Biochemistry Department Information: Difference between revisions

m
Updates
(Created page with "== '''Blood sample requirements''' == Relevant clinical details on the request form help result authorising and decisions on contacting the clinician. Most combinations of the following common tests can be done on one heparin tube (green top). Immediately after filling the heparin tube, mix gently by inversion 8 – 10 times. {| class="wikitable" |AFP** |CEA** |Fertility Hormones (FSH, LH, Oestradiol, Prolactin, Progesterone) |Liver Function Tests (ALB, ALP, ALT, AST, T...")
 
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Most combinations of the following common tests can be done on one heparin tube (green top). Immediately after filling the heparin tube, mix gently by inversion 8 – 10 times.
Most combinations of the following common tests can be done on one heparin tube (green top). Immediately after filling the heparin tube, mix gently by inversion 8 – 10 times.
{| class="wikitable"
{| class="wikitable"
|AFP**
|Antibiotics
|CEA**
(Gentamicin, Tobramycin, Vancomycin)
|Fertility Hormones (FSH, LH, Oestradiol, Prolactin, Progesterone)
|
|Liver Function Tests (ALB, ALP, ALT, AST, TBil)
|Fertility Hormones  
|Rheumatoid Factor
(FSH, LH, Oestradiol, Prolactin, Progesterone)
|Liver Function Tests  
(ALB, ALP, ALT, AST, TBil)
|Rheumatoid Factor *
|-
|-
|Albumin
|Albumin
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|Glucose
|Glucose
|Magnesium
|Magnesium
|Thyroid Tests (TSH, FT3, FT4)
|Thyroid Tests  
(TSH, FT3, FT4)
|-
|-
|Bilirubin
|Bilirubin
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|-
|-
|B12 & Folate
|B12 & Folate
|Drugs (Therapeutic Monitoring, Urine Cannabinoids, Urine Amphetamine)
|Therapeutic Drugs
|Iron Studies (Iron,
(Digoxin, Lithium *, Phenytoin, Carbamezapine, Valproate, Theophyliine)  
 
|Iron Studies  
Transferrin, Ferritin)
(Iron, Transferrin, Ferritin)
|Paracetamol
|Paracetamol
|Troponin I
|Troponin I
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|Urea
|Urea
|-
|-
|CA125**
|BNP (NT-proBNP)
|Ethanol
|Ethanol
|Lipids (Cholesterol,
|Lipids  
 
(Cholesterol, HDL, Triglycerides)
HDL, Triglycerides)
|Tumour Markers
|PSA**
(AFP, βHCG, CA125, CA153, CA199, PSA)
|Uric Acid
|Uric Acid
|}
|}
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1.     BNP, HbA1c and PTH require EDTA blood (purple top).  Separate tube from FBC please.
1.     BNP, HbA1c and PTH require EDTA blood (purple top).  Separate tube from FBC please.


2.     Lactates are performed on VBG or ABG samples.
2.     Lactate is performed on VBG or ABG samples.
 
3.     Lithium or Rheumatoid Factor requires serum (red top).


4.     ** require yellow form for requesting as this is a consultant ordered test.
3.     * Lithium or Rheumatoid Factor requires serum (red top).


Specialised tests are sent away to Canterbury Health Laboratories (CHL) and access to CHL Test Guide Manager is recommended for guidance on sample type, volume, condition of collect, type of assay etc.
Specialised tests are sent away to Canterbury Health Laboratories (CHL) and access to CHL Test Guide Manager is recommended for guidance on sample type, volume, condition of collect, type of assay etc.


== '''Blood gases''' ==
== '''Blood gases''' ==
Immediately after taking sample, expel any air from the syringe and mix gently by inversion 8 to 10 times. Label syringe. Pre-printed labels are acceptable on blood gases.
Immediately after taking sample, expel any air from the syringe and mix gently by inversion 8 to 10 times. Label syringe. Pre-printed labels are acceptable on blood gas samples.


'''Cord gases''' need to be labelled with the Mother’s details (Mother’s name, NHI and/or date of birth), and NOT the baby’s details.  The Mother’s pre-printed labels are acceptable, indicate if the sample is Arterial or Venous on this label.
'''Cord gases''' need to be labelled with the Mother’s details (Mother’s name, NHI and/or date of birth), and NOT the baby’s details.  The Mother’s pre-printed labels are acceptable, indicate if the sample is Arterial or Venous on this label.
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·           '''Falsely increased:''' potassium, magnesium, urate, iron, phosphate, total protein, AST, LD,       folate.  
·           '''Falsely increased:''' potassium, magnesium, urate, iron, phosphate, total protein, AST, LD,       folate.  


·           '''Falsely decreased:''' bilirubin, amylase, GGT.  BNP is not performed on haemolysed samples.
·           '''Falsely decreased:''' bilirubin, GGT.  BNP is not performed on haemolysed samples.


The most common cause of haemolysis is forcing blood from a syringe into a blood tube through the needle.  It is best to remove the needle from the syringe, and the stopper from the tube, and expel the blood gently down the wall of the tube.
The most common cause of haemolysis is forcing blood from a syringe into a blood tube through the needle.  It is best to remove the needle from the syringe, and the stopper from the tube, and expel the blood gently down the wall of the tube.