Washed Red Blood Cells, Transfusion

CERNER / EPIC MNEMONIC: (not orderable on LIS)
POE DESCRIPTION:

Packed RBC [Comments: 'Washed']

DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 1-2 hours
CONTAINER TYPE: Pink top tube
COLLECTION: Special Labeling Requirements: The content of each sample label must include the patient's full name and medical record number, the phlebotomist's initials, the date and time the sample was collected and, for non-LLT draws, the initials of a second medical professional who has confirmed that the sample came from the patient whose name is on the label; the computer label must have this same information plus an accession number and the tests ordered. NOTE:  LLT phlebotomists should write 'LLT' for the second set of initials.
SPECIMEN REQUIREMENTS: Blood
MINIMUM VOLUME: 7 mL
REFERENCE RANGE: Compatible
TEST SYNONYM(S):Washed Red Cells; Saline Washed Cells; Washed Cells

Whole Blood, Transfusion

CERNER / EPIC MNEMONIC: (not orderable on LIS)
POE DESCRIPTION:

Customized Whole Blood Exchange

DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 1 hour
SPECIAL INSTRUCTIONS: For Exchange Transfusion of the Newborn. Held until the expiraton of the sample used for crossmatch. Whole Blood is not otherwise available.
CONTAINER TYPE:

Pink top tube

COLLECTION: Special Labeling Requirements: The content of each sample label must include the patient's full name and medical record number, the phlebotomist's initials, the date and time the sample was collected and, for non-LLT draws, the initials of a second medical professional who has confirmed that the sample came from the patient whose name is on the label; the computer label must have this same information plus an accession number and the tests ordered. NOTE:  LLT phlebotomists should write 'LLT' for the second set of initials.
SPECIMEN REQUIREMENTS: Blood
MINIMUM VOLUME: 7 mL
REFERENCE RANGE: Compatible

Washing Cytology

CPT CODE: 88104
DAYS PERFORMED: Mon-Fri, 0730-1700
TURNAROUND TIME: 24-48 hours
SPECIAL INSTRUCTIONS: Clinical diagnosis and pertinent clinical history must be indicated on requisition. Suspected infectious diseases should be specified.
CONTAINER TYPE: Specimen containers without fixative.
SPECIMEN REQUIREMENTS: Washing from organ site specified
REJECTION CRITERIA:

No patient name on container, discrepancy between patient name and labeling.

Worm Identification, Macroscopic

CERNER / EPIC MNEMONIC: ID WORM
POE DESCRIPTION: WORM ID; ID WORM
CPT CODE: 87168
DAYS PERFORMED: Monday-Friday, 0700-1430
TURNAROUND TIME: 24-48 hours
SPECIAL INSTRUCTIONS: Specimen should be submitted in saline in a sealed clean container.
CONTAINER TYPE: Sealed clean container
SPECIMEN REQUIREMENTS: All parts of suspected worms
REJECTION CRITERIA:

Mislabeled/unlabeled specimen

HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
METHODOLOGY: Macroscopic and microscopic examination
LAST UPDATED:

5-22-2014

TEST SYNONYM(S):Gross Worm Identification; Ova and Parasite, Gross Worm Identification

Wound Culture, Fungus

CERNER / EPIC MNEMONIC:

C FUNGUSSM, CFUNGUS (without smear for swab specimen)

POE DESCRIPTION: CU FUNGUS W SMEAR (NON-SKIN); C FUNGUSSM
CPT CODE: 87102; 87206
TEST INFORMATION: Test includes a culture for fungi and performance of a direct fungal smear. All fungal isolates will be identified. Other isolated organisms (i.e. aerobes, mycobacteria, etc.) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).
DAYS PERFORMED:

Daily, 24 hours

TURNAROUND TIME: Smear results: same day if the specimen is received in the laboratory no later than 1400. Preliminary culture reports are available after 1 week or when a fungal isolate is detected. Culture reports will be finalized after 4 weeks.
SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition.
CONTAINER TYPE: Copan® II swab, sealed sterile container
COLLECTION: The specimen of choice is an aspirate or tissue, NOT a swab. Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface (normal flora) organisms. Ideally, material is obtained by needle aspiration through an intact surface, which has been cleaned with antiseptic. Sampling of open lesions is enhanced by deep aspiration using a sterile plastic catheter. Curetting of the base of an open lesion is optimal. If irrigation is necessary, nonbacteriostatic sterile saline may be used. When a syringe is used to obtain the specimen, ALL air should be expelled after which the specimen should be injected into a sealed sterile container. Swabs should be used as a last resort due to the small volume of specimen obtainable by this method. If a swab must be used, sample the advancing margin of the lesion and abscess walls firmly. Do NOT sample pus or exudate ONLY. Contamination with normal flora from skin or other body sources MUST be avoided since colonizing bacteria and/or saprophytic fungi not involved in the infectious process may be introduced into the sample.
SPECIMEN REQUIREMENTS:

See Collection

REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen received in a preservative.
MINIMUM VOLUME: 0.5 mL or two swabs
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: No fungi observed/isolated
LIMITATIONS OF TEST: The Calcofluor white stain demonstrates yeast forms, spores, and the hyphae of fungi. The filaments of Nocardia species, Streptomyces species, and Actinomyces species, as well as, the capsule of Cryptococcus species are NOT satisfactorily demonstrated with this methodology.
METHODOLOGY: Fungal smear: calcofluor white stain. Culture: Conventional culture utilizing media specifically formulated for fungal isolation.
ADDITIONAL INFORMATION: Specimens from lesions suspected of containing Actinomyces species should also be cultured anaerobically. Refer to Actinomyces Special Anaerobe Culture.
LAST UPDATED:

5-27-2014

TEST SYNONYM(S):Fungus Culture, Wound

Wound Culture, Mycobacterium

CERNER / EPIC MNEMONIC: C AFBSM
POE DESCRIPTION: CU MYCOBACTERIUM W SMEAR; CU AFB AND SMEAR; C AFBSM
CPT CODE: 87206; 87015; 87116
TEST INFORMATION: Test includes culture and acid-fast stain (if specimen volume is adequate). Culture includes decontamination and concentration. If a mycobacterial species is isolated, the organism will be definitely identified. Susceptibility testing will be performed depending upon the isolate identification.
DAYS PERFORMED: Daily
TURNAROUND TIME: Smear results: 24 hours after receipt of the specimen in the laboratory. Preliminary culture reports are available after 1 week or when a mycobacterial isolate is detected. Negative cultures with negative smears will be finalized after 8 weeks. Negative cultures with positive smears will be finalized after 12 weeks. Completion of culture reports may require additional time when mycobacteria are isolated and/or susceptibility testing is performed.
SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition.
CONTAINER TYPE: Copan® II swab, sealed sterile container
COLLECTION: The specimen of choice is an aspirate or tissue, NOT a swab. Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface (normal flora) organisms. Ideally, material is obtained by needle aspiration through an intact surface, which has been cleaned with antiseptic. Sampling of open lesions is enhanced by deep aspiration using a sterile plastic catheter. Curetting of the base of an open lesion is optimal. If irrigation is necessary, nonbacteriostatic sterile saline may be used. When a syringe is used to obtain the specimen, ALL air should be expelled after which the specimen should be injected into a sealed sterile container. Swabs should be used as a last resort due to the small volume of specimen obtainable by this method. If a swab must be used, sample the advancing margin of the lesion and abscess walls firmly. Do NOT sample pus or exudate ONLY. Contamination with normal flora from skin or other body sources MUST be avoided since colonizing bacteria not involved in the infectious process may be introduced into the sample.
SPECIMEN REQUIREMENTS: Pus or other purulent fluid material appropriately obtained from a wound.
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen received in a preservative. Only three specimens per body site with negative acid-fast smears will be processed. Subsequent specimens will be rejected. Specimens from known positive patients will be accepted only once a week for culture and smear per body site.
MINIMUM VOLUME: 0.5 mL or two swabs
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No acid-fast bacilli observed on smear or isolated in culture
LIMITATIONS OF TEST: A single negative smear does not rule out the presence of mycobacterial infection.
METHODOLOGY: Acid-fast smear: fluorochrome stain. Culture: inoculation of conventional culture media and a rapid medium for automated continuous analysis.

ADDITIONAL INFORMATION:

DNA probes may be incorporated to aid with more rapid identification of mycobacterial isolates. This will generate an additional charge(s). Susceptibility testing will be performed only on the first Mycobacterium isolate from each specimen type per patient. Additional susceptibilities may be performed after a period of 4 weeks for patients with suspected treatment failure. Susceptibility testing is performed routinely only for M. tuberculosis complex. Susceptibility testing for other Mycobacterium species is performed by special request only. The battery of drugs routinely tested will vary by isolate and/or physician request. Patients from whom M. tuberculosis is isolated in culture are reported to the City of Chicago Board of Health. This is mandated by law.

LAST UPDATED:

5-13-2014

TEST SYNONYM(S):AFB Culture, Wound; Mycobacterium Culture, Wound

Wound/Infected Site, Routine Culture

CERNER / EPIC MNEMONIC: C AERGS
POE DESCRIPTION: CU WOUND AEROBIC W GRAM STAIN; CU AEROBIC W GRAM STAIN; C AERGS
CPT CODE: 87071; 87205
TEST INFORMATION: The test includes a direct Gram stain, isolation and identification of microorganisms, and susceptibility testing, if appropriate. Other isolated organisms (i.e. anaerobes, yeast, etc.) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME:

Preliminary culture reports are available after 24 hours. Culture reports of no growth will be issued after 72 hours. Completion of culture reports may take 3-5 days after receipt of the specimen when multiple isolates are found.

SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition with surface and/or deep wound delineated.
CONTAINER TYPE: Copan® II swab, sealed sterile container
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface organisms. Ideally, material is obtained by needle aspiration through intact surface, which has been cleaned with antiseptic, and injected into a sealed, sterile container. Sampling of open lesions is enhanced by deep aspiration using a sterile plastic catheter. If irrigation is necessary, nonbacteriostatic sterile saline may be used. Pulmonary samples may be obtained by transtracheal percutaneous needle aspiration. Optimal isolation of microorganisms from tissue is accomplished by processing as much tissue as possible.
SPECIMEN REQUIREMENTS: Pus or other material aseptically obtained from an infected site, abscess, or wound
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, refrigerated specimen, specimen received in a preservative.
MINIMUM VOLUME: 0.5 mL or two swabs
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: Gram stain: depends upon the site of the specimen.Culture: no growth.
LIMITATIONS OF TEST: A specimen with additional microbiologic procedures will be processed only if the specimen is of adequate quantity for all tests requested. A physician will be contacted to prioritize requested procedures when the specimen is of an inadequate quantity. The portion of the surgical specimen submitted for microbiologic analysis should be separated whenever possible from the portion submitted to the Pathology Department utilizing sterile technique.
METHODOLOGY: Smear: Gram stain.Culture: conventional culture on routine media.
LAST UPDATED:

5-13-2014

TEST SYNONYM(S):Abscess Culture, Routine; Ear Culture, Routine; Eye Culture, Routine

Walnut (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

WALNUT

POE DESCRIPTION:

Walnut allergen

CPT CODE:

86003-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube or red top

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.3 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code F256

Wheat (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

WHEAT

POE DESCRIPTION:

Wheat allergen

CPT CODE:

86003-90

TEST INFORMATION:

Included in the Rast Food Panel.

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube or red top

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.3 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code F4

Whitefish (IgE) Rast Allergen

CERNER / EPIC MNEMONIC:

WHITEFISH

POE DESCRIPTION:

Whitefish Allergen

CPT CODE:

86003-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST tube or red top

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.5 mL serum)

REFERENCE RANGE:

See Specialty Labs - Search Test Code S51930

West Nile Virus IgM

CERNER / EPIC MNEMONIC:

WNV IGM

CPT CODE:

86788-90

TURNAROUND TIME:

5-7 working days

CONTAINER TYPE:

SST or red top tube

SPECIMEN REQUIREMENTS:

2.0 mL blood (1.0 mL serum)

MINIMUM VOLUME:

1.0 mL blood (0.7 mL serum)

REFERENCE RANGE:

See Quest Labs - Search Test Code 16012

LIMITATIONS OF TEST:

Cross reactivity has been observed between alphavirus group and flavivirus group, e.g., yellow fever or yellow fever vaccination.

LAST UPDATED:

9-18-2013

TEST SYNONYM(S):West Nile Virus IgM Serum