Laboratory Medicine Updates - August 29, 2006

University of Virginia Health System

Medical Laboratories

"Quality You Expect, Service You Deserve"

 

LABORATORY MEDICINE UPDATE

August 29, 2006

 

Reminder: Availability of Tau Transferrin Test

Testing for Tau Transferrin is available Monday through Friday only.  Samples received in the laboratory before 2PM will be analyzed that day.  Samples received after 2PM will be analyzed the next day.

 

Reminder: Intraoperative PTH Analyses

Intraoperative PTH analysis performed by the laboratory must be scheduled at least 24 hours in advance.  The EDTA (lavender) tubes should be submitted on ice to the Davis Laboratory, tube station 520.  The paperwork should include a phone number where the results are to be called.

 

Change in CK-MB testing

In recent years, cardiac troponin replaced CK-MB as the diagnostic standard in acute coronary syndrome patients and as the preferred marker of myocardial injury1-3.  Since 2000, CK-MB testing has been discontinued in many health centers. The volume of testing at the University of Virginia has decreased to such low numbers that it is not feasible to maintain the testing on-site. Beginning October 1, 2006, the testing will be sent to the Mayo Clinic referral laboratory with a one-day turnaround time.  If a more rapid turnaround is needed, contact the pathology resident on call for clinical chemistry, PIC 1267.

  1. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. J Am Coll Cardiol 2000;36:970-1062. [Free Full Text]
  2. Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction defined-a consensus document of the joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000;36:959-969. [Free Full Text]
  3. Jaffe AS, Ravkilde J, Roberts R, Naslund U, Apple FS, Galvani M, et al. It's time for a change to a troponin standard. Circulation 2000;102:1216-1220. [Free Full Text]

Component Transfusion Equipment Change

In September, the Blood Bank will be changing the component transfusion sets issued for use in routine platelet transfusion.

Currently, the Blood Bank issues a CharterMed Set with a slip connector.  This slip connector requires the attachment of a luer slip connector (ordered from bin #96332 in the storeroom) in order to be attached to the patient line.  However, CharterMed is discontinuing production of this product.

A new CharterMed Component Recipient Set will replace the current equipment once existing inventory is depleted.  The only difference in the new Component Recipient Set is that a screw connector is already attached, eliminating the need for attachment of a luer slip connector.  That is, the new set will be received from the Blood Bank ready to use and will not require additional supplies.

Please call the Blood Bank at 924-2273 with any questions.

 

Use of Microtainer Blood Collection Tubes

The Core laboratory has seen an increase in specimens collected using microtainer tubes on adults.  These tubes should ONLY be used for collection of blood from infants or those where there is no option but to collect by fingerstick.

If the concern is to reduce the volume of blood, be reminded that for most Hematology and Chemistry tests, you can submit 1 ml of blood in the 3 ml tube (this is not true of the blue top tube for Coagulation tests).

The use of these microtainer tubes increases employee safety risks resulting from potential blood splatter.  Additionally, these tubes are not easily labeled with the required bar coded information and therefore must be manually processed within the Laboratory.  This greatly increases turn around time and the risk of clerical error in labeling the aliquot tube.

Collection in these types of tubes is also problematic from a collection standpoint in that they are more prone to clotting and erroneous results if not mixed properly.

 

Prometheus IBD Testing

Effective September 1, 2006, Prometheus Laboratories will no longer offer the tests IBD First Step with reflex to IBD Diagnostic System.  The laboratory is replacing these two tests with the single "IBD Serology 7" test.  All University of Virginia computer systems are in the process of being updated to reflect this change.  In the meantime, any order for IBD First Step will be changed to IBD Serology 7 by the laboratory.