Haematology Department information - Revision history

Glim: Malaria - clarified LAMP PCR, and removed thick film reference

2025-11-07T03:02:47Z

Malaria - clarified LAMP PCR, and removed thick film reference

← Older revision		Revision as of 03:02, 7 November 2025
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	Please include clinical details on the form including recent travel locations, previous history of malaria and which type if positive.		Please include clinical details on the form including recent travel locations, previous history of malaria and which type if positive.

	Malaria screen is performed by PCR, and if positive followed up with immunochromatography (ICT) for malarial antigens ~~and thick~~ and thin film examination.		Malaria screen is performed by LAMP PCR, and if positive followed up with immunochromatography (ICT) for malarial antigens, and thin film examination for species identification.

	The required sample type is EDTA whole blood and can be performed from the same tube as the CBC.		The required sample type is EDTA whole blood and can be performed from the same tube as the CBC.
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	Last reviewed 07/04/2025 by Grace Lim		Last reviewed 07/11/2025 by Grace Lim

Glim: /* Consultant Haematologist Clinical cover */

2025-04-07T03:25:57Z

Consultant Haematologist Clinical cover

← Older revision		Revision as of 03:25, 7 April 2025
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	Dr Bart Baker		Dr Bart Baker

	~~Dr Elayne Knottenbelt~~

	Dr Allanah Kilfoyle		Dr Allanah Kilfoyle

	Dr Matt Stephens		Dr Matt Stephens


			Last reviewed 07/04/2025 by Grace Lim

Glim: Grammer and spacing. Health NZ for Mid Central hospital

2024-07-09T21:17:29Z

Grammer and spacing. Health NZ for Mid Central hospital

← Older revision		Revision as of 21:17, 9 July 2024
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	If results indicate, or if specifically requested, the blood film is examined and a comment made. '''Note this may not be until the next day, or longer on weekends and public holidays.''' If not available immediately, blood film review can be arranged by phone at any time. Please contact the laboratory to arrange this.		If results indicate, or if specifically requested, the blood film is examined and a comment made. '''Note this may not be until the next day, or longer on weekends and public holidays.''' If not available immediately, blood film review can be arranged by phone at any time. Please contact the laboratory to arrange this.

	== Paediatric ==		=== Paediatric ===
	Capillary or venous blood collected into EDTA (purple or lavender top) Microtainers (0.5 ml) can be used. Successful analysis on volumes below 250ul cannot be guaranteed but analysis may be possible below this.		Capillary or venous blood collected into EDTA (purple or lavender top) Microtainers (0.5 ml) can be used. Successful analysis on volumes below 250ul cannot be guaranteed but analysis may be possible below this.

	== Reticulocyte count ==		=== Reticulocyte count ===
	Performed on request or at the discretion of Haematology staff based on the CBC/Blood Film results. Analysis is automated and performed on the same specimen as the CBC so no additional samples are required.		Performed on request or at the discretion of Haematology staff based on the CBC/Blood Film results. Analysis is automated and performed on the same specimen as the CBC so no additional samples are required.

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	[[ESR Indications for testing\|Click here for ESR Indications for testing]]		[[ESR Indications for testing\|Click here for ESR Indications for testing]]

	=== Bone Marrow examination ===		== Bone Marrow examination ==
	Contact with ~~clinical~~ Haematology (~~Medlab Central,~~ Palmerston North) is required before ordering Bone Marrow trephine and aspirate collection. Haematology staff must be present at the collection procedure to prepare the required samples and this '''must be pre-arranged with the laboratory''' as availability of staff cannot always be guaranteed.		Contact with Clinical Haematology (Palmerston North) is required before ordering Bone Marrow trephine and aspirate collection. Haematology staff must be present at the collection procedure to prepare the required samples, and this '''must be pre-arranged with the laboratory''' as availability of staff cannot always be guaranteed.

	Analysis is not carried out on site but referred to Clinical Haematology (Palmerston North) and other reference labs for specialist testing as appropriate.		Analysis is not carried out on site but referred to Clinical Haematology (Palmerston North) and other reference labs for specialist testing as appropriate.
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	· Paediatric: 1.8 ml Sodium Citrate (Blue top tube)		· Paediatric: 1.8 ml Sodium Citrate (Blue top tube)

	Samples must be thoroughly mixed by inversion and be filled to the marked fill level on the tube. Samples must be free from clots, and must not be grossly haemolysed or lipaemic to be suitable for analysis. Please refer to chart below for guidance on fill volumes, tubes filled below the minimum fill indicator may not be acceptable for analysis. Under or overfilled tubes may be rejected and a repeat specimen requested.		Samples must be thoroughly mixed by inversion and be filled to the marked fill level on the tube. Samples must be free from clots and must not be grossly haemolysed or lipaemic to be suitable for analysis. Please refer to chart below for guidance on fill volumes, tubes filled below the minimum fill indicator may not be acceptable for analysis. Under or overfilled tubes may be rejected and a repeat specimen requested.

	'''Please supply sufficient clinical information to ensure the appropriate tests are performed, including any anticoagulants that the patient is receiving.'''		'''Please supply sufficient clinical information to ensure the appropriate tests are performed, including any anticoagulants that the patient is receiving.'''

	== Coagulation screen ==		=== Coagulation screen ===
	[[File:Citrate.png\|thumb\|Click to enlarge picture]]		[[File:Citrate.png\|thumb\|Click to enlarge picture]]
	A routine coagulation screen will include an INR & APTT only. Fibrinogen and TCT will be performed if specifically requested or at the discretion of Haematology staff for further investigation as required.		A routine coagulation screen will include an INR & APTT only. Fibrinogen and TCT will be performed if specifically requested or at the discretion of Haematology staff for further investigation as required.

	D-Dimer, and Factor Assays require one full Blue top		D-Dimer, and Factor Assays require one full Blue top
	~~== Investigation of coagulation disorders ==~~
	Unexplained abnormalities in coagulations screens will be investigated under the direction of the Head of Department. If a bleeding disorder is suspected please phone the laboratory for advice on further testing.

	== Factor VIII ==		=== Investigation of coagulation disorders ===
			Unexplained abnormalities in coagulations screens will be investigated under the direction of the Head of Department. If a bleeding disorder is suspected, please phone the laboratory for advice on further testing.

			=== Factor VIII ===
	Routine Factor VIII assays are batched and performed weekly on Thursday. If this assay is requested urgently outside of 0800hrs to 2000hrs Monday to Friday, and on public holidays, a Haematology lab staff member will be called in to perform this assay. Laboratory staff may contact the requesting Doctor to confirm that the call back is required.		Routine Factor VIII assays are batched and performed weekly on Thursday. If this assay is requested urgently outside of 0800hrs to 2000hrs Monday to Friday, and on public holidays, a Haematology lab staff member will be called in to perform this assay. Laboratory staff may contact the requesting Doctor to confirm that the call back is required.

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	Tests included in a thrombophilia screen:		Tests included in a thrombophilia screen:



	Coagulation screen (INR, APTT, Fibrinogen and TCT)		Coagulation screen (INR, APTT, Fibrinogen and TCT)
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	=== Guideline on Thrombophilia Screen acceptance criteria ===		=== Guideline on Thrombophilia Screen acceptance criteria ===

	=== When screening is indicated: ===		==== When screening is indicated: ====
	· Early age of onset <45 years		· Early age of onset <45 years

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	· Arterial thrombosis '''(Lupus anticoagulant only)'''		· Arterial thrombosis '''(Lupus anticoagulant only)'''

	=== When screening is not indicated: ===		==== When screening is not indicated: ====
	· Commencement of oral contraceptive/hormone replacement therapy.		· Commencement of oral contraceptive/hormone replacement therapy.

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	Please include clinical details on the form including recent travel locations, previous history of malaria and which type if positive.		Please include clinical details on the form including recent travel locations, previous history of malaria and which type if positive.

	Malaria screen is performed by PCR, and if positive followed up with immunochromatography (ICT) for malarial antigens and thick and thin film examination. The required sample type is EDTA whole blood and can be performed from the same tube as the CBC.		Malaria screen is performed by PCR, and if positive followed up with immunochromatography (ICT) for malarial antigens and thick and thin film examination.

			The required sample type is EDTA whole blood and can be performed from the same tube as the CBC.

	== Reference ranges ==		== Reference ranges ==
	Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. [[CBC Reference Ranges\|Click here for a detailed table.]] Contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).		Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. [[CBC Reference Ranges\|Click here for a detailed table.]]

			Contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).

	== Contacts ==		== Contacts ==
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	== Consultant Haematologist Clinical cover ==		== Consultant Haematologist Clinical cover ==
	Mid-Central Hospital provides a 24 hour specialist cover for clinicians and laboratory staff.		Health New Zealand - Mid-Central Hospital provides a 24 hour specialist cover for clinicians and laboratory staff.

	~~The following Haematologists can be contacted at (06) 350 8550 option 5~~


			The following Haematologists can be contacted at (06) 350 8550 option 4

	Dr Bart Baker		Dr Bart Baker

Glim: /* Consultant Haematologist Clinical cover: */

2023-11-03T03:47:46Z

Consultant Haematologist Clinical cover:

← Older revision		Revision as of 03:47, 3 November 2023
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	Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. [[CBC Reference Ranges\|Click here for a detailed table.]] Contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).		Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. [[CBC Reference Ranges\|Click here for a detailed table.]] Contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).

	== ~~Contact~~ ==		== Contacts ==
	Haematology Laboratory		Haematology Laboratory

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	(06) 878 1647 or internal ext 6249		(06) 878 1647 or internal ext 6249

	== Consultant Haematologist Clinical cover: ==		== Consultant Haematologist Clinical cover ==
	Mid-Central Hospital provides a 24 hour specialist cover for clinicians and laboratory staff.		Mid-Central Hospital provides a 24 hour specialist cover for clinicians and laboratory staff.

Glim: Removed DHB

2023-11-03T03:45:33Z

Removed DHB

← Older revision		Revision as of 03:45, 3 November 2023
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	== Consultant Haematologist Clinical cover: ==		== Consultant Haematologist Clinical cover: ==
	Mid-Central ~~DHB~~ provides a 24 hour specialist cover for clinicians and laboratory staff.		Mid-Central Hospital provides a 24 hour specialist cover for clinicians and laboratory staff.

	The following Haematologists can be contacted at (06) 350 8550 option 5		The following Haematologists can be contacted at (06) 350 8550 option 5

Glim: Took out HIT screen, updated contact details

2023-11-03T03:44:43Z

Took out HIT screen, updated contact details

← Older revision		Revision as of 03:44, 3 November 2023
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	'''Note:''' The existence of underlying conditions, drugs and treatment need to be considered as these may be the causative agents of clot formation.		'''Note:''' The existence of underlying conditions, drugs and treatment need to be considered as these may be the causative agents of clot formation.

	~~== HIT screen ==~~
	~~Performed in Haematology using a particle gel immunoassay technique. Required sample type is serum from plain red top or SST tube.~~

	== Malaria ==		== Malaria ==
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	Phone 06 878 1308 Ext 2445		Phone 06 878 1308 Ext 2445

	'''~~Chris Greenwood~~'''		'''Grace Lim'''

	Head of Department		Head of Department

	(06) 878 1647 or internal ext ~~2646~~		(06) 878 1647 or internal ext 6249

	== Consultant Haematologist Clinical cover: ==		== Consultant Haematologist Clinical cover: ==
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	The following Haematologists can be contacted at (06) 350 8550 option 5		The following Haematologists can be contacted at (06) 350 8550 option 5



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	Dr Elayne Knottenbelt		Dr Elayne Knottenbelt

	~~Dr Paul Harper~~

	Dr Allanah Kilfoyle		Dr Allanah Kilfoyle

	Dr Matt Stephens		Dr Matt Stephens

Cgreenwo: added link for ref ranges

2023-03-08T19:44:40Z

added link for ref ranges

← Older revision		Revision as of 19:44, 8 March 2023
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	== Reference ranges ==		== Reference ranges ==
	Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. ~~Please contact~~ the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).		Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. [[CBC Reference Ranges\|Click here for a detailed table.]] Contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).

	== Contact ==		== Contact ==

Cgreenwo at 23:13, 17 November 2022

2022-11-17T23:13:34Z

@@ Line 33: / Line 33: @@
 === Guideline on ESR acceptance criteria ===
 The recommended marker for infection/inflammation is CRP. The lab will therefore only perform ESR testing for specific clinical indications where it has been shown to be of clinical value. ESR requests will only be processed if one of the following clinical details is provided and clearly marked on the request form:
-== Bone Marrow examination ==
+[[ESR Indications for testing|Click here for ESR Indications for testing]]
 Contact with clinical Haematology (Medlab Central, Palmerston North) is required before ordering Bone Marrow trephine and aspirate collection. Haematology staff must be present at the collection procedure to prepare the required samples and this '''must be pre-arranged with the laboratory''' as availability of staff cannot always be guaranteed.

Cgreenwo: Created page with "== Routine Haematology (CBC, FBC, Blood count) == Specimen required: EDTA anticoagulated whole blood (purple or lavender top tube). Specimen must be well mixed and free from clots. Automated analysis will provide: Haemoglobin Haematocrit MCV MCH Platelets WBC and differential These results will be made available in Clinical Portal as soon as they are available. Results from automated analysis may appear as unauthorised in Clinical Portal and are '''subject to..."

2022-08-03T21:40:28Z

Created page with "== Routine Haematology (CBC, FBC, Blood count) == Specimen required: EDTA anticoagulated whole blood (purple or lavender top tube). Specimen must be well mixed and free from clots. Automated analysis will provide: Haemoglobin Haematocrit MCV MCH Platelets WBC and differential These results will be made available in Clinical Portal as soon as they are available. Results from automated analysis may appear as unauthorised in Clinical Portal and are '''subject to..."

New page

== Routine Haematology (CBC, FBC, Blood count) ==
Specimen required: EDTA anticoagulated whole blood (purple or lavender top tube). Specimen must be well mixed and free from clots.

Automated analysis will provide:

Haemoglobin

Haematocrit

MCV

MCH

Platelets

WBC and differential

These results will be made available in Clinical Portal as soon as they are available.

Results from automated analysis may appear as unauthorised in Clinical Portal and are '''subject to change.''' These results will update to authorised when reviewed and released by Scientist staff - this may not be until the next day. Amended results that have changed by a clinically significant amount will be communicated by phone. Community results for General Practice will be reported electronically (by HL7 Healthlink) when the results are authorised, this may not be until the next working day.

If results indicate, or if specifically requested, the blood film is examined and a comment made. '''Note this may not be until the next day, or longer on weekends and public holidays.''' If not available immediately, blood film review can be arranged by phone at any time. Please contact the laboratory to arrange this.

== Paediatric ==
Capillary or venous blood collected into EDTA (purple or lavender top) Microtainers (0.5 ml) can be used. Successful analysis on volumes below 250ul cannot be guaranteed but analysis may be possible below this.

== Reticulocyte count ==
Performed on request or at the discretion of Haematology staff based on the CBC/Blood Film results. Analysis is automated and performed on the same specimen as the CBC so no additional samples are required.

== ESR ==
ESR requests are vetted and only performed for appropriate clinical indications. Clinical details must be provided. A minimum of 1.5ml whole blood is required for this assay, microtainer collects are therefore not appropriate.

=== Guideline on ESR acceptance criteria ===
The recommended marker for infection/inflammation is CRP. The lab will therefore only perform ESR testing for specific clinical indications where it has been shown to be of clinical value. ESR requests will only be processed if one of the following clinical details is provided and clearly marked on the request form:
{| class="wikitable"
|'''Adult Clinical Indications'''
|'''Paediatric Clinical Indications'''
|-
|Temporal Arteritis (Including Giant Cell Arteritis)
|Kawasaki disease
|-
|Rheumatoid Arthritis
|Rheumatic fever
|-
|Polymyalgia Rheumatica
|Ulcerative colitis
|-
|Rheumatic fever
|Crohn’s disease
|-
|Vasculitis (Including Wegener’s Granulomatosis)
|SLE
|-
|Connective tissue disease (includes SLE, scleroderma, polymyositis, dermatomyositis, Sjörgren’s syndrome and systemic sclerosis)
|? Juvenile Idiopathic Arthritis (JIA)
|-
|Hodgkin lymphoma
|
|-
|Investigation of post operative joint replacement infection
|
|-
|Ophthalmology patients
|
|}

== Bone Marrow examination ==
Contact with clinical Haematology (Medlab Central, Palmerston North) is required before ordering Bone Marrow trephine and aspirate collection. Haematology staff must be present at the collection procedure to prepare the required samples and this '''must be pre-arranged with the laboratory''' as availability of staff cannot always be guaranteed.

Analysis is not carried out on site but referred to Clinical Haematology (Palmerston North) and other reference labs for specialist testing as appropriate.

== Coagulation Tests ==
Collection & Specimen required:

· Adults: 2.7 ml Sodium Citrate (Blue top tube)

· Paediatric: 1.8 ml Sodium Citrate (Blue top tube)

Samples must be thoroughly mixed by inversion and be filled to the marked fill level on the tube. Samples must be free from clots, and must not be grossly haemolysed or lipaemic to be suitable for analysis. Please refer to chart below for guidance on fill volumes, tubes filled below the minimum fill indicator may not be acceptable for analysis. Under or overfilled tubes may be rejected and a repeat specimen requested.

'''Please supply sufficient clinical information to ensure the appropriate tests are performed, including any anticoagulants that the patient is receiving.'''

== Coagulation screen ==
[[File:Citrate.png|thumb|Click to enlarge picture]]
A routine coagulation screen will include an INR & APTT only. Fibrinogen and TCT will be performed if specifically requested or at the discretion of Haematology staff for further investigation as required.

D-Dimer, and Factor Assays require one full Blue top
== Investigation of coagulation disorders ==
Unexplained abnormalities in coagulations screens will be investigated under the direction of the Head of Department. If a bleeding disorder is suspected please phone the laboratory for advice on further testing.

== Factor VIII ==
Routine Factor VIII assays are batched and performed weekly on Thursday. If this assay is requested urgently outside of 0800hrs to 2000hrs Monday to Friday, and on public holidays, a Haematology lab staff member will be called in to perform this assay. Laboratory staff may contact the requesting Doctor to confirm that the call back is required.

== Thrombophilia screen ==

6 full 2.7ml blue tops and 5ml in a red top are required.

Tests included in a thrombophilia screen:

Coagulation screen (INR, APTT, Fibrinogen and TCT)

Protein C and S

Antithrombin III (ATIII)

Activated Protein C Resistance (APCR)

Lupus Anticoagulant screen (LA)

Anticardiolipin antibodies (ACA)

Requests for thrombophilia testing are vetted and will only be performed for appropriate clinical indications as per below.

=== Guideline on Thrombophilia Screen acceptance criteria ===

=== When screening is indicated: ===
· Early age of onset <45 years

· Familial history of venous thromboembolism (VTE) with more than two other symptomatic 1<sup>st</sup> degree family members

· Thrombosis after trivial provocation, age <45 years with symptomatic 1<sup>st</sup> degree family member

· Intrauterine death at >20 weeks gestation

· Stillbirth at >20 weeks

· Neonatal purpura fulminans '''(Protein C and S only)'''

· Warfarin-induced skin necrosis '''(Protein C and S only – patient cannot be on warfarin)'''

· Association of thrombosis and fetal losses '''(Lupus anticoagulant only)'''

· Arterial thrombosis '''(Lupus anticoagulant only)'''

=== When screening is not indicated: ===
· Commencement of oral contraceptive/hormone replacement therapy.

· General obstetrics – those clinically at risk should receive thromboprophylaxis regardless of thrombophilia screening

· Cancer patient screening

· Recurrent idiopathic thrombosis - by definition this is an indication for prolonged secondary prophylaxis

· Age of onset >45 years

'''Note:''' The existence of underlying conditions, drugs and treatment need to be considered as these may be the causative agents of clot formation.

== HIT screen ==
Performed in Haematology using a particle gel immunoassay technique. Required sample type is serum from plain red top or SST tube.

== Malaria ==
Please include clinical details on the form including recent travel locations, previous history of malaria and which type if positive.

Malaria screen is performed by PCR, and if positive followed up with immunochromatography (ICT) for malarial antigens and thick and thin film examination. The required sample type is EDTA whole blood and can be performed from the same tube as the CBC.

== Reference ranges ==
Age and sex adjusted reference ranges are issued as part of the standard report for all haematology testing. Please contact the Haematology Department for advice on interpretation of Neonatal and paediatric coagulation results (to 16 years).

== Contact ==
Haematology Laboratory

Phone 06 878 1308 Ext 2445

'''Chris Greenwood'''

Head of Department

(06) 878 1647 or internal ext 2646

== Consultant Haematologist Clinical cover: ==
Mid-Central DHB provides a 24 hour specialist cover for clinicians and laboratory staff.

The following Haematologists can be contacted at (06) 350 8550 option 5

Dr Bart Baker

Dr Elayne Knottenbelt

Dr Paul Harper

Dr Allanah Kilfoyle

Dr Matt Stephens