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Haematology Department information: Difference between revisions
Haematology Department information (view source)
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 == | |||
Contact with | 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 | 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 | ||
== 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 4 | |||
Dr Bart Baker | Dr Bart Baker | ||