24 HOUR URINE COLLECTION - North Bristol NHS Trust
24 HOUR URINE COLLECTION [pic]
1) Choose the correct coloured 24 hour urine container
|Albumin |Calcium (Ca) |5 HIAA | Urate | Cystine** |
|Bence Protein |Catecholamines | | UA stone former | (Day and Night) |
|Cortisol |Citrate | | | |
|Copper |Magnesium | | |**HOSPITAL |
|Electrolytes |Metanephrines | | | REQUEST |
|Protein |Oxalate (Ox) | | | ONLY |
| |Phosphate | | | |
| |CaOx stone former** | | | |
| |CaOx stone former ** (Follow Up) | | | |
| |Cystine stone former** | | | |
If uncertain of the correct container for a test, contact Biochemistry - 0117 323 8383 (Option 2)
To obtain 24 hour urine containers, contact OUTFIT via phone/fax - 0117 323 8338
2) Fill in request form
[pic]
|Department of Blood Sciences – Day/night collection | | |
| | | |
|It is essential that ALL details are completed | | |
| | | |
|Hospital/NHS Number: …………………………….. | | |
|Name: ……………………………………………….. | | |
|Date of birth: …………………… | | |
|Doctor: ………………………………………………. | | |
|Test requested: ………………………………………….. | | |
|Clinic;/GP surgery: ………………………………………. | | |
| | |To be completed by the Healthcare |
| | |professional |
| | | |
| | | |
|Start Date and Time Day: ……………………………. | | |
|Finish Date and Time Day: ………………………….. | | |
|Finish time Day Night: ………………………………… | | |
| | |To be completed by the patient |
| | | |
| | | | | | |
| | | | | | |
| |Please affix | | | | |
| |ICE label here | | | | |
| | | | | | |
IF DETAILS ON THE FORM AND SAMPLE ARE NOT COMPLETE, SAMPLES WILL NOT BE PROCESSED
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This leaflet MUST be sent out with EVERY 24 hour urine sample and the request form (page 5) completed as outlined below and returned to the laboratory
Please do not include any other Request forms
Affix ICE Label here
Date: 29/2/12 Ver 1.0
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