May 21, Dear Valued OSF Lab Customer,

Transcription

1 Dear Valued OSF Lab Customer, OSF System Laboratory is committed to providing you with the high quality products and services you expect to meet your patient s needs by continually assessing processes for ongoing improvements. To that end, all OSF System Laboratories will soon be changing our preferred tube type for much of our clinical chemistry testing to the mint green lithium heparin tube. Rationale for change: Our clinical chemistry instrument manufacturer, Abbott Diagnostics, has validated and supports the use of lithium heparin plasma for many of these tests. The reason for the change is that gold and red top tubes with incomplete clot formation can lead to instrument malfunction which increases turnaround times. The mint green plasma tube can be centrifuged immediately upon collection eliminating the need for clot formation. Important centrifugation requirements: For off-site locations that process blood specimens before sending on to our lab, please note that both the mint green lithium tube and gold top tubes must be centrifuged within 2 hours of collection. Tip/recommendation if add-on testing is likely: Gold or red top tube collections are still required for several tests and these tests cannot be added to mint green top lithium heparin specimen collections that will now be collected for many common chemistry tests. Our recommendation: if there is a high probability of add-on tests being ordered for a patient (especially Mayo referral tests), you may opt to also collect one gold top tube just in case additional testing is needed that cannot be performed on the mint green top lithium heparin specimens. Implementation schedule for non-osf client submitters: 1. Switch over to these drawing/tube guidelines as of noon, Monday, June 8 th. It will be at this time that the electronic test catalogs that you refer to will be reflecting the changes. 2. From now to June 8 th, anticipate your needs and send supply orders for mint green Lithium Heparin tubes. As appropriate, continue to use your gold top supply up through the conversion date. 3. Our automated track system goes live in late June and thus we are making this tube conversion in advance of the track system automation as to account for a learning curve that your staff may encounter. Note that upon June 8 th implementation at noon, if you happen to draw a gold top tube for a test that has converted to a mint green draw, the gold top tube will not be rejected. However, working with your staff to ensure consistency with the conversion will be greatly appreciated. 4. Unless a specimen must be poured over into a transfer tube, it is recommended that whenever possible you send the original, centrifuged tube to OSF System Laboratory for testing. If sending a pour off transfer tube is necessary, please document on the requisition, whether the specimen is plasma or serum. 1

2 Important Disclaimer: The following guidance is correct/applicable at this point in time; however, it must be stressed that EPIC (OSF owned clients) and the OSF System Laboratory Directory of Services and/or Atlas (non-epic clients) are considered the most accurate and up-to-date sources for correct draw information. While the information in the grids below can help clarify the changes, it is best practice to verify draw/tube type specifications at the source (Directory of Services or EPIC) as this information may change in the future as testing methodologies and/or manufacturer s specifications also change. The following is a list of the most common tests that should now be drawn in a mint green lithium heparin tube: 1. Chemistry panels including: comprehensive metabolic panel, basic metabolic panel, hepatic function panel, renal function panel, lipid panel and acute hepatitis panel *Please note that the obstetric panel/obspan requires one gold, one lavender, one pink and one mint top tube. 2. Ethanol 3. Acetaminophen 4. Salicylate 5. Many therapeutic drug levels including: carbamazepine, digoxin, gentamicin, phenytoin, phenobarbital, theophylline, valproic acid, and vancomycin 6. Quantitative Beta HCG 7. Thyroid tests including: TSH, Total T4, Total T3, Free T4, and Free T3 8. Amylase 9. Lipase 10. Estradiol 11. Ferritin 12. Homocysteine 13. Vitamin B Serum Folate (Please remember to check the Directory of Services for the most up-to-date specimen collection instructions.) 2

3 The following tests in the next 5 tables CANNOT be drawn in a mint green lithium heparin tube: Gold Top Tube Preferred BETA 2 MICROGLOBULIN LAB745 Gold Gold, Red, Lavender (B2GLB) DEHYDROEPIANDROSTERONE LAB943 Gold Gold, Lavender, Red SULFATE (DHEA-S) (DHEAS) ELECTROPHORESIS W/ TOTAL LAB965 Gold Gold, Red PROTEIN SERUM (SPE) IMMUNOFIXATION W/ LAB1203 Gold Gold, Red ELECTROPHORESIS SERUM (IFESPE) IMMUNOFIXATION W/O LAB1204 Gold Gold, Red ELECTROPHORESIS SERUM (SIFE) INSULIN LEVEL (INS) LAB1221 Gold Gold, Red, Lavender, Gray LITHIUM (LITHM) LAB1260 Gold Sodium Heparin (Dark Green), Lavender, Gold, Red LUTEINIZING HORMONE (LH) LAB1256 Gold Gold, Red, Lavender PREALBUMIN (PAB) (PALB) LAB667 Gold Gold, Red PSA FREE & TOTAL (PSAFT) LAB1391 Gold Gold, Red PSA SCREEN, TOTAL (PSASCR) LAB1390 Gold Gold, Red PSA, TOTAL DIAGNOSTIC LAB1389 Gold Gold, Red (PSA) RHEUMATOID FACTOR LAB1415 Gold Gold, Red QUANT (RFQT) TESTOSTERONE, TOTAL LAB1538 Gold Gold, Red, Lavender (TEST) FREE KAPPA LAMBDA LIGHT LAB1789 Gold Gold, Red CHAINS (FKLCHN) HIV 1 & 2 ANTIBODY & LAB1857 Gold Gold ANTIGEN DIAGNOSTIC (HIVCD) HIV 1 & 2 ANTIBODY & ANTIGEN SCREEN (HIVCS) LAB1858 Gold Gold 3

4 Red Top Tube Preferred No Gel ALPHA 1 ANTITRYPSIN LAB675 Red Red, Lavender (A1AT) ANTISTREPTOLYSIN O LAB725 Red Red QUANT (ASOQT) LIPOPROTEIN (A) (APOL) LAB1259 Red Red, Lavender Lavender Top Tube Preferred B-TYPE NATRIURETIC LAB735 Lavender Lavender PEPTIDE (BNP) CYCLOSPORINE LEVEL LAB930 Lavender Lavender (CYCLO) HEMOGLOBIN A1C W/ LAB1805 Lavender Lavender ESTIMATED GLUCOSE (A1CGLU) PARATHYROID HORMONE PTH INTACT (PARAT) LAB1331 Lavender Sodium Heparin, Red, Lavender NO GEL Separators added RAPAMYCIN (SIROLIMUS) LAB1404 Lavender Lavender LEVEL (RAPA) TACROLIMUS (FK506) LAB1020 Lavender Lavender Gray Top Tube LACTIC ACID (LACTATE) LAB1243 Gray Sodium Fluoride / Potassium SERUM (LAC) Oxalate Gray Dark Green Top Tubes CARBOXYHEMOGLOBIN (COH) LAB811 Dark Green Lithium Heparin Dark Green Lithium Heparin (WHOLE BLOOD) IONIZED CALCIUM (ICA) LAB1225 Dark Green Sodium Heparin Dark Green Sodium Heparin 4

5 Order of Draw BLOOD CULTURES - First always, usually drawn separately because of STERILE TECHNIQUE BLUE (sodium citrate) NAVY BLUE (no additive) GOLD, RED (no additive) GREEN (sodium heparin) MINT GREEN (lithium heparin) LAVENDER (EDTA) PINK (EDTA) NAVY (EDTA) TAN (EDTA) GRAY (potassium oxalate, sodium fluoride) YELLOW ACD-A 5