By Amitava Dasgupta, Jorge L. Sepulveda
This functional, easy-to-use advisor addresses interference matters in all laboratory checks, together with sufferer epigenetics, means of specimen assortment, enzymes, biomarkers. Clinicians and laboratory scientists can for that reason depend upon one reference which speaks to either their wishes of actual specimen research and optimum sufferer care.
Erroneous health facility and pathology laboratory effects should be complicated and frustrating, in particular in acute care events. whereas a few elements growing interference, will be pointed out within the laboratory, detecting many others is usually depending on medical info unavailable to the laboratory scientists or pathologists. as a result, clinicians needs to turn into knowledgeable in deciding upon such faulty reviews, and dealing with pathologists and laboratory scientists so they can comprehend the resource of such interferences, right the implications, after which make a decision what plan of action needs to be for correct sufferer management.
• functional info for either clinicians and laboratory scientists, provided within the type of tables and charts for simple reference
• specialise in variety and assets of interferences instead of info of toxicologic mechanisms that are good coated in toxicology textbooks
• Covers interferences throughout endocrine, oncology, hematology, immunohistochemistry, immunology, serology, microbiology, and molecular testing
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Extra resources for Accurate Results in the Clinical Laboratory: A Guide to Error Detection and Correction
6 Blood Collection Tubes by Order of Draw Order of Color of Stopper Draw Invert Additive Comments/Common Tests 1 Clear Not required No additive Tube used only as a discard tube 2 Blood culture bottle Invert gently to mix Bacterial growth medium and activated charcoal When a culture is ordered along with any other blood work, the blood cultures must be drawn first 3 Yellow 8À10 times Sodium polyanethol sulfonate (SPS) Tube used for mycobacteria (AFB) blood culture 4 Royal blue (with red band on label) Not required No additive Tube used for copper and zinc 5 Red glass Not required No additive Tube used for serum tests that cannot be collected in serum separator tubes (SST), such as tests performed by tissue typing.
EDTA is adequate for platelet preservation; however, morphological changes occur over time . Clotting can result if there is insufficient EDTA relative to blood. This is usually caused by overfilling the vacuum tube or poor solubility of EDTA (most commonly with disodium salts) . EDTA draws water from cells to artifactually dilute plasma and is generally not recommended for general chemistry tests. Specifically, EDTA chelates other metallic ions such as copper, zinc, or magnesium and alters cofactor-dependent activity of many enzymes, such as alkaline phosphatase and creatine kinase, and hence is not used for these chemistry assays.
A standardized order of draw (OFD) minimizes carryover contamination of additives between tubes. 6 shows an example of the OFD for blood collection as used at Calgary Laboratory Services. Many laboratories have established their own protocols for the OFD for multiple tube collections, with slight variations based on CLSI recommendations. The general order of draw is as follows: Microbiological blood culture tubes Trace element tubes (nonadditive) Citrated coagulation tubes Non-anticoagulant tubes for serum (clot activator, gel or no gel) 5.