Originally Posted by stevielynn I've run CBC's and chem's myself as a supervisor at night when we have no lab and the CBC is maybe 3 minutes. The chem is longer because you have to spin it down and then put it in the machine. Probably 20 minutes in all.
I think that's pretty accurate for most labs. The hematologies can be run within minutes and that's why it's usually the first result you see when looking for your labs. It can take longer however with really low cell counts (white/red/platelet). It means they have to make a slide and do it manually.
Labs usually don't (or shouldn't) let coags sit around either due to the compromise of the integrity of the coagulation process after the blood leaves the body.
With chemistries, I would agree that
once the specimen is on the machine it takes about 20-30 minutes, then the tech has to review the results and confirm them and enter them for viewing by healthcare staff. In the larger hospitals, they
usually do this in "batches" of about 25-50 individual specimens.
Our lab defines stat as results within 1 hour. I used to work in a place that accepted "dire" specimens. The only tests that could be done this way were blood gases, potassium, i-calcium, glucose, and an h&h. There were no other tests that could be done dire because of the impossibility of the equipment to run other types of tests that fast. Dires had to be hand delivered to the lab and handed directly to someone there and told it's dire. Whoever accepted this specimen dropped whatever they were doing and took it to a tech where likewise they drop what they are doing and run the specimen. The result was always called within minutes.
Something I think nurses don't understand about hospital clinical labs is that they receive literally 100's of specimens on any given day. Each specimen has to be accessioned and labelled with labels that are recognized by the laboratory equipment that runs the tests (a lot of places have gone to using lab equipment labels on the floor). If something comes with a label that is skewed (hanging off the bottom of the tube or covering the stopper), it has to be undone and redone so it will go into the not only the centrifuge, but also the machine that runs the tests. Most lab machines read the bar code on a label in the vertical position. So even if the label is crooked on the tube, the label has to be re-printed and the tube relabelled - this is for ALL labs, not just chemistries. Also, all serum and plasma chemistries have to have a "pour-over" tube made for them with identical labelling as the original tube.
The tubes go into a centrifuge that will take about 3-5 minutes or so and then each and every single specimen needs to be aliguoted (the serum or plasma only is sucked up into a pipette and put into the pour-over tube - cells remain in the original tube). Then the pour-over tubes are delivered to the med techs who usually run a full batch unless it's a stat in which case they will run whatever they have ready to go at the time along with the stat.
Furthermore, the techs usually have to add chemicals to the specimen to conduct the tests (reagents) that are necessary to run tests = more time.
Any number of things can slow this process down. Hemolyzed blood will sometimes not run on a machine and special care will have to be taken or special observations made. Mis-labelled tubes that tie up the accessioning process. Nurses calling saying "where's my results!" after only an hour for a routine specimen, not enough specimen in a tube (takes extra time with both the processing and running of such a specimen), messy specimens such as a bloody stopper or blood inside the bag (always wipe the top of your tubes off with alcohol before sending them down - these folks don't usually wear gloves to reach into bags!), and I'll add poorly managed labs and some employess who might be having too much fun at work. Oh! and the floors calling for lab draws take staff away from usually the accessioning/ pour-over process.
Also, people who work in labs are some of the most anal retentive/overly analytic people around--and for good reason, they deal with hundreds of specimens that all look the same and lives depend on what they result.
Toxicology can be really fast or take forever depending on the complexity of the test.
And we all know micro takes days to grow. Serologies and virologies take longer because labs usually receive fewer of these specimens and save them up to run at a certain time of the day or week.
I get frustrated with our lab because our computer interfaces are sometimes VERY messed up. I do have a back-up to look at, but that means opening a new program, but I don't expect too much and I understand that it can take time. I always draw all of my own labs unless I'm extremely busy and even then, only for cultures or a culture when I've already done one.
I have been known to say that nursing school does not emphasized lab enough. I am forever speaking up when my co-workers start slamming the lab. There is always some tension between lab and nursing. I have experienced both sides. It comes down to the fact that each doesn't have a thorough understanding of what the other does. But both are paramount to patient care.
So remember when you send down that tube of blood, yours is not the only one there and it goes through a relatively lengthy process before it's actually on a testing machine.
I hope someone learns something from my post. I think both sides frequently get slammed unfairly.
The end.
What does STAT mean to your Lab?
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