DEVELOPMENT SITE ONLY
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
UNIVERSITY HOSPITAL OF NORTH MIDLAND
NORMAL WORKING HOURS
Monday-Friday
- 0830-1730 hr
- Histology: 0900-1730 hr
Saturday
- Histology: no service
- Biochemistry: 0830-1300 hr
- for advice, contact BMS (bleep 389)
- contact on-call clinical scientist via Rotawatch
- Haematology: 0900-1300 hr
- Microbiology: 0830-1700 hr
- if sending an urgent sample, contact microbiology
- Virology: 0830-1300 hr
URGENT/OUT-OF-HOURS SERVICE
Specimens
- Clearly mark all urgent requests ‘urgent’
- Include patient’s name (or emergency ID), date of birth, unit number, consultant, ward and time of specimen
- essential for electronic reporting of results
- All requests must contain clinical information relevant to investigation requested
- Where request or sample containers are inadequately completed/labelled or illegible, this may result in investigation(s) not being performed
Request: written or phone?
- If sending an urgent microbiology sample, contact microbiology
- Otherwise, do not bleep biomedical scientist (BMS)
- unless results are clinically very urgent and need to be telephoned
Results: VDU or phone?
- Results will be phoned only if:
- delay likely in transmitting results to VDU
- BMS has already agreed to phone
- results alert BMS to possibility that immediate action may be required
Transport of samples
- For urgent and out of hours specimens, contact transport
INVESTIGATIONS AVAILABLE OUT-OF-HOURS
- Be certain that investigation will influence immediate clinical management
- if BMS is in any doubt about relevance of request, they will ask SpR or more senior doctor to contact clinician on-call for relevant laboratory specialty
Select which department
Blood transfusion
Written Request
- Group and save
- Crossmatch of red cells
- Direct Coombs test
Phone
- Urgent transfusion required, phone
- If massive haemorrhage, activate MHP - see Massive haemorrhage protocol
- Unless discussed, antenatal samples and direct antiglobulin test (DAT) are only processed during routine working hours
Haematology
Written Request
- Full blood count (FBC) including differential WBC
- International normalised ratio (INR)
- Activated partial thromboplastin time (APTT)
- D-dimer for screening patients with suspected DVT or PE
- ESR
- Blood films for morphology
- Malarial parasites
- Infectious mononucleosis screen
- D-dimer with fibrinogen for assessment of DIC
- Fibrinogen
Phone
- In appropriate patients requiring urgent general anaesthesia, sickle cell screen
- require 1 hr prior notification
- For patients with suspected temporal arteritis or for paediatrics, ESR
Biochemistry
Written
- Amylase
- Cardiac troponin
- Liver function tests (LFT)
- Creatine kinase (CK)
- Uric acid
- Serum or plasma U&E, osmolality, bicarbonate
- Bone
- Thyroid function tests (TFT)
- Urine U&E, osmolality
- CRP
- NTproBNP
- HCG
- Magnesium
- CSF protein and CSF glucose
- Lactate
- Tumour markers
- Parathyroid hormone
- Therapeutic drug monitoring
- digoxin, phenytoin, carbamazepine, theophylline, valproic acid, lithium
- Toxicology investigations
- paracetamol, salicylate, iron, ethanol
Phone
- CSF Xanthochromia
- Ammonia
- Ethanol
- Hypoglycaemia screen
- SUDI/C samples
- Urinary PBG
- Specialised toxicology requests directly to the Regional Toxicology
Laboratory
- e.g. drugs of abuse, ethylene glycol, methanol
- for transport, phone. Requesting department will be charged
Microbiology
Limited routine service available
- Weekdays 1730–1930
- Saturday 0900–1700 hr
- Sunday 0900–1700 hr
- antimicrobial monitoring assays are batched and run at approximately 1100 and 1530 hr on Saturday, Sunday and Bank holidays
- phone laboratory during these times
- At all times, send samples (especially MRSA swabs) to laboratory promptly to ensure processing as soon as possible
Out-of-hours
- Contact BMS on phone for all requests until 2230 and after 2230 only for:
- CSF samples
- intra-operative specimens taken in theatre where a microscopy is urgently required
- joint aspirates
- ascitic fluids if spontaneous bacterial peritonitis suspected
- After 2230 hr, refer all other requests to on-call consultant medical microbiologist
Histology
- No out-of-hours service available