Our goal is to provide you with the highest quality results possible. The quality of the specimen the laboratory receives is an essential part of quality results. Unacceptable specimens yield questionable or erroneous results. They cannot be processed. Your facility will be notified and a redraw will be requested.
Proper specimen identification is critical to ensuring patient safety and testing accuracy. All specimens require an affixed Ascend specimen barcode label and a submitted order in LabCheck. The barcode label is the legal laboratory requisition that identifies the correct collection date, patient information and order when tests are submitted in LabCheck.
Clotted EDTA tubes account for 16% of all specimens rejected at Ascend Clinical. Although below the national average of 18%, these numbers can be improved with your help because clotting occurs at the time of collection
In order to prevent erroneous CBC results and redraws, the Lavender Top Tube must be mixed by gentle inversion 8 to 10 times immediately after collection.
To ensure adequate mixing of the blood with the anticoagulant, use a slow rolling wrist motion to invert the tube gently.
Failure to immediately invert tubes may lead to the formation of microscopic clots.
Improper Clotting Requires a Redraw
Tubes containing clots produce erroneous results.
Specimens with obvious visual clots cannot be processed.
Specimens with microscopic clotting will not have results reported.
The integrity of a specimen is affected greatly by its handling during transport. Refer to Specimen Handling posters or Test Information in LabCheck or Ascend Reference Manual – Test List section to determine the proper storage and shipping temperature of the specimens.
Refrigerated Specimen Requirements
Temperature requirements for refrigerated specimens are 2-8 C.
Never ship refrigerated specimens without ice packs.
Room Temperature Requirements
Never ship room temperature specimens in the same box with refrigerated specimens.
The quality of the specimens sent to the laboratory is an essential part of quality results and patient care. It is crucial to properly centrifuge those specimens requiring centrifugation such as, Green, Gold/White and Red/Yellow Top Tubes, in a timely manner before sending to the laboratory. When plasma or serum specimens are exposed to cellular elements for a prolonged period of time there is a potential to affect analytical results. Our goal is to provide our clients with the highest quality results possible. Specimens that are poorly spun or unspun will not be processed or tested regardless of unspun stability
For proper centrifugation, refer to Ascend Reference Manual – Specimen Collection and Handling section.
Visually inspect specimens for proper centrifugation before placing specimens in a biohazard transport bag in preparation for shipping.
Monitor canceled unspun or poorly spun specimens in LabCheck’s Message Center within Criticals and Panics.
Perform periodic centrifuge mechanical safety inspections to ensure specimen quality.
The quality of the specimens sent to the laboratory is an essential part of quality results and patient care. Specimens should be shipped the same day of collection. Specimens received past the stability of the test will not be processed. To determine the stability of the test ordered, refer to Ascend Reference Manual – Test List section.
Light Blue Top tubes for Prothrombin Times (PT) not filled to the nominal fill range cannot be processed. Ensure that the correct blood-to-additive ratio is met by checking the draw volume against the nominal fill mark on the tube.
Do not refrigerate samples prior to centrifugation
Invert tubes gently to mix – do not shake the tubes
Avoid excessive vibration by properly balancing the centrifuge
Do not use excessive force if drawing or transferring from a syringe to a test tube
Avoid using 25 gauge or smaller butterfly needles for difficult draws
Avoid drawing through an obstructed access
Action May Be Required
If a patient’s tests are repeatedly canceled due to gross hemolysis, and proper specimen handling and shipping procedures are being followed, an evaluation of the patient’s access site for obstructions to blood flow needs to be considered.
About Gross Hemolysis
In grossly hemolyzed samples (graded as +++ or higher), a large number of red blood cells (RBCs) have lysed, releasing their intracellular contents. Since the intracellular level of Potassium, LDH and AST is several times higher than the normal plasma concentration, hemolysis results in a falsely elevated measurement of the patient’s plasma level. A hemolyzing of just 1% of the RBCs will seriously affect results, causing a false increase ranging from 26% for Potassium to over 200% for both LDH and AST*.