Beaumont Hospital Clinical Directorate of Laboratory ...

1 Beaumont Hospital Clinical Directorate of Laboratory Medicine Guide to Use of Laboratory Services by Beaumont Hospital Users Document Number: LP-GEN-0016 Revision: 7 Active Date: 25th October 2018. Authorised By: Prof. P. Thornton, Clinical Director of Laboratory Medicine Document Number: LP-GEN-0016 Revision: 7. DEPARTMENTAL INFORMATION. DEPARTMENT INFORMATION PAGE NUMBER. Blood Transfusion Clinical Guidelines 9. Laboratory Information 113. Haematology & Clinical Guidelines 19. Coagulation & Flow Laboratory Information 120. Cytometry Chemical Pathology Clinical Guidelines 24. Laboratory Information 145. Immunology Clinical Guidelines 26.

2 Laboratory Information 188. Microbiology Clinical Guidelines 70. Laboratory Information 162. Histopathology, Cytology, Clinical Guidelines 78. Neuropathology & Molecular Laboratory Information 219. Pathology NHISSOT Clinical Guidelines 81. Laboratory Information 240. See next page for detailed table of contents. Page 2 of 261. Document Number: LP-GEN-0016 Revision: 7. 1 INTRODUCTION .. 8. UPDATES OF USER'S HANDBOOK .. 8. 2 TESTING GUIDELINES .. 9. BLOOD TRANSFUSION & 9. ED Trauma packs and Major Emergency Patient Identification Pack (MEPIP) .. 9. Major Emergency Patient Identification Pack (MEPIDP) For Use in Beaumont Hospital Only .. 10.

3 Type & Screen (TS) Specimen Collection .. 11. Patient Identification .. 11. Procedure for taking a Type & Screen 12. The TS Specimen .. 13. Detection of antibody (s) in a TS Specimen .. 16. Cost of Blood Components and Products .. 17. Transfusion Information Leaflets For Patients .. 17. HAEMATOLOGY .. 19. Thrombophilia Screening .. 19. Lupus Anticoagulant .. 22. Anti Xa and Rivaroxaban Anti 22. ESR .. 23. Haematology Molecular Tests .. 23. CHEMICAL PATHOLOGY .. 25. IMMUNOLOGY .. 26. Rheumatoid Factor .. 26. Anti-Cyclic Citrullinated Peptide antibodies (CCP) .. 27. Connective Tissue Disease (CTD) Screen .. 28. Anti-Nuclear Factor (ANF) by Immunofluorescence.

4 30. Anti-Double-Stranded-DNA Antibodies .. 31. Anti-ENA (Extractable Nuclear Antigen) Antibodies .. 32. Anti-Nucleosome Antibodies .. 33. Anti-Histone Antibodies .. 34. Anti-Ribosomal-P-Protein antibodies .. 34. Anti-Neutrophil Cytoplasm Antibodies (ANCA) Anti-Myeloperoxidase Antibodies (Anti-MPO) Anti-Proteinase 3 Antibodies (Anti-PR3) .. 35. Anti-Glomerular Basement Membrane Antibodies (Anti-GBM) .. 38. Anti-Cardiolipin Antibodies (IgG and IgM) .. 39. Antibodies to Beta 2 Glycoprotein 1 .. 40. Anti-Smooth Muscle Antibodies .. 42. Anti-Liver-Kidney Microsomal (LKM) Antibodies .. 43. Anti-Mitochondrial Antibody & M2 subtyping .. 43. Anti-Gastric-Parietal Cell Antibodies (Anti-GPC).

5 44. Anti-Intrinsic Factor Antibodies .. 45. Anti Thyroid Peroxidase Antibodies (anti-TPO) .. 45. Anti TSH-R Antibodies (TRAb) .. 46. Page 3 of 261. Document Number: LP-GEN-0016 Revision: 7. Anti-Adrenal Antibodies .. 47. Anti- Tissue Transglutaminase Antibodies (anti-tTG).. 47. IgA Anti-Endomysial Antibodies (EMA) .. 48. Anti-Neuronal Antibodies Anti-Hu & anti-Yo .. 50. Autoimmune Encephalitis Panel & Anti-NMDA Antibodies .. 51. Anti-Skin Antibodies .. 53. Total IgE and Allergen Specific IgE .. 53. Complement - C3 and 55. Complement Function CH100 .. 56. Complement C1 Esterase Inhibitor (C1 INH) .. 57. C1 Inhibitor Function .. 58. Anti-Streptolysin-O Titre (ASOT).

6 59. Mast Cell Tryptase .. 60. Anti-Pneumoccal 61. Specific IgGs .. 62. Mannose Binding Lectin (MBL) .. 63. Myositis Screen .. 63. Scleroderma Blot .. 65. IgG Subclasses .. 66. Anti-PLA2R Antibodies .. 67. Query Test .. 68. Direct Immunofluorescence (DIF) on Skin Biopsies .. 68. 70. General Sample Collection Guidelines .. 70. Guidelines for Critical Specimens .. 70. Guidelines for Routine Specimens .. 71. Serological 76. HISTOPATHOLOGY/CYTOPATHOLOGY/NEUROPATHOL OGY .. 78. Current Best Practice for Renal Biopsies .. 78. Handling of Tissue after Biopsy has been 78. Coroners's Post Mortem .. 78. NHISSOT .. 81. HLA Antigens .. 81. Graft Rejection.

7 81. 3 Laboratory SERVICES 83. GENERAL INFORMATION .. 83. Location of Department .. 83. Contacting the Department/Telephone Numbers .. 83. Department Opening 88. Use of The Laboratory System: PIPE & Patient Search .. 88. 93. Specimen Collection Guidelines & Order Of Draw .. 93. Urgent samples .. 100. Sample Collection & Labelling Guidelines During Computer Downtime 101. Specimen Acceptance Criteria .. 102. Page 4 of 261. Document Number: LP-GEN-0016 Revision: 7. Specimen Tubes & Containers .. 104. Test Results .. 106. Contacting A/E with critical results.. 107. A/E Patient that has been Discharged .. 107. Specimen Referral .. 108. Specimen Transportation Guidelines.

8 108. Specimen Storage Conditions .. 110. Data Protection Policy .. 110. Time Limits for Requesting Additional Examinations .. 111. Repeat Examination due to Analytical Failure .. 111. Uncertainty of Measurement (UM) .. 111. Complaints .. 112. Accreditation/Quality Standards .. 112. BLOOD TRANSFUSION .. 113. Repertoire of Test Services .. 113. Components/Products Available From the Blood Bank .. 115. Specialised Tests Referred to the IBTS .. 116. Result Reporting: Patient Information Profile Explorer (PIPE) &. Beaumont Hospital Information System (BHIS) .. 116. Clinical Advice for Blood Transfusion Department .. 119. HAEMATOLOGY .. 120. Repertoire of Haematology Tests.

9 120. Repertoire of Flow Cytometry Tests .. 124. Repertoire of Coagulation Tests .. 126. Repertoire of Haematology Molecular Tests .. 129. Clinical Advice & Laboratory Test Interpretation .. 130. Specimens Referred to External Hospitals .. 131. Thrombophilia Screen (TPSC).. 139. Requests for Additional Analysis .. 140. Critical Values .. 141. Emergency Out-Of-Hours Services .. 142. Urgent Blood Film Reports Out of Hours/Weekends .. 142. Sample Collection & Labelling Guidelines for Bone Marrow Aspirates 143. CHEMICAL PATHOLOGY .. 145. Services Offered .. 145. Out of Hours / Weekend Service .. 145. Clinical Contact for Medical Indications/ Clinical Advice.

10 146. Requests for Additional Tests .. 146. Test Profiles and their Components .. 147. Point of Care Testing .. 147. Fluid 147. Molecular / Genetic Requests .. 148. Catecholamines and Metabolites .. 149. Critical Phoning Limits .. 149. Blood, CSF & Fluid Tests .. 152. Page 5 of 261. Document Number: LP-GEN-0016 Revision: 7. Urine Tests .. 169. Repertoire of Test Services Toxicology .. 172. Requests Referred 173. Referral Laboratory Information .. 182. IMMUNOLOGY .. 188. Clinical Service .. 188. Laboratory 188. Out-of-Hours Service .. 189. Educational Activities .. 189. Urgent Requests .. 189. Tests Referred to External Laboratories .. 190.