The remainder of the specimen is then immediately sent to the lab for analysis. The clinician should know that a change in the laboratory results does not necessarily imply a change in the health status of the patient. Harris E. Statistical aspects of reference values in clinical pathology. per manufacturers directions. (4). Specimen Collection Procedure - Glucose Tolerance Testing | Akron Do not administer the Azer Scientific Glucose Drink without contacting the appropriate individual. Phlebotomy Chapter 18 Flashcards If a test has specific fasting requirements, the requirements will be outlined in the test catalog. Winkel P. Application of time series analysis in the clinical setting. tourniquet above the pre-selected venipuncture site. This study was carried out to define the consequences of collecting blood specimens during the forenoon instead of using fasting specimens collected early in the morning. Short-term and long-term intra-individual variations and critical differences of clinical chemistry laboratory parameters. However, see the indi vidual test section for specific requirements. Fasting should last for 12 h, during which water consumption is permitted. However, there were equal numbers of patients from surgical and medical wards. 325 9th Ave, Rm # GWH-47, Seattle, WA 98104-2420, UW Medical Center Northwest1550 N 115th Street, A200Seattle, WA 98133, Clinical Lab, Room NW220, University of Washington Medical Center,1959 NE Pacific street, Seattle, WA 98195, Contact: commserv@uw.edu | Centrifuge the specimen, following the manufacturers recommended spin Instructions for clients using High Volume Receiver (HVR). On an Outpatient confirm the fasting status with the patient and/or parent. A. Light-blue top B. improperly collected, labeled or transported. It brings the entire family the laboratory. See specific collection techniques under the appropriate The multicomparison significance level is at 99%. 2009;17(2):63-4. doi: 10.14236/jhi.v17i2.716. A fasting glucose greater than 125 mg/dl requires a call to the patient=s physician before continuing with the procedure. guidelines under the test dictionary. The nature of the inpatients illnesses was not recorded because the study was performed explicitly on a general inpatient population to assess practical guidelines for specimen collection in general hospitals. Lab Code GLUF Epic Ordering Glucose, Fasting Description This test can be ordered as the fasting time point in the 2-hour oral glucose tolerance test recommended by the ADA for non-OB patients or as a stand-alone fasting glucose. under different conditions must be designated non-fasting. An overnight fast of at least 8 hours is required for most fasting specimens. These results were included in the calculations because such patients are also encountered in the laboratory routine. There are several approaches to these decision limits, on the basis of interviews with clinicians (4) and different calculations (2)(3)(8)(9). culture in the test catalog. 325 9th Ave, Rm # GWH-47, Seattle, WA 98104-2420, UW Medical Center Northwest1550 N 115th Street, A200Seattle, WA 98133, Clinical Lab, Room NW220, University of Washington Medical Center,1959 NE Pacific street, Seattle, WA 98195, Contact: commserv@uw.edu | Keeping the foreskin retracted, allow a few milliliters of urine to pass and then collect urine in a sterile container. For example, for a creatinine http://www.aphl.org/aphlprograms/infectious/tuberculosis/Pages/tbtool.aspx The coefficient of variation (CV, %) of the patient results was compared with the analytical CV. Northern Plains Laboratory may refuse to accept specimens Blood venous sample collection: Recommendations overview and a checklist to improve quality. For Inorganic phosphate was measured only on inpatients. Cleanse the penis, retract the foreskin (if not circumcised), and wash three times with a different soap pad each time. The patient finishes the drink at 0615. Collect S1, blood specimen collected at 0800, fasting; (21), change between blood specimen collected at 0930, after breakfast, and S1; (31), change between blood specimen collected at 1100 and S1; i, index of heterogeneity; IN, inpatients; OUT, outpatients; calc., calculated; MCV, mean cell volume; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; ND, not determined; TT, thromboplastin time. See Glucose tolerance test. name, gender, birth date, chart number, collection date and time. Phleb Chapter 18 Flashcards No pediatric or gynecological patients were included. post-analytical processes. Fasting specimen | definition of fasting specimen by Medical dictionary 2017 Jul;50(10-11):568-573. doi: 10.1016/j.clinbiochem.2017.02.021. without separation or refrigeration. eat meals on schedule. Specimen Collection - University of Texas Medical Branch It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Some tests require LS I.1.02.01 Specimen Labeling and Requests for Testing for additional requirements. The coefficient of variation (CV, %) of the patient results was compared with the analytical CV. Perform At NPLs discretion, we may Specimens for vitamin D analysis should be fresh or frozen serum. Esa Leppanen , Benoit Dugue, When to collect blood specimens: midmorning vs fasting samples, Clinical Chemistry, Volume 44, Issue 12, 1 December 1998, Pages 25372542, https://doi.org/10.1093/clinchem/44.12.2537. Patient's first and last name, no middle initial needed Withdrawing a unit of blood from a patient for therapeutic purposes is used as treatment for polycythemia Polycythemia a significant increase in RBC count GGT means All volunteers (outpatients) considered themselves healthy and had C-reactive protein values <10 mg/L. to clearly mark the samples as to peak and trough. P1NP (Procollagen 1 Intact N-Terminal Propeptide) - Test Catalog Specimens are placed in the timed urine bottle which may contain preservatives. A person exhibiting oliguria would have a daily urine volume of: A. We also thank Brigitta Kuronen for supervising the assays and Ralph Grasbeck, head of the Biochemistry group at the Minerva Institute, for critical assistance in preparing the manuscript. Alcohol should be avoided for 24 h before blood sampling . REFERENCES 1.Standards of Medical Care in Diabetes - 2013, Diabetes Care Volume 36, Supplement 1, January 2013. For safety purposes, instruct the patient to urinate in a clean, dry container, then transfer the urine to the collection bottle. With one hand, separate the urinary opening and hold open until the process is complete. Bethesda, MD 20894, Web Policies When performing Random plasma glucose B. Fasting plasma glucose (Minimum of 8 hours without caloric intake) C. Two Hour Modified Glucose Tolerance Test (Not recommended for routine clinical use. necessary. Green top C. PST D. Red-top D. Red-top A tourniquet is used in venipuncture to: A. concentrate the blood specimen B. find and enter veins more easily C. Keep the vein from collapsing D. all the above B. find and enter veins more easily the specimen(s) utilizing syringe or vacuum tube system. Centrifuge/Spin: Yes. coagulation discard tube should be drawn first. venipuncture with needle bevel side up. Clinical and statistical significance are different concepts and should not be mixed. Fasting Requirements When fasting is required for laboratory testing at PCH the patient should not consume any food or drink except small amounts of water, for the minimum fasting time prior to the specimen being drawn. Patient is given 50g of Glucose or 148 ml of the Azer Scientific Glucose Drink. If more than 15 minutes has passed continue the procedure and notify CCL to put a comment in when they result the test. The plastic graduated cylinders used to measure the Azer Scientific Glucose Drink. Specimens requiring refrigeration may be placed in a basin filled with crushed ice if a refrigerator is not available. Center (701-530-5700). government site. In the outpatient group, we found one undiagnosed case of hypercholesterolemia and one case of subclinical hypothyroidism. Blood lipid measurements. Fasting specimen required; After collection, gently invert tube 8-10 times. Use with high risk populations such as children with cystic fibrosis. When to collect blood specimens: Midmorning vs fasting samples position. Receiver (HVR), the label generated by the HVR must be placed on the transport The within-person CVs were systematically greater (up to 14-fold) than the analytical CVs (Tables 1 and 2). In general, specimens should be refrigerated until picked up by the courier for transport to the laboratory. Furthermore, the specimens may have been collected any time during the working day for convenience and to equalize the need for personnel during working hours. Sample collection directions are provided in the test The first character of the description. adopted by your facility when collecting and handling laboratory specimens. Fax 358-9-4771025. International standards such as ISO25 do not comment on the pathophysiological state or preparation of the patient before obtaining (blood) specimens in sufficient detail. The analytes were as follows: the blood picture (leukocytes, erythrocytes, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, and platelet counts) and leukocyte differential count (neutrophils, lymphocytes, monocytes, eosinophils, and basophils); erythrocyte sedimentation rate; thromboplastin time; the serum concentrations of total calcium, potassium, sodium, creatinine, glucose, total cholesterol, triglycerides, thyrotropin (S-TSH),1 free thyroxine (S-T4F), and C-reactive protein; and the serum activities of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, -glutamyltransferase, total creatine kinase (S-CK), and subunit B of creatine kinase (S-CK-B). Corewell Health Pennock Laboratory, Hastings, MI Specimen Requirements for specimens sent to the Laboratory: Lithium Heparin; send specimen to laboratory immediately. Refrigerate plasma/serumNote: Plasma or serum collected in green, gold or red top tubes should be separated from the cells within 1 hr. Comparison of the individual CVs obtained from three measurements in the morning with the experimentally1 and clinically derived (4) critical differences. Hand written requisitions must be legible. The subjects formed two groups: group 1 (ambulatory subjects corresponding to outpatients) consisting of subjectively healthy individuals with no medication other than oral contraceptives for 1 week before the experiment (n = 51; 31 women, ages 1860 years; mean, 36.7 years; 20 men, ages 2363 years; mean, 42.4 years). Clipboard, Search History, and several other advanced features are temporarily unavailable. Chapter 7, 8 & 10 Flashcards 8:30am A random specimen is suitable for most screening purposes. Ask another phlebotomist to collect the specimen B. Cholesterol, High-Density Lipoprotein, Plasma, Cholesterol, Low-Density Lipoprotein (calculated), Plasma, Cryoglobulin, Qual with Reflex to IFE Typing & Immunoglobulins, Serum, Cryoglobulin, Qualitative, with Reflex to Quantitative IgA, IgG, and IgM, Serum, Leptin, Quant by Chemiluminescents Immunoassay, Serum, Very Long Chain Fatty Acids + Phytanic Acids, Plasma. National Library of Medicine Doumas B. Different medical specialities and different clinical situations may require different standards and procedures. Recommendations for fasting instructions prior to collection of a fasting glucose or lipid profile: tubing and assure the proper ration of anticoagulant to blood. that are not appropriately labeled with 2 unique identifiers. For intraoperative PTH: Please see the intraoperative PTH test, test code PTHR.In patients receiving high biotin doses (i.e. or cream. Influence of the needle bore size used for collecting venous blood samples on routine clinical chemistry testing. TESTING OPTIONS: A. Read and follow the precautions. Answer. Exp., experimentally derived; crit., critical; Clin., clinically derived; ND, no data available; TT, thromboplastin time; ASAT, aspartate aminotransferase; ALAT, alanine aminotransferase. E. Gestational Diabetes Confirmation Test - Order a Gestational 3 Hr Challenge (Lab Code MG3HR). (Potassium Oxalate Sodium Fluoride). Before instructions and information on fasting, diet, and medication restrictions when The discard tube (a non-additive or coagulation tube) must be used to displace the air in the collection sets tubing, but does not need to be filled completely. original collection tube provided a complete barrier is formed between the in the individual specimen requirements. HMC and UW-MT Onsite Locations:Preferred: 4 mL blood in LIME GREEN PST tubeAlso Acceptable: 4 mL blood in ORANGE RST, GOLD SST, RED TOP, GREEN TOP or GREY TOP tubePediatric: 1 Full LIME GREEN MICROTAINEROffsite Clinic or Other Locations:Preferred: 4 mL blood in GOLD SST tubeAlso Acceptable: 4 mL blood in ORANGE RST, LIME GREEN PST, RED TOP, GREEN TOP or GREY TOP tubePediatric: 1 Full LIME GREEN MICROTAINER. Please utilize the No serum-separator tubes were used. 2. performs type and crossmatch testing. PDF Specimen Collection and Preparation provided you are able to identify/verify that the specimen is the correct All specimens submitted to The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). available via hardcopy titled HVR Users Manual. Wash hands thoroughly with soap and water. Some tests require a 12-14 hour fast. and transmitted securely. Extensive laboratory data were obtained from specimens collected from fasting participants at 0800, after breakfast at 0930, and again at 1100. If a second patient identifier used is not listed below, then approval to process the specimen must be obtained from the division Medical Director (not applicable to Blood Bank). REAGENTS 1.Azer Scientific 100 Glucose Tolerance Test Drink One bottle = 296 ml = 100 grams of glucose, .34 gram/ml The Glucose beverage for inpatients will be stored in the Locust Out Patient Lab. 600-1000 mL C. 1000-1500 mL D. Over 1500 mL 4. If the level is less than 125 mg/dl, then 100g of Glucose or 296ml of Azer Glucose Drink is given. A type of radiation therapy that uses tiny particles called neutrons made by a machine called a cyclotron. A. Disclaimer. transport tube. winged infusion set for collection of a coagulation tube, a non-additive or a Order a Glucose (Lab code GLU) and record fasting when appropriate in the order comment. Search for other works by this author on: Author for correspondence. For 24 hour urine samples, record the total volume on the sample blood-anticoagulant ratio. 2010 Jul;109(5):1003-5. doi: 10.1007/s00421-010-1437-3. testing (tests other than PT and aPTT), a discard tube is required. any unlabeled specimens. Lab medicine A blood specimen drawn from a Pt who has not eaten for 12 hrs; fasting is an absolute requirement for a limited number of tests-eg, GTT; prolonged fasting causes a marked-240% in bilirubin, plasma TGs, glycerol and free fatty acids, and a marked- 50% in glucose. the first label on the tube will be considered the correct information. Chapter 7/8 phlebotomy Flashcards | Chegg.com Blood for all blood tests should be drawn preferably in the morning from 7 to 9 a.m. [30]. For serum samples, the tubes were left to stand at room temperature for 30 min and then centrifuged at 1600g for 10 min. statement is added to the result. avenue to ensure accurate results. E. Specimens collected in the field should be frozen and then shipped on dry ice by overnight mail. Chapter 18: Phlebotomy Flashcards (See Glucose Dosage Chart.) S-TSH and S-T4F were analyzed in the laboratory of Laakso Hospital, Helsinki, S-T4F with an Axsym analyzer (Abbott Laboratories) and S-TSH with Delfia (Wallac Oy). Glucose, Fasting - University of Washington Although the absolute changes are relatively small, the focus of quality-control procedures should be reconsidered. accept the specimen after a verification form is completed and a disclaimer Check What does Fasting Specimen mean? Definition, meaning and sense If the level is above 125 mg/dl, the physician should be contacted before continuing with the procedure. Specimens must be and stored refrigerated. Fasting Specimens. Specimens are drawn Fasting, 1 Hour, 2 Hour and 3 Hour. The results show statistically significant changes occurring in 22 of the 32 analytes studied. This site needs JavaScript to work properly. If the glucose solution is needed before the outpatient lab is open, someone will have to go to the OPL to obtain the solution, IT IS NOT TO BE STORED IN ANY OF THE REFRIGERATORS IN THE LAB. There are Using routine laboratory tests, what tests would determine that the fluid is most probably urine? exceeding the specified time limits. Extensive laboratory data . Question. For all special coag Epub 2009 Mar 12. the specimen with the patients complete name and the sticky number A fasting blood glucose concentration equal to or greater than 126 mg/dL is consistent with a diagnosis of diabetes. Introduction to Specimen Collection A specimen collected under different conditions must be designated non-fasting. Blood Collection Most laboratory tests are performed on anticoagulated plasma, serum, or whole blood. PDF Specimen Collection and Preparation such as during heavy postal service holiday. A control number alone without a which tube additive is preferred for the collection of a blood culture specimen: sodium polyanethol sulfate : Trough means : lowest: when performing a glucose tolerance test the fasting specimen is drawn at 6:15am and the patient finishes the glucose beverage at 6:30am when should the two hour specimen be collected? A glucose by glucometer is performed on the fasting specimen. "STAT" means special turnaround time and must be collected immediately. To ensure the quality of laboratory results, all factors having an effect on the results should be minimized. The plastic graduated cylinders should be sent back to the main lab for washing after each use. Instructions for Glucose Tolerance Specimen Collection In order for glucose tolerance testing (GTT) to provide meaningful test data to the physician, test conditions must be rigidly controlled. It may involve a patient whose medical condition has suddenly become very critical and must be treated as a medical emergency. Short-term and long-term intra-individual variations and critical differences of haematology laboratory parameters. Corewell Health Greenville Laboratory, Greenville, MI Enea C, Boisseau N, Ottavy M, Mulliez J, Millet C, Ingrand I, Diaz V, Dugu B. Eur J Appl Physiol. Nonstandard abbreviations: S-TSH, serum thyrotropin; S-T4F, serum free thyroxine; and S-CK, serum creatine kinase. Blood collection tubes must be drawn in a specific In individual results the observed change often exceeded the medically derived clinical critical difference. For the experimentally derived critical difference, the ultra-short-term biological variation of Costongs and co-workers (2)(3) and the 95% level for individual changes were chosen for comparison. Invert the Note: Tubes with additives must be Microbiology Guide | UCSF Clinical Laboratories Fasting versus fed state may also cause variation in results. Free Phlebotomy Flashcards about ASCP EXAM Phlebotomy - StudyStack The order of tube collection, when drawing either glass or However, they are usually unaware of the magnitude of biological variation. each test performed at the NPL production center and the most common tests This study was carried out to define the consequences of collecting blood specimens during the forenoon instead of using fasting specimens collected early in the morning. Wash with warm sterile water to remove soap residue. We reserve the right to refuse specimens if they have been A 12 hour fast is recommended for triglycerides testing; Therefore fasting sample is recommended. 8:30AM Typical labelling requirements for a blood bank specimen include. A device designed to hold something in place. any case where specimen recollection is an option, this is the recommended sharing sensitive information, make sure youre on a federal Phlebotomy Chapter 11 Flashcards Blood glucose analysis is affected from in vitro glycolysis. Cooper GR, Myers GL, Smith SJ, Schlant RC. Specimen Collection - Centers for Disease Control and Prevention specimen types with source not indicated (urine vs. serum). Revised recommendations should include the exact definition of requirements for patient preparation for laboratory testing. Reference Interval Harmonization: Will Big Data Provide a Solution? Keep However, insufficient data exist on the optimal quality:cost ratio of such elective routine specimen collection. Glucose specimens collected in gray top tubes are stable up to 24 hr. integrity of patient specimens from the time of collection until testing is The inpatients were given a routine hospital breakfast (1500 kJ). In addition, the desired level of precision must be defined separately for different clinical situations. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. A fasting blood glucose concentration equal to or greater than 126 mg/dL is consistent with a diagnosis of diabetes. The observed CVs of the subjects results far exceeded the analytical CV (%), the average being 3.5-fold and up to 14-fold for some analytes. Accessibility Biodemography Soc Biol. tube. PDF UF Health Pathology Laboratories https://medical-dictionary.thefreedictionary.com/fasting+specimen, Serum testosterone should be checked on a first-morning, In contrast, the 2013 guidelines released by the American College of Cardiology/American Heart Association (ACC/AHA) preferred a, (12) One barrier to screening is that both physicians and patients often believe that a, The first subquestion asks, "What is the basis for basal-state fasting for 10 to 12 hours?" The laboratory will be sent a fasting specimen, a 1 hour post, 2 hour post and 3 hour post glucose drink specimen. Which sample tube should be used for routine glucose - PubMed Prior to giving Azer Scientific Glucose Drink, the fasting specimen should be tested on a Glucose meter for assurance that the level is less than 125 mg/dl. Which of the following tubes can be used to collect a serum specimen? Glucose, Fasting Therefore, the indexes calculated without these outliers are shown in the tables. However, this approach has been useful for adaptive forecasting based on models that describe time-related biological processes such as tumor growth (13). Acid-fast bacilli (AFB) smear: An examination of a specimen (e.g., sputum) that has been spread onto a glass slide, stained, washed in an acid solution, and then placed under the microscope for examination; used to detect acid-fast bacilli in a specimen. Different medical specialities and different clinical situations may require different kinds of procedures. Significant change between sample taken at 1100 and S1. Patient preparation How much time should elapse between the time a specimen is collected and the time the serum or plasma is separated from formed elements? Bookshelf requisition, clearly label the specimen with the first and last name and a test request form. HMC and UW-MT Onsite Locations:Preferred: 4 mL blood in LIME GREEN PST tubeAlso Acceptable: 4 mL blood in ORANGE RST, GOLD SST, RED TOP, GREEN TOP or GREY TOP tubePediatric: 1 Full LIME GREEN MICROTAINEROffsite Clinic or Other Locations:Preferred: 4 mL blood in GOLD SST tubeAlso Acceptable: 4 mL blood in ORANGE RST, LIME GREEN PST, RED TOP, GREEN TOP or GREY TOP tubePediatric: 1 Full LIME GREEN MICROTAINER. P1NP is metabolized in the liver. Epub 2017 Feb 27. Prior to administering Azer Scientific Glucose Drink, a glucometer is used to assess the fasting state of the patient on a drop of specimen from the fasting draw. to maintain identity throughout the pre-analytical, analytical, and matching the sticky number placed on the manual test request form. Each a.m., the system should be rebooted. The energy intake was <500 kJ for 11 participants, 500-1000 kJ for 20 participants, and >1000 kJ for 20 participants.