determinations; 0oa<u#atio> e!ti>! 3actor A!!ay!.

Red

Seru? Seru? 4/4 =L - Red capped vacutai>er @ith c#ot activator.Determinations; LD( 1o>i!ed 0a#ciu? Phe>ytoi> heophy##i>e MethotreateLithiu? 'a#proate 0ara?aIepi>e Paraceta?o# Sa#icy#ate! 'ita?i> DParathyroid (or?o>e O!?o#a#ity Bo>e MarCer! E>docri>e e!ti>< 8ec#udi><hyroid9

Go#d

Seru?*Ge# Seru? =L - Go#d capped p#a!tic vacutai>er @ith c#ot activator a>d <e# for !eru?!eparatio>.Determinations; S( 3+ 0orti!o# Di<oi> Gro@th (or?o>e ADNAGa!tri> 'ita?i> B$ 3o#ate 3erriti> PSA 3ree PSA 0EA A3P(0G0A$,0A&.&0A, E#ectrophore!i! 1??u>o<#oi>! 81<G 1<M1<A1<E9 B$Micro<#oi> 0eru#op#a!?i>1>fectiou! Mo>ohyroid A Liver A Rheu?ato#o<y0oe#iac A.

Pa<e of +

Li<ht Gree>

P#a!?a*Ge# P#a!?a =L !peci?e> - Li<ht <ree> capped p#a!tic vacutai>er co>tai>i>< #ithiu?hepari> a>ticoa<u#a>t a>d <e# for p#a!?a !eparatio>.Determinations; UE L3 0ardiac E>Iy?e! 0a M< Pho!phate Uric Acidota# Protei> A?y#a!e Lipid! Bo>e Profi#e ropo>i> 1ro> Studie! A0E 0RP

Lave>der

EDA8Pota!!iu?9

Lave>der capped vacutai>er @ith pota!!iu? EDA a>ticoa<u#a>t for @ho#e #ood.Determinations; 3u## B#ood 0ou>t83B09ESR 0*0+ (ae?o<#oi>

Ac(o?ocy!tei>e A0( acro#i?u! 0yc#o!pori>

Pi>C

EDA Pi>C capped tue @ith pota!!iu? EDA a! a>ticoa<u#a>tDeteremination; Group 0ro!!?atch

Grey

3#uorideOa#ate

Grey capped vacutai>er @ith 3#uoride oa#ate a>ticoa<u#a>tDetermination; G#uco!e a>d Etha>o#

Roya# B#ue

raceE#e?e>t!

P#a!?a >o>-<e# - Roya# #ue capped vacutai>erDetermination; race E#e?e>t!.

(i!to#o<y Biop!y 3or?a#i> Pot! Avai#a#e fro? Phar?acy

heatre ucCet! co>tai>i>< for?a#i> Adeuate vo#u?e of for?a#i> i! e!!e>tia# for proper fiatio>. hevo#u?e of for?a#i> reco??e>ded !hou#d e te> ti?e! the vo#u?eof the ti!!ue to e fied.

Dry 0o>tai>er! $% ?#!* %% ?#! 3re!h !peci?e>! for froIe> !ectio>!.

A## u>fied ti!!ue !hou#d e tra>!ported to the #aoratoryi??ediate#y.

Sa#i>e Moi!te>ed GauIe U!e for Mu!c#e a>d 7id>ey Direct 1??u>of#uore!ce>ce SCi>! for Direct 1??u>of#uore!ce>ce tra>!ported fro? GP’!

Steri#e co>tai>er )% ?#! 8ye##o@ #id9avai#a#e i> theatre a>d Microio#o<y

i!!ue for cu#ture

Do >ot add for?a#dehyde

**#" Urine Specimen ontainers

Steri#e p#a!tic co>tai>er 8% ?#!9 6hite0ap

Steri#e p#a!tic u>iver!a# co>tai>er 8%?#!9hi! !peci?e> co>tai>er ca> e u!ed for uri>e f#uid !a?p#e!i>c#udi>< 0S3 a!cetic perito>ea# !y>ovia# Foi>t!putu? ti!!ue for cu#ture 8do >ot add for?a#dehyde9.

$+ hr uri>e 8p#ai>9 $+ hr uri>e co>tai>er @ith >o pre!ervative.

$+ hr uri>e 8acid9 $+ hr uri>e co>tai>er @ith %?#! of co>ce>trated hydroch#oric acidadded. 0o>tai>er! !upp#ied y Bioche?i!try Laoratory. heco>tai>er @i## e ?arCed @ith corro!ive @ar>i>< !i<>!.

$+ hr uri>e 8acid @a!hed9 $+ hr uri>e co>tai>er @a!hed @ith % ?#! of hydroch#oric acid.he co>tai>er @i## e ?arCed @ith haIard @ar>i>< !i<>!.

Pa<e $ of +

**#) Histology Specimen ontainers

Bo>e MarCer! Uri>e $,% ?#! p#a!tic ott#e! avai#a#e fro? Metao#i!? #aoratory

**#0 /ther Specimen ontainers

Steri#e p#a!tic co>tai>er 8% ?#!9 6hite0ap

Speci?e> co>tai>er @ith >o pre!ervative @hich !hou#d e u!edfor: uri>e! f#uid !a?p#e! i>c#udi>< 0S3 a!citic perito>ea#!y>ovia# Foi>t !putu? ti!!ue for cu#ture

Do >ot add for?a#dehyde

Steri#e tra>!port S@a! U!e for a## !@a! i>c#udi>< !cree>i><. A !upp#y of !teri#e tra>!port

!@a! are avai#a#e o> a## @ard! a>d !tocC !upp#ied fro? 0SSD.'iru! ra>!port Mediu? A## !a?p#e! for viru! cu#ture !hou#d e !e>t i> viru! tra>!port

!@a! or i> viru! cu#ture ?ediu? 8!upp#ied y the ?icroio#o<yreceptio>9. P#ea!e checC @ith ?icroio#o<y #aoratory eforetaCi>< !a?p#e! a! there ?ay e !pecia# reuire?e>t! forparticu#ar i>ve!ti<atio>!.

Steri#e p#a!tic U>iver!a# 0o>tai>er!% ?#! 8#ue cap9 @ith !poo>

3aece! !a?p#e!.

Steri#e co>tai>er )% ?#! 8ye##o@ #id9avai#a#e i> theatre a>d Microio#o<y

i!!ue for cu#ture. Do >ot add for?a#dehyde

he?a !cree> !#ide! U!e for 3aeca# Occu#t B#ood a>a#y!i!. S#ide! avai#a#e fro?Bioche?i!try. O>#y he?a-!cree> !#ide! accepted.

(epari> a>d RPM1 ?ediu? i> !teri#ep#a!tic co>tai>er! % ?#!

Avai#a#e fro? (ae?ato#o<y for Bo>e Marro@ Sa?p#e! for1??u>ophe>otypi>< 0yto<e>etic Studie! a>d Mo#ecu#ar

MarCer!.

*&#' Phlebotomy Service

A ph#eoto?y !ervice i! avai#a#e o> a## @ard! dai#y fro? %):% – :%. hi! !ervice i! #i?ited to ur<e>t reue!t!o> Saturday’! Su>day’! a>d Pu#ic (o#iday!. o avai# of the ph#eoto?y !ervice co?p#eted reue!t for?! ?u!te p#ace o> the @ard efore %):%. A ph#eoto?y !ervice #i?ited to >e@ ad?i!!io>! i! avai#a#e i> theafter>oo>!.

Outpatie>t ph#eoto?y a>d GP Referra#! i! #ocated i> the A?u#atory Day 0are 0e>tre o> the <rou>d f#oor of the

0#i>ica# Service! Bui#di><. Patie>t! referred y Ge>era# Practitio>er! ca> acce!! the ph#eoto?y !ervice fro?4:%% a? – $:%% p? Mo>day to 3riday. No appoi>t?e>t i! reuired.

he ph#eoto?y !ervice for A>ticoa<u#a>t Mo>itori>< i! #ocated i> the ‘o#d outpatie>t!’ area of the ?ai> ho!pita#.

Acce!! to the ph#eoto?y !ervice i! re!tricted to patie>t! @ho are + year! of a<e or o#der.

A ph#eoto?y !ervice for private referra#! i! avai#a#e i> the 0o>!u#ta>t! Private 0#i>ic at St 'i>ce>t’! Private(o!pita#.

*&#* Phlebotomy /pening Hours

1>-Patie>t! Mo>day to 3riday %):% – :%.

After>oo> ph#eoto?y for >e@ ad?i!!io>!

Sat*Su>* Ba>C (o#iday! ):% – :% Ur<e>t Reue!t! O>#y

Out-Patie>t! Mo>* 6ed %4:%% – 4:%%

ue*hur!*3ri %4:%% – ):%%

A>ticoa<u#atio> Mo>itori><Service 8AMS9

Mo> – 3ri 4:%% – :%% a?

AMS i! #ocated i> O#d Outpatie>t! Depart?e>t

GP Ph#eoto?y Service 4:%% a? – $:%% p? Mo>day to 3riday. No appoi>t?e>t reuired.

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*)#' Specimen +ransport

1t i! e!!e>tia# that !peci?e>! e tra>!ported !afe#y a>d efficie>t#y to the #aoratory i> order to e>!ure the !afety of !taff tra>!porti>< !a?p#e! other !taff patie>t! a>d ?e?er! of the pu#ic a>d to e>!ure that the !peci?e>!reach the #aoratory i> proper co>ditio>! a>d i> a ti?e#y ?a>>er. A## !peci?e>! !hou#d e di!patched to the#aoratory a! !oo> a! po!!i#e. Ur<e>t !a?p#e! !hou#d e !e>t i> the POD or rou<ht to the appropriate#aoratory. So?e !a?p#e! a#!o reuire !pecia# ha>d#i>< i.e. protectio> fro? #i<ht or i??ediate freeIi>< !e>t outfroIe> etc. 1f i> dout re<ardi>< the !peci?e> co>tai>er reuired or the !pecia# reuire?e>t! @he> taCi>< p#ea!erefer to the e!t Reuire?e>t Ma>ua# or co>tact the #aoratory for advice.

Speci?e>! !hou#d a#@ay! e p#ace! i> the tra>!port a< attached to the reue!t for? a>d the a< !hou#d e!ea#ed. Mu#tip#e !peci?e>! !hou#d e tra>!ported i> ri<id tra>!port co>tai>er! a>d !hou#d >ot e carried y ha>dor i> p#a!tic a<!.

*)#* Specimens from <ithin the hospital

Patho#o<y Porter! co##ect !peci?e>! fro? de!i<>ated #ocatio>! o> the @ard! o> Mo>day – 3riday at4:% &:, a>d %:,a? a>d at hour#y i>terva#! fro? the outpatie>t depart?e>t.

Out!ide the!e co##ectio>! ti?e! !peci?e>! !hou#d e !e>t via the p>eu?atic tue !y!te? 8POD9 if appropriateto the !peci?e> type.

Pa<e + of +

B1OLOG10AL SUBSAN0E 0AEGOR/ B.

Please note that @iffy bags do not meet the criterion in relation to the outer pac!aging# A>y uerie! re<ardi>< the aove !hou#d e directed to Mr. Do>a# Murphy Laoratory Ma>a<er.

*"#' +urnaround +ime

ur>arou>d ti?e i! <ive> a! the ?ai?u? >u?er of @orCi>< hour!*day! et@ee> !a?p#e receipt a>d i!!ui>< areport u>der >or?a# operati>< co>ditio>!. he tur>arou>d ti?e for i>dividua# te!t! i! <ive> i> the e!tReuire?e>t! Ma>ua#.

1> additio> to the routi>e !ervice each depart?e>t operate! a> “ur<e>t” !y!te? @herey the tar<et tur>arou>dti?e i! !horter. he tar<et tur>arou>d ti?e for ur<e>t U*E 3B0 a>d coa<u#atio> !cree> i! hour. 1f te!t! arereuired ur<e>t#y p#ea!e ticC the ur<e>t o o> the reue!t for?. 1f re!u#t! are etre?e#y ur<e>t p#ea!e co>tactthe depart?e>t to di!cu!! your reuire?e>t! a>d if po!!i#e your reue!t @i## e faci#itated. Overu!e of theur<e>t !ervice @i## adver!e#y affect the tur>arou>d ti?e for a## ur<e>t te!t!. Ma>y !pecia#iIed te!t! are perfor?edo> a @eeC#y a!i! if !uch te!t! are reuired ur<e>t#y p#ea!e pho>e the appropriate #aoratory to di!cu!! thereue!t.

Speci?e>! fro? eter>a# patie>t! 8OPD a>d GP’!9 received after ,:% re!u#t! ?ay >ot e reported u>ti# the >et?or>i>#e!! ?arCed ur<e>t o> the reue!t for?# 1f GP !peci?e>! are ur<e>t p#ea!e i>dicate thi! o> thereue!t for? a>d provide pho>e >u?er! for pho>i>< ur<e>t re!u#t! after >or?a# !ur<ery hour!.

*"#* Re9uesting 1dditional 7aminations

U!er! ?ay reue!t additio>a# ea?i>atio>! o> !peci?e>! a#ready !e>t to the #aoratory. Additio>a# reue!t! ?aye ?ade vera##y over the pho>e. he a>a#y!i! @i## e perfor?ed provided the !peci?e> ha! ee> !toredappropriate#y a>d there i! !ufficie>t !peci?e> re?ai>i>< to perfor? the additio>a# te!t!. he ti?e #i?it for the

additio> te!t for each depart?e>t i! <ive> e#o@.

*"#& +ime Limit for Re9uesting 1dditional 7aminations

3iochemistry; @ithi> - day! 8te!t depe>de>t9.3lood +ransfusion; )$ hr! after co??e>ce?e>t of tra>!fu!io>.ndocrinology; @ithi> day! @ith eceptio>!Haematology; +-2 hour! depe>di>< o> a!!ay4uclear Medicine; – A0( G( ADNA Ga!tri> - ?o>th3PSA – @eeC3’! (ae?ate>ic! Di<oi> 0orti!o# PSA 8free9 u?our MarCer! 8apart fro? 3PSA9 – + day!.-mmunology; +4 hr! – $ ?o>th! depe>di>< o> te!t.Metabolism; ?o>th! for a## !eru? te!t! ecept io>i!ed ca#ciu? a>d +4 hr! for uri>ary te!t!.

Microbiology; #ood te!t! ?o>th! 0S3 – ?o>th a>d $+ hour! for other !peci?e>!.

Please contact the appropriate laboratory for more detail on the time limit for re9uesting additionale7aminations

Pa<e 2 of +

*0#' Reporting of Results, linical 1dvice and -nterpretation

Re!u#t! are avai#a#e for vie@i>< o> the #aoratory i>for?atio> !y!te? 8L1S9 fo##o@i>< authori!atio>. Acce!! to L1Si! avai#a#e to a## @ard! i> St. 'i>ce>t’! Pu#ic a>d Private (o!pita#! a>d ?a>y of the eter>a# ho!pita#!.

Pri>ted report! are i!!ued a>d de#ivered to the @ard! three ti?e! dai#y Mo> – 3ri at $:, +:% a>d ):% a>dSaturday! = Su>day!: :%%.Report! to GP’! a>d Eter>a# (o!pita# are !e>t fro? Patho#o<y Receptio> dai#y Mo>- 3ri.

1> additio> to the hard copy report! re!u#t! are reported e#ectro>ica##y to GP’! via (ea#th#i>C. hi! (SE fu>ded!y!te? i! avai#a#e free of char<e to a## GP’!. hrou<h (ea#th#i>C re!u#t! are avai#a#e e#ectro>ica##y @ithi> t@ohour! of authori!taio>. 1f acce!! i! reuired p#ea!e co>tact Mairead O’Leary Et. 2&,.

Re!u#t! are reported @ith refere>ce*therapeutic ra><e!. A <uide to i>terpretatio> of re!u#t! a>d c#i>ica# advice i!<ive> o> the report if appropriate. Re!u#t! that have ee> reue!ted to e pho>ed a>d a>or?a# re!u#t! arepho>ed to the appropriate #ocatio> !uFect to defi>ed criteria @ithi> each #aoratory.

6here #ood i! reuired ur<e>t#y or for tra>!fu!io> the patie>t ’! @ard @i## e co>tacted y pho>e a! !oo> a! the#ood*#ood product! are ready for i!!ue. 6here #ood i! reuired for !ur<ery the fo##o@i>< day @ard! @i## o>#y eco>tacted if there i! a difficu#ty i> !upp#yi>< the #ood. he cro!!?atch report for? @i## e he#d i> the ho!pita##ood a>C a>d @i## e i!!ued @ith the fir!t u>it co##ected.

0#i>ica# Advice a>d 1>terpretatio> i! avai#a#e a>d ca> e otai>ed y co>tacti>< the appropriate #aoratory. Au!efu# o>#i>e refere>ce i! avai#a#e for #aoratory te!t! i!: http:**#ate!t!o>#i>e.or<. No #o u!er>a?e orpa!!@ord i! reuired.

he Patho#o<y Medica# a>d*or Laoratory Scie>tific !taff !hou#d e co>!u#ted @here u>certai>ty ei!t! aout theavai#ai#ity appropriate>e!! or !e#ectio> of te!t! the >ature of the !peci?e> reuired or the i>terpretatio> ofre!u#t!.

*$#' -nstructions for Aard n9uiry for Vie<ing Laboratory Results

he L1S a##o@! @ard e>uiry for re!u#t! to i>dividua#! @ith u!er>a?e a>d pa!!@ord. o vie@ patie>t re!u#t! e>terthe patie>t’! ho!pita# >u?er a>d the fir!t t@o character! of the !ur>a?e. he patie>t’! de?o<raphic! @i##appear o> the !cree>. 0hecC that the patie>t de?o<raphic! are correct.

At the otto? of the !cree> there i! a fie#d to !e#ect the di!cip#i>e. Di!cip#i>e !pecific re!u#t! ca> e vie@ed theappropriate #etter for the di!cip#i>e:3 - Bioche?i!try M - Microio#o<y P - (i!to#o<y- - 1??u>o#o<y - E>docri>o#o<y R - Metao#i!?3 - Nuc#ear Medici>e H - (ae?ato#o<yLeave #a>C 8u!e !pace ar to re?ove9 to !ee re!u#t! fro? a## di!cip#i>e!.

B#ood ra>!fu!io> e>uiry i! >ot avai#a#e o> @ard e>uiry – co>tact #ood tra>!fu!io> for re!u#t!.he !e#ected patie>t’! re!u#t! are di!p#ayed o> Re!u#t! Scree> @ith the ?o!t rece>t !peci?e>! fir!t.

he ?ai> ody di!p#ay! each: ES NAME – RESUL – a>d RE3EREN0E RANGE 8@here app#ica#e9.

0o??e>t! are a#!o di!p#ayed.1f the re!u#t! are >ot yet co?p#ete or ready for re#ea!e they are !ho@> a! “1> Pro<re!!”

Re!u#t! fa##i>< out!ide Refere>ce Ra><e! are hi<h#i<hted“3#a!hi><” re!u#t! i>dicate that the re!u#t ha! cha><ed !i<>ifica>t#y fro? the previou!#y reported va#ue.1f a !peci?e> i! part of a dy>a?ic fu>ctio> te!t a co??e>t to that effect @i## di!p#ay- u!e optio> “3” to vie@ fu##re!u#t!.1f the report ete>d! eyo>d the otto? of the !cree> a ?e!!a<e “0ur!or do@> for ?ore” appear! i> ahi<h#i<hted ar at the otto? of the !cree> 8u!e do@> arro@ Cey to vie@ >et pa<e of re!u#t!9. hi! ca> occur

Pa<e ) of +

http://labtestsonline.org/

http://labtestsonline.org/

@ith a>y !peci?e>. 1t i! e!!e>tia# to arro@ do@> a>d vie@ a## re!u#t! a>d co??e>t!. 1?porta>t i>for?atio> a>dco??e>t! ?ay e ?i!!ed if the e>tire report i! >ot read. 1f you pri>t the re!u#t you ?u!t pri>t oth pa<e!.o ?ove et@ee> !peci?e>! o> thi! patie>t u!e “Pa<e Up” or “Prev” a>d “Pa<e Do@>” or “Net” Cey!.

*5#' -nfection ontrol

he 1>fectio> ea? @orC i> co>Fu>ctio> @ith a## (ea#thcare !taff patie>t! a>d vi!itor! provide a> effectivei>fectio> preve>tio> a>d co>tro# !ervice. hey provide advice o> a## a!pect! o> i>fectio> preve>tio> a>d co>tro#i>c#udi>< the appropriate ?a>a<e?e>t a>d p#ace?e>t of patie>t! @ith a> i>fectio> a>d carry out !urvei##a>ce ofpro#e? or<a>i!?! a>d hea#thcare a!!ociated i>fectio>! @ithi> the ho!pita# a>d co??u>icate re!u#t! of the!e tohea#thcare !taff a>d ?a>a<e?e>t. 0a!e! of diarrhoea !u!pect B ?e>i><iti! or !u!pected outreaC! ofi>fectio> ?u!t e reported to the i>fectio> co>tro# !i!ter a>d*or the co>!u#ta>t ?icroio#o<i!t.

he tea? deve#op a>d participate i> pro<ra?! de!i<>ed to i>for? educate advi!e a>d trai> !taff a>d patie>t!aout i>fectio> co>tro# i!!ue!.

*8#' ollection of 3lood ulture 3ottles

@o ott#e! are reuired - A green top 8aerobic? a>d a purple top 8anaerobic? ott#e.

6a!h ha>d! thorou<h#y a>d put o> <#ove!. Re?ove the p#a!tic f#ip top a>d !teri#iIe the epo!ed ruer cap @itha> a#coho# !@a. A##o@ a#coho# to dry.Do >ot u!e di!i>fecta>t! !uch a! iodi>e or ch#orheidi>e for thi! purpo!e.0#ea> the ve>ipu>cture area @ith Medi!@a! e>i>< at the ce>tre of the !ite a>d !crui> a circu#ar?otio> out@ard! to a dia?eter of three or four i>che! for aout % !eco>d!. Do >ot <o acC over the previou!#y!crued area!. he a#coho# @a!hi>< ?i<ht have to e repeated depe>di>< o> the c#ea>#i>e!! of the !Ci>. A##o@the a#coho# to dry. Do >ot touch the ve>epu>cture area after thi!.U!i>< a >eed#e-protected utterf#y >eed#e a>d #ood cu#ture adaptor cap pu!h i> the anaerobic >purple? ott#efir!t 84 - %?#! of #ood dra@9 a>d the> the aerobic >green? ott#e. hi! !eue>ce i! to preve>t the e>try of airi>to thi! ott#e. See the i>!tructio> #eaf#et !upp#ied @ith #ood cu#ture ott#e!.Lae# each ott#e @ith the patie>t! >a?e ho!pita# >u?er a>d date a>d ti?e of co##ectio>.Se>d the ott#e! i> the a< attached to the ye##o@ ?icroio#o<y reue!t for? to the ?icroio#o<y #aoratory duri><>or?a# @orCi>< hour! or e p#ace the !pecia# O>-0a## o i> (ae?ato#o<y out of hour!.

*(#' Haemolysed Specimens

:actors in performing venipuncture, <hich may cause haemolysis include;

• U!i>< a >eed#e @ith a !?a## dia?eter 8e<. $ <au<e or ?ore9

• U!i>< a !?a## >eed#e @ith a #ar<e vacutai>er tue.

• U!i>< a> i?proper#y attached >eed#e a>d !yri><e !o that frothi>< occur! a! the #ood e>ter! the !yri><e.

• Pu##i>< the p#u><er of a !yri><e acC too uicC#y.

• ShaCi>< or vi<orou! ?ii>< of #ood co##ectio> tue!.

• 3orci>< #ood fro? a !yri><e i>to a #ood co##ectio> tue e!pecia##y throu<h a >eed#e.

• 3ai#ure to a##o@ the #ood to ru> do@> the !ide of the tue @he> u!i>< a !yri><e to fi## the tue.

• 3ai#ure to a##o@ a#coho# !@a to dry

• Dra@i>< fro? !ite of hae?ato?a

• 'ery !#o@ f#o@ i>to tue

• Dra@i>< #ood fro? i>d@e##i>< #i>e

Pa<e 4 of +

&'#' Dra< /rder for 3lood Specimens

1f !evera# differe>t #ood !a?p#e! are reuired fro? o>e patie>t it i! i?porta>t that the !peci?e>! taCe> i> thefo##o@i>< order:

• B#ood cu#ture ott#e! 8fi## a>aeroic purp#e-topped ott#e fir!t9

• 0itrate tue! 8#i<ht-#ue topped for coa<u#atio> !tudie!9

• Dry tue! 8red topped9 for te!t! o> !eru?.

• (epari> tue! 8<ree>-topped for p#a!?a che?i!trie! etc.9

• EDA tue! 8#ave>der-topped for fu## #ood cou>t! a>d #ood a>C tue! etc.9• 3#uoride*oa#ate tue! 8Grey-topped for <#uco!e9

• Sodiu? (epari> 8Navy topped for Ki>c a>d Lead9

Ge>t#y ?i !peci?e> co>tai>er! i??ediate#y fo##o@i>< co##ectio> y i>ver!io> five ti?e!

&*#' Protocol for oral glucose tolerance testing >/==+? in /PD B : entre

E>!ure patie>t ha! ee> fa!ti>< over>i<ht for et@ee> 4 a>d + hour!.

Record factor! that ?ay i>f#ue>ce i>terpretatio> of re!u#t! e.<. ?edicatio>! i>fectio> i>activity etc

aCe #ood !a?p#e for <#uco!e a>a#y!i! 8<rey-topped tue9. Lae# tue @ith the ti?e of co##ectio> a>d a! 3a!ti><

839. Record thi! i>for?atio> o> the Bioche?i!try reue!t for?. (o#d fa!ti>< !a?p#e u>ti# !eco>d !a?p#e i!otai>ed.

he <#uco!e #oad i! the> <ive>. 1>!tructio>! o> prepari>< the <#uco!e dri>C are avai#a#e fro? the Bioche?i!tryDepart?e>t. he <#uco!e dri>C !hou#d e co>!u?ed over a ?ai?u? of five ?i>ute!. i?i>< of the te!t !tart! atthe beginning of i><e!tio>.

After i><e!tio> i>!truct the patie>t not to eat, drin!, smo!e or e7ercise a>d to retur> Fu!t efore t@o hour! ha!e#ap!ed !i>ce the <#uco!e #oad. P#ea!e <ive the patie>t a copy of the OG patie>t i>for?atio> !heet 8L:23-/2/=++2-4:/9.

After eact#y $ hour! !i>ce the i><e!tio> 8e>i><9 of the <#uco!e #oad taCe a !eco>d !a?p#e for <#uco!ea>a#y!i! a>d #ae# tue @ith the ti?e of co##ectio> a>d a! the $ hr !a?p#e. Record ti?e o> reue!t for?. 0hecCthat the patie>t ha! >ot vo?ited @ithi> the $ hour!- record o> reue!t for? if patie>t ha!. he fa!ti>< a>d the $ hr !a?p#e !hou#d e !e>t to the 0#i>ica# Bioche?i!try Depart?e>t to<ether attached to the !a?e reue!t for? o>@hich /=++ !hou#d e c#ear#y !tated.

3urther i>for?atio> o> the Ora# G#uco!e o#era>ce e!t ?ay e otai>ed fro? the Bioche?i!try Depart?e>t.

C Po#yca# 8tetra pacC9 cat >o 444 Nutricia 0#i>ica# 0are U7

&&#' 1nticoagulant Monitoring Service

he (ae?ato#o<y Depart?e>t ru>! a> A>ti-0oa<u#atio> Mo>itori>< Service 8AMS9 for patie>t! taCi>< ora#a>ticoa<u#a>t! 8?ai>#y @arfari>9 @he> they are di!char<ed fro? ho!pita#. he !ervice i! a ?o>itori>< !ervice >ot

a c#i>ic. he !ervice ?o>itor! patie>t’! 1NR #ood te!t! advi!e! o> the do!e of ora# a>ticoa<u#a>t to taCe a>d@he> to retur> for the >et #ood te!t. A doctor doe! >ot !ee the patie>t at a>y !ta<e. he patie>t re?ai>! there!po>!ii#ity of hi!*her referri>< doctor or GP @ho? the patie>t i! advi!ed to co>tact if !he*he ha! a>y pro#e?!.he !ervice ?u!t receive a co?p#eted A>ticoa<u#atio> Mo>itori>< Service Referra# 3or? fro? a doctor efore apatie>t i! accepted to the Service. hi! ?u!t e de#ivered to the !ervice prior to the patie>t atte>di><.he AMS ca> e co>tacted o> Et. +, or A>ticoa<u#a>t Nur!e Specia#i!t B#eep 22.

Pa<e & of +

Patie>t! @ho are droppi>< off a !peci?e> ca> <o direct#y to the patho#o<y receptio> 8#ocated i> the ph#eoto?yarea9.

&0#' Patient -nstructions for ollection of Mid Stream Urine >MSU?

Ahy do patients need to give a sample of urine >MSU? for testingo e!ta#i!h if you have a uri>ary tract i>fectio> 8U19

+ips before passing a sample of urine;Do >ot e?pty your #adder for three hour! if po!!i#e.Lae# the co>tai>er @ith your !ur>a?e fir!t >a?e date of irth date* ti?e a>d referri>< doctor.6a!h your ha>d! a>d the> @a!h your <e>ita# area @ith !oap a>d @ater.

Ho< to produce a mid2stream specimen of urinehe ai? i! to <et a !a?p#e of uri>e fro? the ?idd#e of your #adder.Uri>e i! >or?a##y !teri#e 8>o acteria pre!e>t9. 1f acteria are fou>d i> the !a?p#e it ?ea>! that the uri>e?ay e i>fected. A ?id-!trea? !a?p#e i! the e!t !a?p#e a! the fir!t it of uri>e that you pa!! ?ay eco>ta?i>ated @ith acteria fro? the !Ci>.

6o?e> - ho#d ope> your #aia 8e>tra>ce to the vaa9 apart @hi#e uri>e i! pa!!ed. 1f you have a vaa#

di!char<e or period a ta?po> !hou#d e i>!erted prior to co##ecti>< the !a?p#e.

Me> - U>circu?ci!ed ?a#e! !hou#d retract the fore!Ci> @hi#e the uri>e i! pa!!ed.

• Do >ot ope> the !teri#e ott#e u>ti# you are ready to taCe the !a?p#e.

• Pa!! !o?e uri>e i>to the toi#et.

• 6ithout !toppi>< the f#o@ of uri>e catch !o?e uri>e i> the !teri#e ott#e 8fi## appro. ha#f fu##9.

8he ott#e @i## e provided y your doctor or !upp#ied y Patho#o<y Receptio>9.

• 3i>i!h off pa!!i>< uri>e i>to the toi#et.

• 0#o!e the #id fir?#y. P#ace ott#e i>to a< a>d c#o!e a<.

• 6a!h ha>d! thorou<h#y @ith !oap a>d @ater.

8So?e !peci?e> ott#e! co>tai> a pre!ervative. 1f thi! i! the ca!e a ?arC o> the ott#e @i##

i>dicate the idea# a?ou>t of uri>e. (o@ever if that i! difficu#t a>y a?ou>t i! etter tha> >o>e.9• 0hecC that the for? co>tai>! the full nameE address and date of birth of the per!o> !a?p#ed a>d add the

date the sample @a! taCe>.

• he !a?p#e !hou#d idea##y e rou<ht to the doctor! !ur<ery or the #a @ithi> t@o hour!.

• 1f that i! >ot po!!i#e put the !a?p#e i> the frid<e u>ti# it i! rou<ht to the !ur<ery or #a.

Results A re!u#t @i## e avai#a#e after $- day! a>d @i## e !e>t to your doctor.

&$#' Patient -nstructions :or ollecting a :aeces BStool Sample

Ahat is the purpose of a faeces Bstool test in microbiologyo detect if a patie>t ha! a o@e# i>fectio>.

+ips before passing a sample of faecesB stool;

• Lae# the co>tai>er @ith your !ur>a?e fir!t >a?e date of irth date* ti?e a>d referri>< doctor.

• P#ace p#e>ty of #avatory paper i> a c#ea> potty or i> the #avatory pa>.

• MaCe !ure there i! >o trace of di!i>fecta>t or #each pre!e>t a! thi! @i## i>terfere @ith the te!t.

• 3aece! 8a o@e# ?ove?e>t9 !hou#d the> e pa!!ed o> to the toi#et paper.

• Ope> the co>tai>er. U!i>< the #itt#e !poo> provided !coop up $ !poo>fu#! of faece!.

• P#ace i> the co>tai>er. here i! >o >eed to fi## the co>tai>er. Scre@ the #id fir?#y acC o> the co>tai>er.

N.B. 1f you have !evere diarrhoea or a @atery !too# a potty ?ay e >eeded to co##ect the i>itia# !a?p#e.

• he co>tai>er @ith the !too# !a?p#e !hou#d e p#aced i> the p#a!tic a< attached to the for? a>d !ea#ed.

Pa<e $ of +

• 3#u!h a@ay the re?ai>i>< paper a>d faece! do@> the #avatory.

• 6a!h your ha>d! thorou<h#y @ith !oap a>d @ater.

• 0hecC that the for? co>tai>! the full name, address and date of birth of the per!o> !a?p#ed a>d add the

date the !a?p#e @a! taCe>.

• Bri>< the !a?p#e i>to Patho#o<y Receptio> 8Grou>d 3#oor St. 'i>ce>t’! U>iver!ity (o!pita#9.

Re!u#t! @i## e !e>t to your doctor @ithi> @orCi>< day!.

&5#' -nstructions for Patients ma!ing a &"2hour Urine ollection

-mportant points1t i! very i?porta>t that you co##ect all the uri>e that you pa!! duri>< a> e7act $+-hour period. Do not void uri>edirect#y i>to the $+-hour co>tai>er ut i>to a !uita#e c#ea> deter<e>t-free Fu< a>d the> pour i>to the $+-hourco>tai>er.E>!ure that the co>tai>er i! #ae##ed @ith patie>t ’! fu## >a?e date of irth a>d addre!! date a>d ti?e co##ectio>of !peci?e> !tarted a>d fi>i!hed.Lo!! of a>y uri>e or a co##ectio> ?ade for either ?ore or #e!! tha> $+ hour! @i## i>va#idate the te!t a>d ?i<ht#ead to a> i>correct dia<>o!i!.

-f this container contains acid as a preservative andBor has a <arning label, then care needs to bee7ercised <hen adding urine to it from your collection vessel# +he follo<ing points should also be noted;

Hydrochloric 1cid >fuming li9uid? causes burns and is irritating to eyes, s!in and respiratory system# -f incontact <ith s!in, <ash immediately <ith plenty of <ater and see! medical advice# 6eep out of reach ofchildren# 4ot to be ta!en internally - <ould cause severe irritation and damage# 1 member of the3iochemistry Staff <ill e7plain the procedure to you and give you an information leaflet# Please read theinformation sheet carefully#

Procedure:E?pty your #adder at )a? o> ri!i>< 8or at a ?ore co>ve>ie>t ti?e9 a>d thro< a<ay the !a?p#e. O>#y after thi!!a?p#e ha! ee> pa!!ed i! the co##ectio> !tarted. 6rite !tart ti?e o> co>tai>er #ae#. 0o##ect a## your uri>e i> theco>tai>er provided o> every occa!io> that it i! pa!!ed duri>< the fo##o@i>< $+ hour! a>d !tore refri<erated ifpo!!i#e. E?pty your #adder at )a? o> ri!i>< the >et ?or>i>< 8or at the ?ore co>ve>ie>t ti?e cho!e>9 a>d addthi! !a?p#e to the co##ectio>. 6rite the fi>i!h ti?e o> the co>tai>er #ae#. P#ea!e e>!ure that the #ae# o> theco>tai>er a>d the reue!t for? are fu##y co?p#eted a>d that the cap i! c#o!ed !ecure#y. Bri>< the co##ectio> to the

ho!pita# o> the day of co?p#etio>.

1>co?p#ete 0o##ectio>!:1f you for<et a>d #o!e a !a?p#e do@> the toi#et the> p#ea!e thro@ a@ay a## the uri>e co##ected up to that ti?e a>d!tart a<ai> the fo##o@i>< ?or>i><.1f you are ?aCi>< a> acid co##ectio> retur> the co>tai>er @ith the acid to the #aoratory a>d reue!t a >e@co>tai>er fro? the #aoratory.linical 3iochemistry Department, St Vincent’s University Hospital, lm Par!, Dublin "#+el#; '* &&*"00'#

Pa<e $$ of +

&8#' Patient -nformation /ral =lucose +olerance +est

Principle; he ora# G#uco!e o#era>ce e!t i>vo#ve! the taCi>< of t@o #ood !a?p#e! o>e @he> you arrive8fasting for 82*" hours9 a>d o>e $ hour! after a <#uco!e dri>C.

Procedure; After the fa!ti>< #ood ha! ee> taCe> a>d after you have taCe> the <#uco!e dri>C you @i## ereuired to re?ai> i> the ho!pita# for $ hour! after @hich ti?e the !eco>d #ood !peci?e> @i## e taCe>.

hrou<hout the te!t 8the $ hour! et@ee> the t@o #ood !a?p#e!9 p#ea!e o!erve the fo##o@i><:

• No 3ood

• No Dri>C

• No S?oCi><

• No Eerci!e

P#ea!e report acC to the Ph#eoto?y Outpatie>t Depart?e>t i> ti?e to have your !eco>d #ood !a?p#e 8$ hour!after <#uco!e dri>C9 taCe>.

&(#' 1rrangements for the Performance of an 1utopsy

Po!t-?orte? Procedure Guide#i>e! for 0oro>er a>d (o!pita# po!t ?orte?! are avai#a#e at the Nur!e! Statio> o>

each @ard. he!e <uide#i>e! de!cried the circu?!ta>ce! i> @hich the 0oro>er ?u!t e co>tacted a>d a#!ode!crie! the procedure to e fo##o@ed @he> the 0oro>er order! a po!t ?orte?. 1> additio> o> each @ard thereare i>dividua# pacCet! co>tai>i>< copie! of the <uide#i>e! 0oro>er ’! 1>for?atio> BooC#et! a>d 1>for?atio>BooC#et for Re#ative! a>d co>!e>t for?!.

oroner Post Mortem1> the ca!e of a 0oro>er ’! PM the ?edica# tea? co>tact! the 0oro>er a>d the 0oro>er @i## decide if a> autop!yi! >ece!!ary. 1f a> autop!y i! >ece!!ary the 0oro>er @i## fa the officia# order fro? for a> autop!y to the ?ortuaryoffice. he Patho#o<i!t ?ay choo!e to <o ahead a>d perfor? a> autop!y o> the a!i! of havi>< received a> order for the autop!y over the te#epho>e. Receipt of !uch a> order i! recorded i> the te#epho>e diary.

1> the ca!e of a 0oro>er ’! PM o>#y the officia# order of the 0oro>er i! >ece!!ary to perfor? the po!t-?orte?.0o>!e>t fro? the >et of Ci> i! >ot reuired. he fa?i#y @i## e advi!ed y the ?edica# tea? of the reuire?e>t

for the PM a>d co>!u#ted i> re#atio> to the rete>tio> of or<a>! a>d !u!eue>t di!po!a#. A 0oro>er Bereave?e>tPacC i! #ocated at the >ur!e’! !tatio> o> each @ard a>d i! <ive> to each fa?i#y. he pacC co>tai>! he 0oro>er Po!t Morte? 1>for?atio> 3or?, @hich i! co?p#eted y the doctor a>d >et of Ci>. he pacC a#!o co>tai>!ooC#et! aout PM ea?i>atio>! ereave?e>t a>d death i!!ue!.

Hospital >4on2oroner? Post Mortem3or a (o!pita# PM to proceed it i! the re!po>!ii#ity of the c#i>ica# tea? 80o>!u#ta>t or Re<i!trar9 to receive@ritte> i>for?ed co>!e>t fro? the >et-of-Ci> of the decea!ed y co?p#eti>< the (o!pita# Po!t Morte? 0o>!e>t3or? M3-MOR-PM(0ON. A fu## or partia# ea?i>atio> i! di!cu!!ed @ith the >et of Ci> a>d i>dicated o> theco>!e>t for?. Detai#! o> rete>tio> of or<a>! are a#!o i>dicated o> the co>!e>t for?. he ?edica# tea? de#iver!a## re#eva>t docu?e>tatio> i>c#udi>< c#i>ica# detai#! re<ardi>< the decea!ed to the Patho#o<y Depart?e>t. hePatho#o<i!t! e>!ure! that a## re#eva>t docu?e>tatio> i! avai#a#e efore proceedi>< @ith the autop!y.

A (o!pita# Bereave?e>t PacC i! #ocated at the >ur!e’! !tatio> o> each @ard a>d i! <ive> to each fa?i#y. hepacC co>tai>! (o!pita# Po!t Morte? 0o>!e>t 3or? @hich i! co?p#eted y the doctor a>d >et of Ci>. he pacCa#!o co>tai>! ooC#et! aout po!t ?orte? ea?i>atio>! ereave?e>t a>d death i!!ue!

)'#' Hospital 3lood 3an! Service

)'#* Phlebotomy -nstructions >:or 3lood +ransfusion Samples F :orms?

Refer to ‘B#ood ra>!fu!io> Reue!t 3or?! a>d Speci?e>’ for <uide#i>e! o> co?p#eti>< reue!t for?! patie>tide>tificatio> a>d #ae##i>< !peci?e>!.

Pa<e $ of +

blood bac! into the fridge co>tact a ?e?er of the #ood a>C !taff a>d retur> it to thi! per!o>. 1f out!ide>or?a# hour! co>tact the (ae?ato#o<y Scie>ti!t O>-0a## 8B#eep +2,9.

3lood must only be stored in a dedicated and controlled blood fridge# Units of red cells must never beplaced in a <ard fridge#

B#ood i! >or?a##y o>#y he#d for $+ hour! after the ti?e that it ha! ee> reue!ted for ut ?ay e he#d for a #o><erti?e fo##o@i>< a !pecific reue!t to the B#ood ra>!fu!io> Laoratory. (o@ever if #ood i! ei>< he#d for apatie>t that ha! ee> tra>!fu!ed i> the precedi>< ?o>th! a fre!h Group a>d (o#d !a?p#e ?u!t e !e>t to the

B#ood ra>!fu!io> Laoratory every )$ hour! 8!ee !ectio> o> ‘Group a>d Scree>’9.

)*#) SD Plasma >/ctaplas?

SD P#a!?a 8So#ve>t Deter<e>t P#a!?a9 @a! i>troduced i>to 1re#a>d a! a rep#ace?e>t for 3re!h 3roIe> P#a!?a833P9 i> order to ?i>i?i!e the ri!C of tra>!?i!!io> of v0"D fro? 1ri!h do>or!. SD P#a!?a i! a poo#ed 8atched9product prepared fro? do>or! i> the US 8to reduce the ri!C of v0"D tra>!?i!!io>9 a>d i! !uFected to a proce!!that i>activate! #ipid-e>ve#oped viru!e! a>d acteria.SD P#a!?a i! avai#a#e u>der the trade>a?e /ctaplas a>d u>#iCe other #ood product! i! a #ice>!ed ?edici>ea>d reuire! a pre!criptio>. SD P#a!?a for <roup AB patie>t! i! avai#a#e a! Uniplas a>d i! >ot yet #ice>!ed.SD P#a!?a ca> e co>!idered a! euiva#e>t vo#u?e to vo#u?e to 33P. SD P#a!?a i! >or?a##y avai#a#e i>p#e>tifu# !upp#y fro? the ho!pita# B#ood ra>!fu!io> Laoratory.SD P#a!?a i! >ot cro!!?atched therefore it i! >ot >ece!!ary to !e>d a !a?p#e if the patie>t’! #ood <roup i! o>record. SD P#a!?a i! i!!ued a! ABO !uita#e o>#y.P#ea!e avoid over orderi>< thi! product a! o>ce it i! defro!ted it ?u!t e u!ed @ithi> " hours a>d it ca>>ot erefroIe>. 1dea##y it !hou#d e ordered i> !?a## ua>titie! a! reuired rather tha> o>e #ar<e order.hi! product i! u!ed to correct c#otti>< defect!. 1t should not e u!ed a! a vo#u?e epa>der a! cheaper a>d!afer a#ter>ative! are avai#a#e.

SD P#a!?a 1>for?atio> Leaf#et produced y the Natio>a# (ae?ovi<i#e>ce Office. "a> $%%.Ri!C of vo#u?e over#oad #eadi>< to re!piratory di!tre!! @ith !evere ?oridity*?orta#ity e!pecia##y u!i>< rapidi>fu!io> rate! @ith very !?a## a>d*or e#der#y recipie>t!.Occa!io>a# !evere A>aphy#actic reactio>! e!pecia##y @ith rapid i>fu!io> rate!.Do!a<e of SD P#a!?a <e>era##y depe>d! upo> the c#i>ica# !ituatio> a>d u>der#yi>< di!order ut $ – , ?#!*7< i!a <e>era##y accepted !tarti>< do!e. 1t i! i?porta>t to ?o>itor the re!po>!e oth c#i>ica##y a>d @ith ?ea!ure?e>tof prothro?i> ti?e 8P9 partia# thro?op#a!ti> ti?e 8P9 or !pecific factor a!!ay!.he B0S( 8Briti!h9 <uide#i>e! reco??e>d that each u>it of p#a!?a e tra>!fu!ed to a> u>co?pro?i!ed adu#tover % ?i>ute!.0oa<u#atio> factor rep#ace?e>t i> the ?a!!ive#y hae?orrha< patie>t ?ay reuire fa!ter i>fu!io>.3or a patie>t @ho i! e#der#y very !?a## a>d*or cardiac or re!piratory co?pro?i!ed i> the >o>-#eedi>< !ituatio>tra>!fu!io> rate! for p#a!?a !hou#d >ot eceed $-+ ?#!*7< per hour.Each u>it of SD P#a!?a co>tai>! $%%?#! co?pared to a u>it of 33P @hich co>tai>! $$%-%%?#!. hi! !?a##ervo#u?e ?ay >eed to e co>!idered @he> ca#cu#ati>< do!e!.

A## p#a!?a !hou#d e tra>!fu!ed @ithi> + hour! of defro!ti><.

Suggested +imes for -nfusion of SD plasma in the 4on23leeding Patient#

Patient6ei<ht

U>it! Reuired Rate of tra>!fu!io> per hr

$% 7it +% ?#! – 4% ?#!

% 7< $ u>it! 2% ?#! – $% ?#!

+% 7it! 4% ?#! – 2% ?#!

,% 7it! %% ?#! – $%% ?#!

2% 7< + u>it! $% ?#! – $+% ?#!

:irm -ndications for giving SD Plasma include;he correctio> of hae?o!tatic di!order! @here >o other ?ore !uita#e therapy ei!t! or i! avai#a#e.Rep#ace?e>t of !i><#e factor p#a!?a deficie>cie! @here >o #ice>!ed vira##y-i>activated or reco?i>a>t !i><#efactor co>ce>trate i! avai#a#e 8e.<. 3actor ' deficie>cy = acety#-cho#i>e!tera!e deficie>cy9.

Liver di!ea!e either i> the pre!e>ce of hae?orrha<e or prior to a> e#ective procedure. Acute Di!!e?i>ated 1>trava!cu#ar 0oa<u#atio>.

Pa<e $, of +

U!ed i> hro?otic hro?ocytope>ia Purpura 8P9 a! the treat?e>t of choice i> co>Fu>ctio> @ith p#a!?a3or rever!a# of the effect! of ora# a>ti-coa<u#atio> a!!ociated @ith !eriou! #eedi>< - o>#y if P00 8prothro?i>co?p#e co>ce>trate9 i! >ot avai#a#e or co>trai>dicated 8!ee Reco??e>datio>! for Ma>a<e?e>t of B#eedi><a>d Ece!!ive A>ticoa<u#atio>9

So#ve>t Deter<e>t P#a!?a 8SD P#a!?a9 i! >ot i>dicated i> the ?a>a<e?e>t of over a>ticoa<u#atio> @ith 6arfari>i> the a!e>ce of #eedi><.SD Plasma is 4/+ indicated in treatment of;

• (ypovo#ae?ic !hocC

• Se#ected >utritio>a# deficie>cie!.• 0orrectio> of i??u>odeficie>cy

• Rep#ace?e>t of f#uid i> p#a!?aphere!i! @ith the eceptio> of P.

he!e are <uide#i>e! o>#y a>d ?u!t >ever rep#ace c#i>ica# a!!e!!?e>t for each patie>t. 0o>!u#t a !e>ior ?e?er of your ho!pita# ?edica# !taff if you have a>y uerie!.

)*#" ryoprecipitate

hi! co>tai>! factor '111 a>d 3iri>o<e>. he ?i>i?u? do!e for a> adu#t i! $ poo#! 8euiva#e>t to % !i><#e do>or u>it!9. (o@ever a hi<her do!e of poo#! 8, u>it!9 i! reuired i> the coa<u#opathy of Liver ra>!p#a>tatio> orD.1.0. O>ce tha@ed 0ryoprecipitate ?u!t e u!ed a! !oo> a! po!!i#e.

)*#0 Platelets

P#ate#et! have a very !hort !he#f #ife a>d are not he#d a! a !tocC ite?. hey are >ot cro!!?atched !o it i! >ot>ece!!ary to !e>d a !peci?e> if the patie>t’! <roup i! o> record. A Doctor !hou#d order the? @he> reuired o>a >a?ed patie>t a!i!.he >or?a# i!!ue do!e i! o>e Poo# of P#ate#et! 8or o>e Aphere!i! U>it9.

A## p#ate#et! !hou#d e ordered throu<h the ho!pita# B#ood ra>!fu!io> Laoratory duri>< >or?a# hour! or the(ae?ato#o<y Medica# Scie>ti!t o> – ca## 8B#eep +2,9 out!ide hour!. 1> a> atte?pt to co-ordi>ate p#ate#et orderi><p#ea!e p#ace a## (ae?ato#o<y*O>co#o<y order! @ith the (o!pita# B#ood ra>!fu!io> Laoratory before &#)' p#m# each day. hi! ?i>i?i!e! tra>!port co!t! a>d co>fi>e! reue!t! to the routi>e day. Orderi>< out!ide hour! fro?the 1BS ?ay i>cur etra char<e!. N.B. P#ate#et! Mu!t Never Be P#aced 1> A>y 3rid<e

)*#$ 1lbumin

P#ea!e co>tact the B#ood ra>!fu!io> Laoratory or the (ae?ato#o<y Medica# Scie>ti!t o> – ca## 8B#eep +2,9 after,p? to order A#u?i>. A## atched product! i>c#udi>< A#u?i> are i!!ued o> a >a?ed patie>t a!i! @ith a reporta>d #ae#.,.% A#u?i> 8,%%?# vo#u?e9: 3or a#u?i> rep#ace?e>t i> patie>t! @ith a#u?i> a>d #ood vo#u?e deficie>cy.8See pacCa<e i>!ert9.$% A#u?i> 8%%?# vo#u?e9: he ?ai> i>dicatio> for the u!e of thi! product i! to treat hypoa#u?i>ae?ia 8SeepacCa<e i>!ert9.

)*#5 ytomegalovirus >MV? 4egative Products

0M' i! a co??o> i>fectiou! a<e>t that ca> e tra>!?itted y the tra>!fu!io> of #ood product!. 1t i! tra>!?ittedvia the #eucocyte! 8@hite ce##!9 pre!e>t i> red ce## a>d p#ate#et tra>!fu!io>!. 3re!h 3roIe> P#a!?a Octap#a!U>ip#a! a>d 0ryoprecipitate have >ot ee> !ho@> to tra>!?it 0M'.

0M' i>fectio> i! ofte> a!y?pto?atic i> hea#thy per!o>!. A>tiodie! deve#op +-4 @eeC! after the i>fectio> a>d ca>e de?o>!trated i> !ta>dard !cree>i>< te!t!. 1>fectio> cau!ed y the viru! i! >ot c#i>ica##y !i<>ifica>t i>i??u>oco?pete>t patie>t! ut ca> cau!e !evere a>d eve> fata# di!ea!e i> i??u>o!uppre!!ed patie>t! >otpreviou!#y epo!ed to the viru!.

he u!e of #ood co?po>e>t! fro? 0M' !ero>e<ative do>or! i! the !ta>dard ?ethod for the preve>tio> of thetra>!?i!!io> of 0M' y #ood tra>!fu!io>. Leucocyte dep#etio> of #ood co?po>e>t! a#!o reduce! the ri!C of0M' tra>!?i!!io>. 6here the provi!io> of 0M' !ero>e<ative #ood co?po>e>t! i! >ot po!!i#e 8e.<. @here (LA?atched p#ate#et! are reuired9 it i! accepta#e to provide #eucodep#eted co?po>e>t! to at ri!C patie>t! provideda ua#ity co>tro# checC ha! ee> perfor?ed o> the co?po>e>t to co>fir? adeuate #eucodep#etio> to ;%2 re!idua# @hite ce##! * pacC .

he fo##o@i>< cate<ory of patie>t! !hou#d receive MV negative red cells and platelets;

Pa<e $2 of +

)*#8 -rradiated Products

ra>!fu!io> a!!ociated <raft ver!u! ho!t di!ea!e 8A-G'(D9 i! a rare ut u!ua##y fata# co?p#icatio> of #oodtra>!fu!io>. 'ia#e #y?phocyte! pre!e>t i> red ce## a>d p#ate#et do>atio>! ca> cau!e A-G'(D i> !evere#yi??u>oco?pro?i!ed patie>t!.he u!e of irradiated #ood product! i! the !ta>dard ?ethod for the preve>tio> of the tra>!?i!!io> of A-G'(Dy #ood tra>!fu!io>. Ly?phocyte! ca> e re>dered >o>-via#e y epo!ure to io>i!i>< radiatio>. Epo!ure tothe radiatio> i! perfor?ed u!i>< co>tro##ed co>ditio>!. 1rradiated #ood product! are #ae##ed @ith a> approvedar code #ae# y the #ood tra>!fu!io> !ervice oard a>d !hou#d e tra>!fu!ed to the fo##o@i>< patie>t!:

Patie>t! @ith co><e>ita# i??u>odeficie>cy !tate!.Patie>t! @ith (od<Ci>’! di!ea!e.Bo>e ?arro@ a##o<raft recipie>t!Periphera# !te? ce## or o>e ?arro@ auto<raft recipie>t! for ) day! prior to !te? ce## * ?arro@ harve!ti>< a>d ?o>th! po!t tra>!p#a>tatio>.Patie>t! treated @ith puri>e a>a#o<ue dru<! 3#udarai>e 0#adrai>e a>d Deoycofor?yci>.Patie>t! receivi>< (LA ?atched tra>!fu!io>!.1rradiatio> of red ce##! reduce! their epiry ti?e fro? , day! to + day!. 1rradiatio> of P#ate#et! doe! >ot a#ter therouti>e epiry ti?e of ,-) day!. P#ea!e try to order the!e 0M' >e<ative a>d irradiated product! efore $.%p?.

)*#( 1utologous 3lood

Due to the #o@ de?a>d for Auto#o<ou! Pre-Depo!it #ood do>atio> i> St 'i>ce>t ’! U>iver!ity (o!pita# thi! !ervice

i! >ot avai#a#e o> !ite. (o@ever !uita#e patie>t! @ho are i>tere!ted i> thi! !ervice ?ay e referred to the 1BS.3or further i>for?atio> co>tact LiI 7ehoe ra>!fu!io> Survei##a>ce Officer Et: +%2, or B#eep 2+.

)*#*' :actor oncentrates

S?a## ua>titie! of P00 - Prothro?i> 0o?p#e 0o>ce>trate 8Octap#e9 3iri>o<e> Reco?i>a>t 3'11a8Novo!eve>9 Reco?i>a>t 3'111 8Advate9 '63 83a>dhi9 a>d 31; 8Be>efi9 are he#d i> the B#ood ra>!fu!io>Laoratory. Order the!e factor co>ce>trate! fro? the B#ood ra>!fu!io> Laoratory.N.B. A 0o>!u#ta>t (ae?ato#o<i!t ?u!t e co>tacted to approve the i!!ue a>d do!e of 3actor co>ce>trate!.

Pa<e $4 of +

)&#' urrent Prices /f 3lood 1nd 3lood Products 2 '*B'*B&''8

Product 0o!t

Red 0e##! €$) per u>it

R00 8Ne<ative 3or Specific Red 0e## A>ti<e>!9 €+ per u>it

Octap#a! 8 Sd P#a!?a9 €$2 per u>it

P#ate#et! €4$, per u>it

, A#u?i> €2% per u>it

$% A#u?i> €+4 per u>it

0?v e!ti>< €$, per u>it

0?v H 1rradiated €, per u>it

Supp#e?e>tary 3ee 83or Specia# Order! Out Of(our!9

€2$ per order

Octap#e 8Pcc9 €&% per ,%%1U via#

7o<e>ate €%$% per %%%1U via#

Novo!eve> €&2.%% per %%1U via#

3iri>o<e> €2% per <

Be>efi €+% per %%%1U

0ryoprecipitate €$2$ per poo#

A>tithro?i> 111 €$, per ,%%1U

)&#* Ho< +o ontain osts

Before #eedi>< the patie>t checC @ith the B#ood ra>!fu!io> Laoratory that the patie>t ha! >ot a#ready ee><rouped a>d he#d.1f a de#ay occur! @ith the co??e>ce?e>t of the tra>!fu!io> immediately retur> the #ood to the #ood a>Cfrid<e to preve>t !poi#a<e.Do >ot !tore #ood in any fridge other tha> a dedicated a>d co>tro##ed #ood frid<e. Avoid over orderi>< of SD P#a!?a a>d P#ate#et! a! they have a very !hort !he#f #ife 8#i?iti>< the po!!ii#ity thatthey cou#d e u!ed for a>other patie>t9.Order p#ate#et! efore &#)' p#m. dai#y.Order !pecia# reuire?e>t! duri>< >or?a# hour! to avoid the 1BS !upp#e?e>tary char<e.

Pa<e $& of +

))#' Use of Prothrombin omple7 oncentrate >PB/ctaple7? for Management ofMa@or Haemorrhage in Patients on /ral 1nticoagulation

MaFor or Life threate>i>< #eedi>< e<: 1>tracra>ia# (ae?orrha<e 80o>tact (ae?ato#o<i!t for Advice9. Refer toB#ood ra>!fu!io> Procedure!.

. Stop @arfari>

$. Give ,-%?< of vita?i> 7 y !#o@ 1' pu!h.

. Give ,$,, or ,%1U*7< P008Octap#e9 accordi>< to patie>t’! 1NR.

+. Repeat 1NR % ?i>ute! po!t i>fu!io>

,. O>#y <ive SD P#a!?a 8,-$%?#!*C<9 if P00 i! co>trai>dicated.

)"#' Managing 1nticoagulation in the Perioperative Period

E#ective Sur<ery: Refer to S'(G Medici>e! Guidemergency Surgery; 3or e?er<e>cy rever!a#: !eeC advice fro? the hae?ato#o<i!t re the u!e of Prothro?i>0o?p#e 0o>ce>trate 8P00*Octap#e9 a>d refer to B#ood ra>!fu!io> Procedure! a>d Guide#i>e!. 'ita?i> 7!hou#d o>#y e <ive> $-,?< y !#o@ 1' pu!h 8do!e depe>d! o> >eed for reco??e>ce?e>t of a>ticoa<u#atio>po!t !ur<ery9. Repeat 1NR % ?i>ute! po!t i>fu!io> of P00 a>d a<ai> at 2 hour!. Additio> of vita?i> 7 !hou#davoid the >eed for further rep#ace?e>t @ith c#otti>< factor!.

)"#* Ma7imum Surgical 3lood /rdering Schedules

1f #oodu!a<ei! #iCe#yto ehi<her

Pa<e % of +

Procedure No Of U>it!

0ro!!?atched

Uro#o<y

Radica#Pro!tactecto?y

+

Radica# 0y!tecto?y +

Radica# Nephrecto?y

Si?p#e Nephrecto?y ype a>d Scree>

URP ype a>d Scree>

'a!cu#ar

3e?-Pop

Aorto-3e? Bypa!! +

A.A Repair +

Be#o@ * Aove 7>ee3e?-Pop Bypa!!

iia# Bypa!!

1#io.3e? *3e?.3e? $0arotid E>dartrecto?y $

O-Gy>

Radica# (y!terecto?y $

'aa# (y!terecto?y ype a>d Scree>

Ado?i>a#(y!terecto?y

ype a>d Scree>

Oto#ar><

Lary><ecto?y

3ree 3#apHNecC

Di!!ectio>

$

o>!i#ecto?y ype a>d Scree>

Procedure No Of U>it!

0ro!!?atched

horacic

Loecto?y $

Oe!opha<ecto?y $

Media!ti>o!copy ype a>d Scree>

P>eu?o>ecto?y $

Deco>!trictio> $

horacoto?y $

P#a!tic!

Brea!t 8tra? f#ap9

Reco>!tructio>

$

Orthopaedic!

ota# (ip Rep#ace?e>t $

ota# 7>ee Rep#ace?e>t $

3ractured NecC Of 3e?ur $

Dy>a?ic (ip Scre@ $

Spi>a# 3u!io> $

Ge>era#

Ep#oratory Laparoto?y ype a>d Scree>

Pa>createcto?y*6hipp#e! +

Sp#e>ecto?y $

Ga!trecto?y $

0o#ecto?y*(e?i-0o#ecto?y $

Liver Re!ectio> +

tha> reco??e>ded the reue!ti>< doctor ca> over-ride the MSBOS y co>tacti>< the B#ood ra>!fu!io>Laoratory.

)0#' /ther 3lood +ransfusion Services

3or i>for?atio> o> other !ervice! !uch a! i>ve!ti<atio> of a !u!pected tra>!fu!io> reactio> Direct 0oo?! e!t!auto i??u>e hae?o#ytic a>ae?ia rare #ood <roup! etc. co>tact the B#ood ra>!fu!io> Laoratory direct#y atEt: +++&.3or i>for?atio> o> Ste? 0e## (arve!ti>< co>tact the 0ryoio#o<y Laoratory at Et: ++$2 8or the B#oodra>!fu!io> Laoratory9.

Pa<e of +

)5#' Referral Laboratories

Specia#i!ed te!t! >ot prefor?ed i> S'U( are referred to eter>a# #aoratorie!. Speci?e>! for referra# #aoratorie!are di!patched fro? Bioche?i!try a>d Microio#o<y. 6he> re!u#t! are received fro? the referra# #aoratory theoria# report i! a#@ay! for@arded to the reue!ti>< c#i>icia>. A #i!t of the referra# #aoratorie! curre>t#y u!ed i!di!p#ayed e#o@. A ?ore detai#ed #i!t of the te!t referred a>d referra# i! avai#a#e i> the e!t Reuire?e>t Ma>ua#.

Bruce##a Dia<>o!tic U>it Liverpoo# Microio#o<y Laoratory Ai>tree (o!pita# Lo@er La>e Liverpoo# L& )AL.

0#ay?o> Bio?>i! Laoratorie! hree RocC Road Sa>dyford 1>du!tria# E!tate Sa>dyford Du#i> 4.Depart?e>t of 0#i>ica# Bioche?i!try +th 3#oor Du>ca> Bui#di>< Roya# Liverpoo# U>iver!ity (o!pita# Pre!cot StreetLiverpoo# L) 4;P U>ited 7i><do?.

Depart?e>t of Neuropatho#o<y Beau?o>t Du#i> &.

Dept of Neuro1??u>o#o<y Natio>a# (o!pita# for Neuro#o<y = Neuro!ur<ery 1>!titute of Neuro#o<y 5uee>! SuareLo>do> 60N BG.

Dept. of 0#i>ica# Bioche?i!try race E#e?e>t U>it Roya# 1>fir?ary (o!pita# G#a!<o@ G+ OS3 U7.

Dr A>> 0urti! Norther> Ge>etic! Service 1>!titute of (u?a> Ge>etic! 0e>tra# ParC@ayNe@ca!t#e-upo>-y>e NE BK U7.

Dr Bo Peat!o> 0#i>ica# Bioche?i!try Depart?e>t 3ree?a> (o!pita# 3ree?a> Road Ne@ca!t#e upo> y>e NE ))DN

Dr D (o#t Poi!o>! 0e>tre Ne@ 0ro!! (o!pita# Avo>#ey Road Lo>do>

Dr G@e> 6arC SAS Peptide (or?o>e Sectio> 0#i>ica# Laoratory Roya# Surrey 0ou>ty (o!pita# Gui#dford SurreyGUK ,;; U7.

Dr " R Bo>ha? Depart?e>t of 0he?ica# Patho#o<y = Neo>ata# Scree>i>< Sheffie#d 0hi#dre>! (o!pita# N(S ru!t6e!ter> Ba>C Sheffie#d S% $(.

Dr ".M La>d Neuro?etao#ic U>it Bo %, Natio>a# (o!pita# 5uee> Suare Lo>do> 60N BG.

Dr "oa>>e Mar!de> 7i><! 0o##e<e (o!pita# De>?arC (i## Lo>do> SE, &RS.

Dr "oy Ardi## Re<u#atory Peptide La Mu#hou!e Bui#di>< Roya# 'ictoria (o!pita# Be#fa!t B$ 2BA%+4 &% $+%,% $,,*$,

Dr Ly>ette 3aira>C! Puri>e Re!earch Laoratory +th 3#oor North 6i>< St ho?a! (o!pita#La?eth Pa#ace Road Lo>do> SE )E(

Dr Peter S?ith 0o>@ay 1>!titute U0D Be#fie#d Du#i> +

E#ectro? Micro!copy Laoratory Dept. of A<ricu#ture U0D Be#fie#d Du#i> +.

E>docri>e Laoratory Depart?e>t of Medica# Bioche?i!try a>d 1??u>o#o<y U>iver!ity (o!pita# of 6a#e!(eath ParC 0ardiff 03+ +;6

(=1 3i#to> N(S B#ood = ra>!p#a>t ,%% North Bri!to# ParC North@ay 3i#to> Bri!to# BS+ )5(

1??u>o#o<y Laoratory "oh> Radc#iffe (o!pita#

1ri!h B#ood ra>!fu!io> Service Dia<>o!tic Laoratory St. "a?e! (o!pita# Du#i> 4.

1ri!h Me>i><ococca# a>d Me>i><iti! Refere>ce Laoratory he 0hi#dre>! U>iver!ity (o!pita# e?p#e Street Du#i>

".S Patho#o<y Service! Be@#ay (ou!e $ "a?e!to@> Road Lo>do> N6 )B/

7evi> Gree> 1??u>o#o<y Depart?e>t = Protei> Refere>ce U>it PO Bo 4&+ Sheffie#d S, )/

7i><! 0o##e<e Lo>do> Stra>d Lo>do> 60$R $LS E><#a>d

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user manual ed 6 july 09

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