Home
User Guide – December 2014 - Central Manchester University
Contents
1. Test Factor Affecting Outcome Result Processing ALL SECTI ONS OF HAEMATOLOGY All Tests e Failed Specimen e Would not process Acceptance Policy Routine samples and Blood Transfusion samples e Unlabelled e Would not process e Wrong sample for e Would not process requested test e Wrongly labelled e Would not process e Sample leaked in transit e Would not process If multiple samples were put in the specimen bag ALL samples would not be processed e Sample broke in transit e Would not process If multiple samples were put in the specimen bag ALL samples would not be processed COAGULATI ON Routine Under filled e Would not process clotting sample tests Routine Haemolysis e Would process clotting Depending on the degree of haemolysis an estimated tests result may be reported off the analyser with a comment 7 Validity of result due to haemolysis Routine Lipaemia e Would process clotting Depending on the degree of lipaemia an estimated result tests may be reported off the analyser with a comment Validity of result due to lipaemia All clotting Clotted e Would not process tests Clotting Secondary e Depending on size of clot would process and assays clot in frozen add comment Validity due to secondary sample clot or would not process and add comment Clotted Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team Copy No Elect
2. Activated Partial Thromboplastin Time APTT Antithrombin Bleeding time Factor 11 Factor V Factor VII Factor VIII Factor IX Factor X Factor XI Factor XII Fibrinogen D DIMER FDP LMWHeparin Xa approx therapeutic range Prothrombin time Protein C Chromogenic Protein S free Thrombin Time Von Willebrand Factor Antigen VWF AG Von Willebrand Factor Activity Ristocetin Co factor Central Manchester University Hospitals NHS NHS Foundation Trust 1 45 1 80 cp Centipoise 24 6 34 9 secs 82 133 u dl 2 8 mins 78 130 u dl 65 140 u dl 65 160 u dl 50 170 u dl 60 160 u dl 70 140 u dl 60 140 u dl 55 160 u dl 1 82 4 5 g l 250 ng ml 0 30 0 70 u ml 12 5 15 3 secs 69 154 u dl 61 167 u dl 14 8 19 2 secs 50 154 u dl 50 150 u dl For childrens or neonate reference ranges please ring laboratory 701 2123 For significantly abnormal results suggest discussion with Haematology Consultant or Senior Registrar Adult Haemostasis SPR bleep number 2022 Paediatrics ask switch to page Dr Will or Dr Grainger If you are unable to reach any ward department with significantly abnormal results which require immediate action please bleep the Lead Nurse on 2677 Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead 2
3. As above Blue cap vacutainer 2x1 3ml 2ml or 5ml Paed bottle Factor IX assay Factor X assay Factor assay Factor XII assay Factor VIII inhibitors Factor IX inhibitors Platelets Aggregation Studies von Willebrand factor activity Contact Lab 64809 Molecular Diagnostic Centre von Willebrand factor multimers von Willebrand Factor Blue cap vacutainer 2x1 3ml 2ml or 5ml Paed bottle Ristocetin induced platelet Contact Lab 12123 aggregation RIPA Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team 12 of 28 cesi available Report s Urgent Non urgent Available UT hr 5 days 5 days 5 days 5 days 10 days 10 days 1 month 1 month 5 days arrangement Same day by arrangement 3hr 1 month pere 3hr 1 month Same day by 5 days arrangement Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead ih Ltd Central Manchester University Hospitals i 7 3 Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Thrombophilia Assays Test Specimen s Result s available Report s Urgent Non urgent Available Antithrombin Blue cap vacutainer 3 hr lt 1 month lt 1 month 2x1 3ml 2ml or 5ml Paed bottle Factor V Leiden Blue cap vacutainer Mutation screen Prothrom
4. Central Manchester Haematology Service Directorate of Laboratory Medicine NHS Foundation Trust Blood Counts BLOOD COUNTS Test Result s available Report s Urgent Non urgent Available 1 x 4ml purple cap EDTA Full blood count and automated 1x 2ml EDTA Thr 4 hr 24 hr differential 1x 0 5ml EDTA Manual blood film Any of the above specimen by 24 hr 24hr types arrangement Reticulocyte count Any of the above lhr 4 hr 24 hr from FBC sample Erthrocyte Sedimentation Rate 1x 4ml purple cap EDTA 1 5 hr 4 hr 24 hr ESR 1x 2ml EDTA paediatric from FBC sample Screening test for glandular 1 x 4ml Dark Purple 30 min Same day 24hr fever from FBC sample CSF 1ml sample in plastic universal 2hr 6 hr 24 hr Bone marrow report 4 slides 1x 3 ml EDTA by 7 days 7 days arrangement Detection of malarial parasites From full blood count 2 hr by N A 24 hr 2 specimen arrangement Plasma Viscosity 1 x 4ml purple cap EDTA 1x 2ml EDTA 1 hr 8 hr 24 hr N A not applicable gt Paediatric samples Please ring lab Ext 64030 From time of receipt in the laboratory FOR FURTHER ADVI CE AND I NFORMATI ON TELEPHONE 0161 276 64030 OR 64032 Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team 10 of 28 Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead LALELA Central Manchester Haematology Servic
5. C Whitehead 8 of 28 LiL Fr Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Tel 0161 276 8980 e mail Hannah Belli cmft nhs uk Departmental Fax 0161 276 8089 Central Sample Reception Title Central Specimen Reception Manager Name Rebecca Whitehouse Tel 0161 276 4692 e mail Rebecca whitehouse cmft nhs uk Title Client Services Manager Name Colette McAlister Tel 0161 2764062 e mail Colette mcalister cmft nhs uk Results Hotline Tel 0161 2768766 Haematology Tests Guidelines to availability of Tests The results availability times given below represent the time generally required to produce a result following receipt of the sample in the laboratory Sample transport times are not included Where appropriate if a result is required the same day samples must be received sufficiently early to allow completion of the test Please contact the lab if the test you require is not listed below The tests below are available during the normal working day A list of haematology transfusion tests provided outside core hours is given after the list of all tests available Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI_HAEM28 Author Haematology Management Team Authorised by C Whitehead 9 of 28 ih Ltd Central Manchester University Hospitals
6. Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 4 of 28 LiL Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine participates in all appropriate national external quality assurance schemes NEQAS where available Accreditation The Haematology Department is accredited by Clinical Pathology Accreditation UK CPA UK we are an accredited training laboratory for the Institute of Biomedical Sciences IBMS and our qualified biomedical scientists are registered with the Health Professions Council HPC The Blood Transfusion service conforms to the Blood and Safety Quality Regulations and is certified as such by the Medicines and Health Regulatory Agency MHRA Our Stem Cell Therapeutics facility are both JACIE and HTA accredited CPA Accredited Medical Laboratory Reference No 0862 Services Available The department participates in the Directorate of Laboratory Medicine User Satisfaction Survey and also in Clinical Liaison meetings with our users We are always willing to meet with our users to discuss their needs and issues If you have any comments on the services that we provide or would like to discuss new services you would wish to see developed please contact the Laboratory Manager or He
7. 2 of 28 Lik Central Manchester University Hospitals NHS Central Manchester Haematology Service i i NHS Foundation Trust Directorate of Laboratory Medicine ISTH DIC scoring system The ISTH group produced a simple scoring system for the diagnosis of DIC depending on the Platelet count the PT the fibrinogen level and critically the FDP D Dimer results PARAMETER RESULT SCORE 1 Platelet count 100x10 l 0 lt 100 10 1 1 lt 50x10 l 2 2 PT 3s prolonged 0 23s but 6s 1 gt 65 3 Fibrinogen gt 1 09 0 1 0g l 1 4 FDP D Dimer No increase 0 Moderate increase 2 250 5000 Strong increase 3 25000 A total score of 25 DIC as long as the score is associated with a clinical disorder known to cause DIC If the score is 25 you must ring the ward medic and make them aware of the risk of DIC Guidance Note D dimer testing in the diagnosis of venous thromboembolism VTE in hospital patients e VTE is highly unlikely in patients who are judged by means of a clinical scoring system to be clinically unlikely to have VTE and who have a negative D dimer test e D dimer testing has very limited usefulness to aid diagnosis in patients where the clinical probability of VTE is high e D dimer is frequently raised in hospital inpatients without VTE e D dimer is increased in infection cancer inflammation surgery trauma ischaemic heart disease stroke pregnancy sickle cell disease amp trait e D dimer tes
8. B and BM samples required to accurately determine levels of minimal residual disease MRD This is because there can be large differences in the interpretation of the relapse risk if you are looking at leukaemic gene expression in PB or BM For this reason it is important to identify the sample type PB or BM on the requisition form or request card The accurate monitoring of MRD requires the samples to be fresh to reach us ideally within 24 hours of phlebotomy and no later than 48 hours This has a big effect on the Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead 18 of 28 LiL Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine reliability of the result with large inaccuracies in quantitation levels beyond 48 hours this is as important as the amount of sample required JAK 2 service For JAK2 tests 10ml EDTA peripheral blood is required and not a bone marrow sample If both a BCR ABL and JAK2 test are required then 10ml EDTA PB must be sent for each test Lymphoma service The current service provision for the assessment of clonality in putative cases of Lymphoma predominantly tests DNA extracted from FFPE tissue Blocks should be sent to the appropriate histopathology la
9. LiL FA Central Manchester University Hospitals INHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Central Manchester Haematology Service User Guide December 2014 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 1 of 28 ZJIUTF Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Contents About Us Location Postal address Working hours Quality Statement Accreditation Services Available Scope of Service Specimen Acceptance Policy Consultant and Management Staff Contact Details Haematology Management Team Haematology Clinical Team Senior Laboratory Staff Blood Transfusion Team Molecular Diagnostics Centre Team genetic investigations Haematology Administration Central Sample Reception Results Hotline O o 2 0 oc 1 10 OG n RA A A A Haematology Tests m Blood Counts m um Coagulation m A Blood Transfusion m Un Haematinics m N Haemolytics m Molecular Diagnostics m Stem Cell Therapeutics m Leukaemia Cell Biology N Haematology tests available outside core working hours N _ Reference Ranges t3 m Blood Counts N N Coagulation
10. N ISTH DIC scoring system Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 2 of 28 LiL Central Manchester University Hospitals INHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Guidance Note D dimer testing in the diagnosis of venous thromboembolism VTE in hospital patients 23 Guidance on Laboratory testing for Heritable Thrombophilia is available to view on the Trust intranet 24 Warfarin Scheme 24 Guidelines for Heparin Dosage for Heparinization for Thrombotic Conditions 25 Haematinics 25 Haemolytics 25 Factors Affecting the Results or Processing of Haematology Tests 26 Maximum Surgical Blood Order Schedule MSBOS 28 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 3 of 28 LEA Central Manchester University Hospitals INHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine About Us The laboratory offers a comprehensive test repertoire for neonatal paediatric and adult haematological investigation and treatment of patients including Blood Counts Coagulation Red Cell and Haematinic Investigations Molecular Dia
11. Tel e mail Title Name Tel e mail Laboratory Medicine Haematology Department Date of issue December 2014 Hematology Clinical Director Dr Kate Ryan 0161 276 6722 kate ryan cmft nhs uk Paediatric Hematology Clinical Director Dr Andrew Will 0161 701 8416 andrew will cmft nhs uk Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 6 of 28 Lik Central Manchester Haematology Service Central Manchester University Hospitals NHS NHS Foundation Trust Directorate of Laboratory Medicine Senior Laboratory Staff Title Name Tel e mail Title Name Tel e mail Title Name Tel e mail Title Name Tel e mail Title Name Tel e mail Blood Transfusion Team Title Name Tel e mail Laboratory Medicine Haematology Department Date of issue December 2014 Chief Biomedical Scientist Blood Counts Michelle Brereton 0161 276 5393 michelle brereton cmft nhs uk Chief Biomedical Scientist Coagulation Lynne Keighley 0161 276 4080 lynne keighley cmft nhs uk Chief Biomedical Scientist Red Cell Laboratory Simone McLaughlin 0161 701 0146 simone mclaughlin cmft nhs Chief Biomedical Scientist Blood Transfusion Jane Uttley 0161 276 8599 jane uttley cmft nhs uk Chief Biomedical Scientist Stem Cell Therapeutics Wendy Ogden 0161 901 1248 wendy ogden cmit nhs uk Lead Bl
12. ad of Service by telephone letter or e mail Scope of Service The range of haematology tests offered together with the specimens required are described in the list of tests Specimen Acceptance Policy The Directorate of Laboratory Medicine has a Specimen Acceptance Policy A copy of the Directorate Specimen Acceptance policy is included in the DLM handbook obtained from the Client Services Office CSB1 Blood Transfusion operates a Zero tolerance Policy Specimen and request labeling guidelines are included in the Trust Transfusion Policy Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI_HAEM28 Author Haematology Management Team Authorised by C Whitehead 5 of 28 LALELA Central Manchester Haematology Service Central Manchester University Hospitals NHS NHS Foundation Trust Directorate of Laboratory Medicine Consultant and Management Staff Contact Details Haematology Management Team Title Name Tel e mail Title Name Tel e mail Title Name Tel e mail Head of Scientific Services Dr John Ardern 0161 276 4076 john ardern cmft nhs uk Laboratory Manager Claire Whitehead 0161 276 4421 claire whitehead cmft nhs uk Lead BMS Blood Transfusion Stem Cell Therapeutics and Paediatrics Roy Kettle 0161 276 8599 roy kettle cmft nhs uk Haematology Clinical Team Title Name
13. amp Grouping Samples Grouping Clotted Sample e Would not process Sample Samples for Sent to the lab cold e Would not process Cold i e not in warm water Agglutinins HAEMATI NICS and HAEMOLYTI CS Red Cell No EDTA sample e Only serum folate can be measured Folate Sent only clotted sample Red Cell EDTA clotted e Would not process Folate Ferritin B12 Only EDTA sent e Would not process Serum folate Haematinic Haemolysis e Would process and add appropriate comment assays Haemolytic EDTA clotted e Would not process assays Plasma Sample stored in fridge e Would not process Viscosity This list is not exhaustive there may be other factors affecting the reporting of results which are not listed Laboratory Medicine Haematology Department Date of issue December 2014 Author Haematology Management Team Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead 27 of 28 LiL F F Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Maximum Surgical Blood Order Schedule MSBOS http staffnet cmft nhs uk Policies Transfusion Maximum 620Blood96 20O0rder 6 20Sch edules 620doc9 620July pdf When blood is available for a placenta praevia case an antibody screen sample is required on Mondays and Thursdays All other major surgical procedures will be a Group and Save unless discussed with Blood T
14. bin G20210A Blue cap vacutainer 14 days Mutation screen 14 days Lupus anticoagulant 2X blue capped vacutainer 2 wks 3x1 3ml 2x2ml or 5ml Paed bottle Protein C Blue cap vacutainer month 1 month 3x1 3ml 2x2ml or 5ml Paed bottle Protein S 3hr 1 month 1 month See Molecular Diagnostics Centre section for further information From time of receipt in the laboratory FOR FURTHER ADVI CE OR I NFORMATI ON TELEPHONE 0161 276 4030 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 13 of 28 LALELA Central Manchester University Hospitals YZK Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Blood Transfusion BLOOD TRANSFUSI ON Test Result s available Report s Urgent Non urgent Available Adult 7 ml EDTA pink cap Cross matching Paediatric 2ml edta red top 45 60 min 4 hr N A Neonatal 1 3ml edta red top Non urgent cross matching can take from 2 hours or longer depending on the workload priorities at that time Adult 7 ml EDTA pink cap Blood group paediatric 2ml edta red top 10 min Within 24 hrs 24 hr Antibody screen and save Adult 7 ml EDTA pink cap 30 min Within 24 hrs 24 hr serum paediatric 2ml edta red top Cord blood 7 ml EDTA pink cap 2 hours Within 24 hrs 24 hr Investigations mat
15. boratory to be cut for PCR analysis to be performed in the MDC laboratory The block should be examined for the location of the biopsy tissue and 5 10 and 3x10um should be cut and sent to the laboratory Clonality analysis can also be performed on PB and BM the requirements are 10 20ml PB in EDTA and or 2 3ml BM in EDTA Contact details Laboratory Enquiries 0161 276 4809 Clinical Scientific Diagnostic advice and results interpretation Dr Abida Awan 0161 276 4137 Stem Cell Therapeutics Stem Cell Therapeutics Stem Cell Procurement Processing and Cryopreservation Contact 0161 276 4078 0161 701 1248 The laboratory is open for routine services Monday Friday 09 00 to 17 15 Leukaemia Cell Biology Leukaemia Cell Biology Research laboratory Contact 0161 276 8042 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 19 of 28 LiL FA Central Manchester University Hospitals INHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Haematology tests available outside core working hours e Full blood count Auto differential and platelet count e Sickle test e Malarial parasites Screening kit and Film e ESR e Prothrombin time INR e APTT RATIO e Factor assays when authorised by a consultant haematologis
16. e Central Manchester University Hospitals NHS Foundation Trust Directorate of Laboratory Medicine Coagulation COAGULATI ON Test Result s available Report s Urgent Non urgent Available APTT Blue cap vacutainer 60 min 3hr 24 hours 1 3ml 2ml or 5ml Paed Prothrombin time bottle 24 hours As above 60 min 3hr 24 hours Blue cap vacutainer 60 min 3hr 1 3ml 2ml or 5ml Paed bottle FDP D Dimers 24 hours Fibrinogen As above 60 min 3hr 24 hours Bleeding time Test carried out on patient by by contact lab ext 12123 arrangement arrangement Anticoagulant Control Test eon available Report s Urgent Non urgent Available 24 hours Heparin control Blue cap vacutainer 60 min 1 3ml 2ml or 5ml Paed bottle 24 hours Oral Anticoagulant Control INR As above 60 min hr Laboratory Medicine Haematology Department Date of issue December 2014 Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 11 of 28 Lik Central Manchester Haematology Service Directorate of Laboratory Medicine Central Manchester University Hospitals NHS Foundation Trust Coagulation Factor Assays Test Specimen s Blue cap vacutainer 1 3ml 2ml or 5ml Paed bottle Factor I assay Factor V assay Blue cap vacutainer 1 3ml 2ml or 5ml Paed bottle Factor VII assay Factor VIII assay As above
17. ernal 7ml EDTA pink cap cord 7ml EDTA pink cap Kleihauer test 60 min Within 24 hrs 24 hr Direct Antiglobulin Test 7 ml EDTA pink cap Within 24 hrs 24 hr Haptoglobulin Estimation 7 ml clotted red cap Within 10 days 10 days Cold agglutinin titres 4 C 7ml EDTA pink cap 48 hr 48 hr kept at 37 C by prior arrangement with the laboratory only Haemolysins 7 ml EDTA pink cap 24 hr Antibody titre 7 ml EDTA pink cap NBS NBS 5 working days 5 working days N A not applicable From time of receipt in the laboratory FOR FURTHER ADVICE OR INFORMATION TELEPHONE 0161 276 4400 or 64887 URGENT REQUESTS FOR BLOOD TRANSFUSION 0161 276 4400 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 14 of 28 Lik Ltd Central Manchester University Hospitals LYZ Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Haematinics HAEMATI NI CS Test Result s available Report s Urgent Non urgent Available Serum and red cell folate 1x4ml purple cap EDTA N A 3 working 5 days 1 x 7 ml red cap clotted days Serum vitamin B12 1 x 7 ml clotted 5 days days Serum ferritin 1 x 7 ml clotted Loue 3 working 5 days days Serum intrinisic 1x7 ml clotted 5 working 7 days factor antibodies days Erythropoietin EPO 1x7 ml clotted 7 da
18. gnostics Stem Cell Therapeutics and Blood Transfusion services We aim to provide a user responsive service with rapid turn around of accurate results Expert clinical and scientific advice is available on the investigation of haematological disorders the interpretation of test results and on any further investigations which may be required Location The laboratory is situated in the Manchester Royal Infirmary and is part of the Central Manchester University Hospitals NHS Foundation Trust CMFT within the Clinical Science Buildings For a full map of the hospital site please click on this link or if you have a paper copy type the following into your browser http intranet cmht nwest nhs uk directorates HSA pdf Manchester 20Hosps 20Insi de 20Aug 09 pdf Postal address Department of Haematology Directorate of Laboratory Medicine 1 Floor Cobbett House Manchester Royal Infirmary Oxford Road Manchester M13 9WL Working hours The laboratory is open for routine services Monday Friday 08 30 to 17 15 The Out of Hours service covers the remainder of the 24 hour period weekends and Bank holidays for urgent emergency work and some specialised work where required Quality Statement The investigations performed within the CPA accredited laboratory are recognised standards of practice Documentation relating to internal quality control and quality assurance are retained for scrutiny by users of the Service The department
19. iagnostic AML FLT3 ITD detection for risk stratification of diagnostic AMLs in a research setting qualitative Myeloproliferative Disorders MPDs JAK2 V617F mutation screening qualitative JAK2 V617F allelic load quantitation MPL W515L K mutation analysis qualitative Lymphoma Immunoglobulin and T cell receptor clonality analysis Test under development e kinase domain mutation analysis e D816V KIT mutation analysis in mastocytosis and AML e JAK2 Exon 12 mutation analysis in MPDs e CALR Mutation Screen in MPDs Blood sample requirement Result report available 15 20 mls EDTA 3 weeks anticoagulated peripheral 2 weeks blood or 2 3 mls EDTA 2 weeks anticoagulated bone marrow 2 weeks please see molecular 2 weeks oncology sample requirements below 2 weeks 10 20 mls EDTA 3 weeks anticoagulated peripheral blood or 2 3 mls EDTA anticoagulated bone marrow please see molecular oncology sample requirements below please see molecular oncology sample requirements below 10 working days Contact laboratory for progress update Molecular oncology sample requirements For quantitative real time PCR tests peripheral blood PB is routinely monitored for BCR ABL in CML samples with occasional bone marrow samples BM as required by the clinician For BCR ABL monitoring in ALL patients monitoring of PML RARA Inv 16 AML1 ETO and NPM1 in AML patients paired P
20. o 2 0 3 0 Nil Next Morning APTT Ratio 3 0 3 5 NI 2 500unisover24hrs Next Morning APTT Ratio 3 5 4 0 Nil Stop for 1 hr then 2 500 units 6hr 12hr over 24 hrs Nil APTT Ratio 24 0 Stop for 2hr then 5 000 units 6hr 12hr over 24 hrs For S C Heparin 250 iu kg b d 200 for females gt 60yrs Take specimen 4 6hrs post injection APTT DOSE ADJ USTMENT REPEAT APTT RATIO 1 5 42 500 units b d Next Morning 1 5 2 0 31 250 units b d Next Morning 2 0 3 0 Next Morning 3 0 3 5 1 250 units b d Next Morning 3 0 4 0 2 500 units b d Next Morning 24 0 5 000 units b d Next Morning Haematinics Serum folate 3 0 16 ug l Red cell folate 200 600 ug Serum vitamin B12 150 900 ng l Serum ferritin Male 15 200 ug Female 7 90 ug Erythropoeitin EPO 3 18 ml U mL Zinc Protoporphyrin ZPP Paediatric only 30 80 umolZPP mol heam Haemolytics Haemoglobin A2 2 3 3 3 Haemoglobin F 1 5 96 G6PD 4 8 13 6 ug l 8 3 20 1 ug l 0 9 months Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 25 of 28 Lik Central Manchester Haematology Service Directorate of Laboratory Medicine Central Manchester University Hospitals NHS NHS Foundation Trust Factors Affecting the Results or Processing of Haematology Tests
21. ochromatosis HFE gene mutation identification C282Y 3 weeks H63D S65C anticoagulated blood Haemophilia A and B FVII amp FXI deficiency F7 F8 F9 F11 gene mutation Please contact laboratory 6 weeks prenatal identification haemophilia carrier and directly diagnosis 2 weeks prenatal diagnosis von Willebrand disease 6 weeks prenatal Molecular diagnosis prenatal diagnosis in Please contact laboratory diagnosis 2 weeks type 3 VWD directly Haemoglobinopathy Alpha and beta thalassaemia mutation Please contact laboratory 6 weeks identification directly Necessary referral information can be found at www tinyurl com haemoglobin opathyreferral Contact details Laboratory Enquiries 0161 276 4809 Clinical Scientific Diagnostic advice and results interpretation Dr Tony Cumming Dr Steve Keeney 0161 276 4880 4809 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 17 of 28 Lik Central Manchester Haematology Service Directorate of Laboratory Medicine Haemato Oncology Central Manchester University Hospitals NHS NHS Foundation Trust Investigation Leukaemia quantitative BCR ABL t 9 22 AMLY ETO t 8 21 NVERSION 16 PML RARA t 15 17 NPMI mutation screening for risk stratification of d
22. ood Transfusion Practitioner Mary Marsden 0161 276 8041 mary marsden cmft nhs uk Copy No Electronic QPulse Edition No 004 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 7 of 28 LALELA Central Manchester Haematology Service Central Manchester University Hospitals NHS NHS Foundation Trust Directorate of Laboratory Medicine Title Name Tel e mail Title Name Tel e mail Senior Blood Transfusion Practitioner Carmel Parker 0161 901 1961 carmel parker cmft nhs uk Senior Blood Transfusion Practitioner Louise Polyzois 0161 901 1961 louise polyzois cmft nhs uk Molecular Diagnostics Centre Team genetic investigations Title Name Tel e mail Title Name Tel e mail Title Name Tel e mail Consultant Clinical Scientist Molecular Diagnostics Centre Dr Tony Cumming 0161 276 4880 4809 tony cummin cmft nhs uk Principal Clinical Scientist Haemostasis and Thrombosis amp Haemoglobinopathies Dr Steve Keeney 0161 276 5990 4809 steve keeney cmft nhs uk Principal Clinical Scientist Molecular Oncology Dr Abida Awan 0161 276 4137 4809 abida awan cmift nhs uk Haematology Administration Title Information Lead Name Hannah Belli Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by
23. ransfusion staff beforehand on Extension 4400 or Bleep 2525 Out of Hours If a particular case requires more than the amount indicated on the schedule you must contact the laboratory personnel on extension 4400 or bleep 2525 out of hours Remember to obtain positive patient identification when taking blood samples Good documentation is essential Include on request forms any special requirements e g irradiated previous transfusion history reason for request and when the blood is required NB In the interest of patient safety all unused units of blood in the Blood Satellite Fridges MUST be returned to the Transfusion Laboratory within 48 hours Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 28 of 28
24. ronic QPulse Edition No 004 Document No MI HAEM28 Authorised by C Whitehead 26 of 28 LALELA Central Manchester Haematology Service Directorate of Laboratory Medicine Central Manchester University Hospitals INHS NHS Foundation Trust BLOOD COUNTS FBC Small sample e Paediatric would process if there is greater that 100ul otherwise comment Insufficient Adult would process if blood volume is sufficient to reach the bottom of the label otherwise comment Insufficient FBC amp ESR Small sample e Paediatric separate sample ESR e FBC ESR requires 2ml in FBC tube otherwise will be reported as Insufficient FBC amp Film Old Sample Greater FBC would not be processed and comment Too old for than 48 hours analysis e Film would be reported as old for morphology FBC ESR amp Clotted Sample e Would not be processed Retic FBC EDTA may cause clumping e This would result in a falsely low platelet count of platelets laboratory will check a blood film and ask for citrated Coag sample to attempt an accurate measurement of the platelets CSF Contaminated with red cells Would process appropriate comment will be added Bone marrow Not enough marrow e Could not perform stains repeats would be requested smears material to perform stains on BLOOD TRANSFUSI ON X Match Extreme Haemolysis e Would not use repeats will be requested Samples
25. s dece or reduced result 1 x 4ml EDTA N A 3 workdays 5 workdays N A not applicable From time of receipt in the laboratory 1 INFORM THE LABORATORY IF A TEST 15 TO BE PERFORMED URGENTLY Telephone laboratory samples screened on Fridays by arrangement with laboratory 3North West Genetic Diagnostic Service for Haemoglobinopathy All requests for genetic diagnosis in haemoglobinopathy which are approved under the NW SHA Indications for Genetic Diagnosis of Haemoglobinopathies algorithm are centrally funded Please see www tinyurl com haemoglobinopathyreferral for associated forms and guidance For haemoglobinopathy genetic studies contact Dr Keeney Molecular Diagnostics Centre 0161 276 4809 For Red Cell Haemolytic Screen contact laboratory on 0161 276 4689 FOR FURTHER ADVICE OR INFORMATION TELEPHONE 0161 276 4689 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 16 of 28 LiL FgIF g Central Manchester University Hospitals LYZ Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Molecular Diagnostics Non Malignant Haematology Investigation Blood sample requirement Result report available Heritable Thrombophilia Factor V Leiden and Prothrombin 2 weeks G20210A mutation screen anticoagulated blood Hereditary Haem
26. t e D dimer FDP e Fibrinogen e Crossmatch e Blood Group e Direct Coombs Test e Blood product issue e Gandular fever screen e Reticulocytes e Specialised tests following discussion with on duty haematologist and duty BMS staff Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 20 of 28 5 T 2 FBC Reference Ranges 2009 Central Manchester University Hospitals NHS Foundation T rust Hb updated to g L March 2013 Pathology Harmony October 2014 e Qo Yo Birth Term 2 14 days Ov i Is gt u 4 6 5 c 2 x 4 WI c oO 75 E c V D zE 38 2o c occ Sg rs 55 g asz Me Q S 2 Ref Paediatric H tol Ch 37 Third Edition Simpki inchli we o g c erence Paediatric Haematology Chapter 37 Thir ition Simpkin and Hinchliffe Adapted for Sysmex XE Analysers c9 Moo Copy No Electronic QPulse Edition No 004 Laboratory Medicine Document No MI HAEM28 Authorised by C Whitehead Haematology Department Date of issue December 2014 Author Haematology Management Team 21 of 28 Lik Central Manchester Haematology Service Directorate of Laboratory Medicine Plasma Viscosity At 25 C From 3 years Coagulation
27. ting is not useful in the diagnosis of VTE in patients with concomitant diseases e There is a decrease in the specificity of D dimer testing for VTE with increasing ie D dimer testing is less reliable in older patients e D dimer should not be used to exclude VTE in children The negative predictive value of D dimer in children with suspected VTE has not been validated and levels may vary with age Guidance e D dimer testing should only be requested in patients with a low clinical probability of VTE or in the assessment of recurrence risk for VTE post completion of anticoagulant therapy e n patients with a high clinical probability of VTE or in patients with co existing illness D dimer testing is unlikely to add any useful diagnostic value and should not be requested Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 23 of 28 LiL Central Manchester University Hospitals NHS Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Reference Thacil J et al Appropriate use of D dimer in hospital patients Am J Med 2010 123 17 9 Guidance on Laboratory testing for Heritable Thrombophilia is available to view on the Trust intranet Detailed information and guidance on Thromboprophylaxis in Pregnancy and the Puerperium is a
28. vailable on the Intranet in the maternity section of Staffnet Policies http staffnet cmft nhs uk Policies Default aspx Warfarin Scheme WARFARIN SCHEME APTT 9 10am Warfarin dose given at Target 5 00pm 1 Start 10 mg 2 As per APTT 1 8 10 mg 1 mg 0 5 mg 3 2 3 ratio As per APTT 10 mg 5 mg 4 mg 3 mg 2 mg 1 mg NIL 4 Stop Heparin Predicted Maintenance gt 8 mg 1 4 8 mg 1 4 7 5 mg 1 5 7 mg 1 6 1 7 6 5 mg 1 8 6 mg 1 9 5 5 mg 2 0 2 1 5 mg 2 2 2 3 4 5 mg 2 4 2 6 4 mg 2 7 3 0 3 5 mg 3 1 3 5 3 mg 3 6 4 0 Nil then 2mg 4 1 4 5 24 5 Nil for two days and then 1 mg Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 24 of 28 Lik Ltd Central Manchester University Hospitals Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Guidelines for Heparin Dosage for Heparinization for Thrombotic Conditions GUI DELI NES FOR HEPARIN DOSAGE FOR HEPARINI ZATION FOR THROMBOTIC CONDITIONS Take baseline PT APTT Give 5 000 i v bolus then start pump at 30 000 units over 24 hrs eg 30 000 units in 24 mls of N Saline and set pump at 1ml per hour Repeat APTT after 6 hrs Bolus Rate RepeatAPIT APTT Ratio 1 5 6hr 12hr APTT Ratio 1 5 2 0 Nil 2 500 units over 24 hrs 6hr 12hr APTT rati
29. ys days Haemochromatosis Blue cap vacutainer C282Y H63D and S65C 3 weeks 3 weeks genotyping Zinc Protoporphyrin ZPP 1 x 4ml purple cap EDTA 3 working 5 days Paediatric only days In vivo radiosotope studies carried out by the Department of Nuclear Medicine Blood volume Red cell survival Telephone 0161 276 4820 to arrange in vivo studies N A not applicable from time of receipt in the laboratory Serum intrinsic factor antibodies are carried out on patients with a low B12 level less than 120ng l See Molecular Diagnostics Centre section for further information FOR FURTHER ADVICE OR INFORMATION TELEPHONE 0161 276 4689 or 64803 Laboratory Medicine Copy No Electronic QPulse Haematology Department Edition No 004 Date of issue December 2014 Document No MI HAEM28 Author Haematology Management Team Authorised by C Whitehead 15 of 28 ih FIF Central Manchester University Hospitals li 7 3 Central Manchester Haematology Service NHS Foundation Trust Directorate of Laboratory Medicine Haemolytics meme CS Test EA Report s Available Urgent pre operative Pts gt 1 yr old ond S Routine Haemoglobinopathy E M workda S Universal Antenatal Provisional report Haemoglobinopathy Screening 1 x 4ml EDTA 3 workdays 5 workdays 7 workdays 3DNA Testing for the Haemoglobinopathies 4 x 4ml EDTA G6PD Screen 1 x 4ml EDTA V Within 4 hours 3 workdays 5 workday
Download Pdf Manuals
Related Search
Related Contents
Machine à pop-corn Mode d`emploi – page 1 Ultra Products UltraRAE 3000 User's Manual Philips 9160XL Electric Shaver User Manual Beyma POWER 15 Sierra Products EasyFire B Model User's Manual the American AW1118D Piston Pump service manual SCALIX Advanced Administration and Troubleshooting Training PNY GM9500GN2E50X-SB GeForce 9500 GT graphics card Copyright © All rights reserved.
Failed to retrieve file