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Test Ordering

All ordering of tests MUST be transmitted trough the CERNER LIS computer except when:

the LIS is deemed non-operational and downtime procedures are i, or when the area is not serviced by a computer or the procedure is not available through the computer.

Manual requests must have the patient’s name, date of order, patient number, location and name of ordering physician.

After CERNER LIS computer is operational, Central Receiving will generate computer slips for the manual requests issued when the CERNER LIS computer was down.

STAT and Urgent Requests

Please note that STAT requests should be limited to emergency situations.  Indiscriminate ordering of STATS slows down the reporting of all results including those which are legitimate STATS.

All STAT requests must be ordered in the CERNER LIS System as STAT for results needed as quickly as possible in non-emergency situations for example: pre-ops.  Requests will be batched, allowing efficient laboratory operation, and results will be available in the CERNER LIS System as soon as the results are reviewed and verified.STATS: See STAT Test List.CEREBROSPINAL FLUID: Total protein and glucose.BLOOD GAS ANALYSIS: All Blood Gases Samples are considered STAT.Pediatric Specimens:The laboratory will attempt to provide the maximum number of tests possible according to the blood received.  If the sample collected is small or marginal, please indicate your order of preference for the tests required.  In case of doubt as to the amount of sample required and test availability contact the Chemistry Supervisor at extension 2977.All samples must be logged in the CERNER LIS System before delivering them to the Chemistry Lab.

Clinical Chemistry tests routinely use the SST tubes (gel barriers).  There are exceptions to this, and some of these are listed below:

  1. Testing for therapeutic drugs require Plain red.Ammonia tests require Green Heparin tubes sent immediately on ice.Blood Gas specimens are to be collected using the blood gas kit; no needles are to be attached to the syringe.Tests for urine toxicology and blood alcohol are to be sent to Chemistry.  The messenger from the laboratory during the hours of 8:30 am to 4:30 pm or the hospital Messenger during the other hours.Lactic Acid Grey top tube on ice.Lead is a Tan top (Lead free) tube.BNP is a Lavender top Tube.Chemistry services are available 24 hours a day, 7 days a week, extensions: 2977, 2922, 2921.
  2. Specimens are to be delivered to Central Accessioning, Room A2-421.

All URINE CONTAINERS for 24 hour urine Chemistries must be obtained from Central Sterile or from the Clinics.  Only a 15 ml aliquot in most cases is required for the laboratory.  Volume must be measured and recorded on the request slips.  DO NOT send container. All URINE CONTAINERS FOR ENDOCRINE TESTING must me obtained from Clinical Chemistry and 100 ml. aliquot for each test required sent to the laboratory.Routine Urine Chemistries: Procedure for collecting 24 hour urine specimens:First urine voided upon awakening in morning should be discarded and the time of avoiding noted.Start urine collection from noted time and collect all further voidings in the proper collection container.Keep urine refrigerated as much as possible.Terminate urine collection the next morning at the previously noted time.  For example:  If started at 8:00 am, stop collecting urine after 8:00 am the next morning.The total volume of urine collected during the 24 hour period must be accurately measured and an aliquot submitted to chemistry.The total volume (TV) must be noted on the computer bar code label.Aliquot should be placed in leak-tight container.  The container must be properly labeled with a bar code label.Any urine specimen collected for Endocrine analysis must be accurately measured; 100 ml aliquots for each test requested sent to clinical chemistry so that sample can be sent to the appropriate reference laboratory.  Total volume must written on accompanying request.  No urines will be accepted that ate leaking or do not indicate total volume.Creatinine Clearance TestsA blood specimen must accompany urine.  Results cannot be calculated without serum values.Urine collections must be accurately timed to nearest MINUTE.  Record time and volume on request slips.Urine for VWA, Catecholamines, and Metanephrines must be collected with acid preservatives in dark bottles.  Bottles must be obtained from the Chemistry Lab, room #A2-452.See procedure above for collecting 24 hour urines.  Notes total volume and submit 100 ml aliquot to chemistry laboratory.For Blood Gases – PATIENT BAR CODE LABEL showing name, hospital number and nursing station MUST be affixed to any container delivered to the chemistry laboratory or blood gas laboratory.  Blood Gas Specimens are to be collected using the Blood Gas Kit.  No needles are to be attached to the syringe.NOTE: UNLABELED SAMPLES WILL NOT BE PROCESSED.Cerebrospinal fluid – Total protein and glucose are to be collected in designate containers provided through central sterile.

Transport and Delivery

All blood and urine chemistry samples are to be delivered to the Central Receiving area, Room #A2-428.All urinary endocrine tests are to be delivered to Central Receiving area, Room #A2-428 and will be sent to Reference Laboratory.All blood gas samples on ice are to be delivered to the Chemistry Laboratory as follows:Blood Gas Lab, Room #A2-563, Mon – Fri 8:00 am – 4:00 pm.  All Other Times:  Room #A2-452 (Chemistry Lab).