Tufts Medical Center - Clinical Lab Support

CLINICAL LABORATORY SUPPORT

Telephone Numbers:

Laboratory:

Receiving Area: (617) 636-5818, 5819, 7222
Send-Out Area: (617) 636-7205

Supervisor:

Beth Harubin, MS
Assistant Director of Laboratory Services

Hours:

Clinical Lab Support is open 24 hours a day, 7 days a week.

Services:

The staff of the Clinical Laboratory Support (CLS) section manage the operations of the following areas:

a. Laboratory Information Systems:

Intra-laboratory operation of the computer system to provide laboratory/patient information and generation of reports.

b. Phlebotomy services:

The Clinical Lab Support department provides phlebotomy services for adult and pediatric in- patients and outpatients according to the following schedule:

Inpatient Services:

Phlebotomy services are requested by entering orders for scheduled phlebotomy collections in the Hospital Computer Order Entry system, Soarian. The cut-off time for an order entry request is 1 hour before the draw time is scheduled to begin. Phlebotomy will make two attempts to collect a sample at a given scheduled draw. Units will be notified of unsuccessful attempts and a "Dr. Draw" comment will be entered into the Hospital Computer system.

Following Inpatient Schedule:

Adult In-Patient:	AM Labs, 1 PM, 3 PM, 5 PM, 9 PM, 11 PM and 1 AM(Monday-Friday)
	AM Labs, 1 PM, 5 PM and 1 AM (Saturday & Sunday)


Outpatient Services: Outpatient orders must be placed in the Hospital Computer Order Entry System, Soarian. All outpatient expired account numbers will be required to be updated before service can be provided.

Following Outpatient Schedule:

Adult Out-Patient:	Biewend 3: 8:00 AM - 6:00 PM (weekdays only) South 5: 8:30 AM - 4:15 PM (weekdays only)

Pediatric Out-Patient:	Floating 3: 9:00 AM - 6:00 PM (weekdays only)
	Every other Saturday 10:00 AM - 12:00 PM for General Pediatrics patients only

IVF Patient:	Floating 3: 7:00 AM - 8:30 AM (weekdays only)
	South 5: 7:00 AM - 4:15 PM (Transplant Clinic - Mondays Only) 8:30 AM - 4:15 PM (Tuesday-Friday)

Unscheduled Phlebotomy Services: Requests for on-call phlebotomy must be the requirements listed below: Admissions blood for new arrivals. Enzymes, Glucose, Ptt and timed tests only. Unscheduled Phlebotomy services are requested by paging 1789. The phlebotomists response time to complete the on-call service are as following: 1 hour for routine requests and enzymes. 2 hours for new admits. Following Unscheduled Phlebotomy Schedule: 4:00 PM - 11:15 PM (7 days a week). Midnight - 3:30 AM (7 days a week).

c. Test referral to outside laboratories:

Specimens for esoteric tests not done by the in-house laboratories are referred to other institutions or commercial laboratories. The laboratory will process the specimen, route it to the appropriate outside laboratory, enter results in hospital computer system, and generate patient reports. The test result will include the name of the reference laboratory that performed the test.

d. Specimen accessioning, processing, preservation and storage:

Clinical Lab Support's Central Receiving Area functions as an accession area for Chemistry and Hematology specimens, and as a receiving and routing center for Microbiology, Molecular Pathology, specimens from other hospitals and specimens to be referred to reference laboratories. It also serves as a resource for information on proper specimen collection and preparation for routing.

Most Commonly Ordered Tests:

TEST	SPECIMEN REQUIREMENTS	ADD ON REQUESTS	AVAILABILITY	T.A.T
17OH Progesterone Adult (83498)
17OH Progesterone Pediatric (83498)		Interpretation provided with results.
Aldosterone	Tube: 1 ml serum, refrigerated		Tue-Sat afternoon	3-5 days
Alpha-1-Antitrypsin Pi Type (82104)	2-5 cc red top Deliver ASAP to lab before 3pm		Mon-Fri	1-3 weeks
Anti SS-DNA (86226)	1 mL serum		Mon	1 week
APOe Genotyping (83890)	Lavender top		Mon-Fri	7-10 working days
BK DNA Virus	Purpose top
Ca 19-9 (86316)	Red top		Mon-Fri	5 days
CA 27.29	Gold top		Mon-Sun morning	1 day
Catecholamines, Random Urine: (82384)	10.0 ml Urine Container, leak proof Random Urine Room Temperature Note: After urine is collection: add 0.5-1.0g/L Boric Acid or 6N HCL to maintain a ph below 3.		Monday-Friday morning	1 day
Carotene (82378)	Red top		3 x weekly	2-3 days
General Use:	Vitamin A synthesis/Nutritional
Chlamydia trachomatis Culture	Swab (endocervical, urethral, rectal, conjunctival), fresh biopsy, fluids (pleural, peritoneal, body), pelvic washing		Mon-Fri	3 days
Chromogranin A	Gold top Refrigerated 2-8°C no additive		Tes, Thur, Fri morning	3 days
Clozapine (Clozaril) C-Peptide (84681)	Red top		Mon-Fri morning	1 day
C-Peptide (84681)	Gold top		Mon-Fri morning	1 day
CSF, CDRL.	1 mL fresh CSF, submitted in a sterile, plastic CSF tube		Mon-Sat	1 day
DHEA (82627)	Gold top			Once weekly
DHEA-Sulfate	Gold top		Mon-Fri	1 day
EBV DNA Qual PCR	Plasma, serum, CSF stability		Mon-Fri	1 day
Erythropoietin (82668)	1 mL random serum	>19 IU/L	Mon-Fri	Available next day
Nonesterified Fatty Acids (Free Fatty Acids)	Gold top		Mon-Fri	3-5 days
Fractionated Metanephrines, Random Urine (83835)	10 ml random urine, submitted in a plastic leak proof container (refrigerated) Minimum: 4.5 ml		Mon-Fri morning	2 days
Free T4 (84439)	1 mL random serum		Setup Mon-Fri Reported Tues-Sat	Approx. 5-7 days, adding transport time
Free T4 by Direct Analysis (84439)	1 mL serum		Setup Mon-Fri Reported Tues-Sat	Approx. 5-7 days
Fructosamine (82985)	Red top	174-286 umol/L	Mon, Wed, Fri	3-4 days
Gliadin Ab (83520)	1 mL serum		Wed	Up to 7 days
Growth Hormone (83003)	1 mL serum	Random <7.0 ng/mL	1 x weekly
General Use:	Evaluate growth status
HCG Tumor Marker (84702)	1 mL serum	<10*	Sun-Sat	2 days
Hep Be Ag (87350)	1 mL serum	Non Reactive	Sendout
General Use:	Reactive shortly following reaction HBsAG
Hep Be Ab (86707)	1 mL serum	Non Reactive	Sendout
General Use:	Reactive near end of acute phase or entering convalescent phase indicates immunity
Hep Delta Ab (86692)	1 mL serum	Non Reactive	Sendout
General Use:	Detection of transmittable Hepatitis D virus
Herpes Simplex Virus 1 & 2 DNA, Real Time PCR	CSF, Whole Blood, and Serum		Mon-Fri	1 day
Histoplasma antigen	Urine container		Mon-Fri	3-5 days
HIV Genotyping (87536)	Yellow tube (X2)			Varies, up to 3 weeks
Homovanillie Acid (HVA) with Creatinine, Urine	Urine container		Mon-Fri	1 day
IGF-II (Insulin Like Growth Factor II)	Gold top		Tues	3-5 days
Immune Cell Function (86353)	1 ml whole blood) (Gn-green top tube, sodium heparin ONLY (room temperature) Minimum: 0.5 ml		Tue- Fri afternoon	2 days
Immunoglobulin G Subclasses	Gold top		Mon-Fri	1 day
Lamotrigine	Red top		Mon-Fri	2 days
Lidocaine (80176)	Red top		1 x daily (Sat)	24/4 Hours
Lipoprotein (a): 1 mL serum drawn from fasting patient	Gold top		Mon-Fri	1 day
Mercury	Royal Blood/Trace metal tube Call lab
Metanephrines, 24 hr urine (83835)	10 ml plastic aliquot, leak proof-24 hr urine container. (Room temperature) 30 ml 6N HCL		Mon-Fri morning	1 day
Myoglobin (Urine) (83874)	10 mL of random or 24 hr urine		Daily (Sat)
Parvovirus (Big), IgG + IgM (86747)	Gold top		Thur	7 days
Parovirus PCR	Purple top
Plasma Free Metanephrines (83835)	2 ml Plasma (L, Lavender-top tube EDTA) drawn from a fasting patient. (Frozen) Minimum: 1.5 ml		Mon - Fri afternoon	2 days
Plasma Hemoglobin (83051)	Lavender top		2 x weekly
Quanteferon	10 cc green top Call lab
Rast: Allergen-Referred	Gold top		Mon-Fri	5-8 days
Renin Activity, Plasma	3 mL plasma			3 days
Saccharomyces cerevisiae IgA, IgG Antibody Panel	Gold top		Mon-Fri	Not defined
Serotonin Release Activity	Gold top
Somatomedin-C (Insulin-Ciko Growth Factor IGF-1) (84305)	Gold top		Setup Mon-Fri Transport Tue-Sat	5 days
Testosterone, Free + Total (84402)	Gold top			Once weekly
Thyroglobulin (84432)	Gold top		Mon, Wed, Fri	7 days
Total Catecholamines, Plasma (82383)	4.0 ml Green Top Sodium Heparin Tube Plasma (Fasting) Frozen, minimum: 2.5 ml		Monday, Weds, Friday morning	2 days
Toxoplasma IgM Antibody	Gold top			1 day
Vitamin A (84590)	Gold top (protect from light)		Mon, Wed, Fri	4 days
Vitamin E Beta & Gamma Tocopherol (84446)	Red top (Protect from light)
VMA, 24hr Urine	10 mL of a 24-hour urine, collected with 25 mL 6N HCL.		Mon-Fri	3 days
Xylose (84620)	Gold top		2 x weekly