| Chemical Pathology
Serum Troponin Amylase Glucose
Sodium Potassium Chloride*
Creatinine Urea CRP
Calcium Phosphate Magnesium
Bilirubin ALT AST
CPK DIG Lithium
Paracetamol Salicylate Osmolality
EDTA WB Ammonia
Urine Sodium Potassium Osmolality
CSF Glucose Protein
Spectrophotometry **
* Chloride available only for paediatrics, or for cases of poisoning.
** On call BMS will scan out of hours if urgent clinical decision needed but will reserve the right NOT to interpret scan if equivocal until seen by Consultant Biochemist
Haematology and Blood Transfusion
Haemoglobin White cell count
Platelets Haematocrit
Cross-match Blood group
Issue of Blood Products
DCT ESR (specific conditions only)
Malarial parasites Sickle test
Prothrombin time/INR APTT.
Thrombin time Fibrinogen
D-Dimer (specific conditions only)
Factor assays at request of Consultant haematologist only
Issue of appropriate blood products
Microbiology
CSF Examinations of fluids which are turbid or when meningitis is suspected and immediate treatment needs to be instigated.
Microscopy Urgent microscopy of a specimen where it is considered necessary in order to attempt to make an immediate diagnosis of the bacterial cause, e.g. abscesses or septic arthritis.
Blood culture Specimens should be collected by the medical staff and
placed in the incubator in the main pathology laboratory reception.
NOTE: The collection site for Blood cultures MUST be cleaned using an
alcohol wipe and allowed to dry immediately prior to specimen collection.
The rubber bung on the top of the blood culture bottle MUST also be cleaned
using an alcohol wipe prior to inoculation.
On weekdays the majority of other specimens can be left overnight and cultured the next day. This does not significantly delay reports or decrease chances of pathogen isolation and enables clinicians to collect specimens before starting antibiotics.
Such samples should be stored as follows:
Urines boric acid bottle room temperature out of direct sunlight
Pus and other swabs transport medium room temperature
Stools refrigerator
Sputum and exudates refrigerator
At weekends and bank holidays a delay of several days can be avoided by inoculating non-urgent specimens. The on-call microbiology BMS will undertake this task but it is reasonable to allow such specimens to accumulate during the day and be dealt with as a batch in the evening. Please make it obvious that such specimens can be dealt with when convenient and differentiate them from any which require an immediate microscopy report and in the latter cases contact the BMS on call.
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