DEPARTMENT OF PATHOLOGY HACKENSACK UNIVERSITY …
DEPARTMENT OF PATHOLOGY HACKENSACK UNIVERSITY MEDICAL CENTER
30 PROSPECT AVENUE, HACKENSACK, NJ 07601 and
HACKENSACK UNIVERSITY MEDICAL CENTER AT PASCACK VALLEY
250 OLD HOOK ROAD, WESTWOOD, NJ 07675
MANUAL OF LABORATORY SERVICES
The procedures outlined in this manual will be followed unless a different procedure is specifically requested by the physician. A Pathologist must be contacted to approve any such deviation from standard protocol. These test reference ranges are valid as of the date of this revision. New test methodologies and instruments within the department may result in changes to these ranges. All patient reports are released from the department with current reference ranges on the report. Always refer to the patient report for the most updated reference range for a procedure.
2012 Revision
Ciaran M. Mannion, MD Chair, Department of Pathology and Laboratory Director
2
LABORATORY SERVICES MANUAL DEPARTMENT OF PATHOLOGY
TABLE OF CONTENTS
TOPIC I. GENERAL INFORMATION A. Hours B. Location C. Telephone Directory
PAGE
5 5 5
II. TEST REQUESTS/COLLECTION OF SPECIMENS
A. Ordering Laboratory Tests
6
B. Specimen Collection and transport
7
Collections Sent Via Pneumatic Tube
9
Diagnostic Technician Beeper Distribution
11
C. Unsatisfactory/Sub-Optimal Specimen Policy
12
D. Routine Procedures
12
E. Timed Requests/Timed Collections.
13
F. Stat Procedures/ Draw Stats
14
Ordering Stat Procedures
14
Stat Procedure List
14
G. New Admissions
16
H. Pre-Admission Testing (PAT)
16
I. Pre-Operative Requests (Pre-Ops)
16
J. Point-of-Care Testing
17
K. Reference Laboratory Testing
17
L. HackensackUMC at Pascack Valley Testing
17
III. REPORTING RESULTS.
A. Turn Around Time
18
B. Availability of Laboratory Results
19
C. Critical Values Policy
19
Critical Value Lists (Adult and Children/Newborn)
23
IV. BLOOD BANK /TRANSFUSION SERVICE
25
A. Ordering Blood
26
B. Specimen Collection and Labeling
26
C. Trauma or Down time Numbers
27
D. Blood Requests for Surgical Procedures
27
E. Antibodies
27
F. Emergency Blood Transfusion Orders
27
G. Administration of Blood Products
28
H. Transfusion Reactions
29
I. Releasing Blood Products
29
V. CYTOLOGY SPECIMENS A. Body Cavity Fluid Collection B. Breast Smear/Nipple Discharge Collection C. Cerebrospinal Fluid Specimen Collection D. Colonic Brushing Specimen E. Direct Scraping Collection (Skin and Mouth) F. Esophageal and Gastric Brushing Collection G. Fine Needle Aspiration Collection H. Pap Smear Specimen Collection I. Respiratory Specimen Collection J. Sputum Specimen Collection K. Urine Specimen Collection L. Pelvic Washings M. Vitreous Fluid
VI. MICROBIOLOGY SPECIMENS A. Blood Cultures B. Cultures For Routine Bacteria
Body Fluids Catheters. Cerebrospinal fluid (CSF) Ear Eye G.C. Culture Genital Lower Respiratory Tract Nasopharyngeal Stool Throat Urine Wound C. Anaerobe Specimen Collection and Transport D. Smear For General Bacterial Stain E. Fungal Culture F. Fungal Smear G. T.B. Culture (AFB) H. Intestinal Parasites I. Blood Smears For Parasites J. Cryptosporidium K. Pinworm Prep L. Trichomonas
VII. MOLECULAR PATHOLOGY TESTING A. Monitoring Bone Marrow Transplantation B. Molecular Coagulation Panel
3
29 30 30 31 31 31 32 32 34 35 35 36 37
37 39 39 39 40 40 41 41 41 42 43 44 45 46 47 47 50 50 51 51 52 53 53 54 54
54 55
4
C. B & T Cell Gene Rearrangement
55
D. BCR-ABL PCR
55
E. BCR ABL FISH
56
F. PML-RARA FISH
56
G. PML-RAR PCR
56
H. C-MYC FISH
56
I. 11-14 Translocation, FISH
57
J. T(14-18), FISH
57
K. Bordetella pertussis/para pertussis PCR
57
L. Mycobacterium tuberculosis (MTB) PCR
58
M. 16S rDNA sequencing for bacterial detection/identification
58
N. HER2/Neu gene amplification FISH
58
O. K-RAS Gene Mutation
58
VIII. SURGICAL PATHOLOGY SPECIMENS
59
1. Routine Histopathology Specimens
59
2. Histopathology Specimens Requiring Special Handling
59
3. Specimens Exempted from mandatory submission to
61
Pathology
4. Specimens that can be Ordered as "Gross Examination Only"
62
IX. PATIENT REQUESTS FOR LAB SPECIMENS
62
X. REFLEXIVE TESTING
63
XI. PEDIATRIC REFERENCE RANGES
66
X. ALPHABETICAL TEST LISTING ? starts on page
75
5
I. GENERAL INFORMATION
A. HOURS
Hackensack campus: Mon-Fri: 7AM - 3PM FULL SERVICE 3PM - 7AM STAT SERVICE and selective routine testing.* Sat/Sun/Holidays: ALL SHIFTS - STAT SERVICE and selective routine testing.* (Refer to alphabetic listing of tests, Weekends/Holiday for test availability) * Routine testing is dependent on the Stat workload and staffing of the Department.
HackensackUMC at Pascack Valley - Westwood campus: The Laboratory at the Westwood campus provides 24/7 STAT SERVICE to the Satellite ED for a specific menu of tests (see pages 17-18). Other tests collected at this site will be forwarded to the Hackensack campus for analysis. Out-patient specimen collection is available Monday-Saturday, 7 AM ? 7 PM.
B. LOCATION
Hackensack campus: The Main Laboratory and the Stat Laboratory of the Department of Pathology are located on the first floor, East and West Pavilion Building. Westwood campus: The Laboratory at the North Campus is located on the first floor of the main building, just off the Entrance Lobby.
C. TELEPHONE DIRECTORY
Main Laboratory Number (Hackensack campus) 551-996-4860
Anatomical Pathology/Cytology Reports
551-996-4808
Blood Bank
551-996-4813
Blood Donor Room
551-996-4818 and 4819
Charting
551-996-4812
Chemistry
551-996-4862
Cytology
551-996-4852
Diagnostic Technicians Office/Phlebotomy (5 Main, Room 5645)
551-996-4829
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