lab bulletin

LAB BULLETIN

Subject: Changes in Chemistry Samples, Test Menu, and Reference/Critical Ranges
To: All Northwest Hospital Laboratory Users
Effective Date: 12/15/2008
Explanation of Change: The Laboratory has acquired new chemistry/immunology “Dimension Vista” analyzers from Siemens. As a result, we are
able to consolidate 4 different instrument platforms into one leading edge analyzer.
These analyzers will:
Decrease sample analysis times Reduce sample volumes Increase sensitivity and specificity Improve testing efficiency while reducing expenditures
Improved Technology: There are some changes in sample type, the test menu, normal reference ranges and critical reporting.
The primary chemistry sample type is switching from serum to Lithium Heparin Plasma. These samples will be collected in the light-green-
top PST tubes. All general Chemistry panels, thyroid tests, cardiac tests, and Hepatitis tests will be drawn in the PST tube.
Chemistry tests that will continue to need serum are: some therapeutic drugs (including Salicylate, DIG, Dilantin, and Carbamezapine),
reproductive hormones (including FSH, LH, Prolactin, Progesterone, Estradiol, and Testosterone), tumor markers (including AFP, CA125, CEA, PSA, and cPSA), and special immunology testing (including HIV, CCP, Varicella, HSV, Rubella, dsDNA, ANA, ENA, and H. Pylori). Amylase testing: NWCL will be performing a total amylase instead of reporting a panel including a pancreatic amylase and calculated salivary amylase. If a serum Pancreatic Amylase is desired, it must be ordered individually (as a miscellaneous test in Soarian) and will be sent to Mayo Medical Laboratories for testing. New tests available: the Laboratory will be adding Free T3 and IGE to its test menu in the first quarter of 2009. These tests will be run on lithium heparin plasma and will be reported real-time. Reference range and critical value changes: these are necessary to adjust for changes in methodology and will better align ourselves with community standards for reporting. The changes listed below have been confirmed using our NWH normal patient population. Current Reference Range
New Reference Range
limit, no change in therapeutic range) Beta HCG **This test is not intended for aiding in the diagnosis of cancer, or for monitoring the treatment of cancer patients. If that is needed, please indicate on the requisition and the sample will be sent to a reference laboratory for testing. CRP Gentamicin (change in peak and Trough (1.0 – 2.0 ug/mL) (0.0 – 3.0 mg/L) with the following interpretation guide: 7 – 11 years (26 – 77 mg/dL) 12 15 years (22 – 79 mg/dL) 16 – 18 years (24 – 74 mg/dL) Adult (40 – 59 mg/dL) Current Reference Range
New Reference Range
ADA A1C target for adults with diabetes < 7% ADA A1C target for adults with diabetes < 7% relationship of % A1C to average plasma glucose) Relationship of % A1C to average plasma glucose (mg/dL): Relationship of % A1C to average plasma glucose (mg/dL): 1 month – 1 year (20 – 200 mg/dL) 1 year – adult (40 – 250 mg/dL) Adult (0 – 159 mg/dL) with the following interpretation guide: MA raw values reported in mg/dL (no reference range
MA raw values reported in mg/L (no reference range established)
Alb/Creat ratio (0 – 29 mg MA/g Creat)
Alb/Creat ratio (0.000 – 0.019 mg MA/ mg Creat)
urine reference range, no change in serum reference range) Potassium (65 – 210 ng/dL)
(0.65 – 2.1 ng/mL)
Current Reference Range
New Reference Range
value, no change in therapeutic range.) Triglyceride (0 – 199 mg/dL) with the following interpretation guide: critical value, no change in therapeutic range.) Urine Total Protein Random All of the above changes will print on the laboratory patient reports with a comment alerting providers that the range has changed effective 12/15/2008. Information Contact: Michelle Manis - Chemistry Supervisor, 206.368.2038 Richard Patton, MD - Pathologist, 206.368.1779

Source: http://www.nwhfoundation.biz/lab/bulletins/Vista_lab_bulletin12_08.pdf