What does STAT mean to your Lab?

sharann, BSN, RN · Feb 11, 2005

I appereaciate all the responses. Begali, I never have slammed lab and have been nice to them(they never lost my specimens yet!), I just was irritable about the actual draw time. I understand how it can take some time for results(I worked as a tech in a small MD office for a stint). Our manager flipped yesturday because labs were ordered STAT and not drawn an hour later for a pre-op.

Happy Friday all, they just conned me into working relief on my day off, grumble...

Liann · Feb 11, 2005

I think the confusion comes from the definition of STAT. This staus should only be used when a result is dire, as was previously stated.

People abuse STAT status to get thing moving quickly for various reasons, such as STAT Rhogam orders we get for outpatient prenatal visits...yeah, Blood Banker...drop that transfusion you are working on and get that Rhogam STAT so the patient can get on with HER busy day.

Our Blood Bank also runs all blood gases and STAT chemistries for the entire hospital, including the OR. You try deciding which is more important, the gas or the transfusion...sometimes on the same patient! Our protocol is to run all gases within 15 minutes of receiving them. Thats IF they are not clotted or not on ice, requiring recollect. NICU capillary tubes are notorious for arriving clotted...argh.

There are indeed many samples received in a day. Everyone thinks that THEIR patient is the most important. I do the best I can.....with what I have to work with....

fergus51 · Feb 11, 2005

Our NICU is able to run its own blood gases and it's a Godsend! No need to worry about the ice or the tube breaking on the way to the lab or clotting or not getting the results quickly enough.

begalli · Feb 11, 2005

Begali, I never have slammed lab and have been nice to them(they never lost my specimens yet!),

Aww, please don't get me wrong. That's not what I meant.

But frequently things like - they dropped the tube and called later and told me the specimen was hemolyzed and needs to be recollected- is what I'm talking about. Dropped tubes in labs is as rare as nurses forgetting to wear their work shoes to work ( :chuckle sorry, I couldn't think of anything else).

In my experience, a tube could be misplaced in the 100's of specimens they receive but if you insist and have them look for it, it's there. Or sometimes a specimen is "lost" because it's mislabelled with another patient's name. I've done this myself in a rush to get things done.

My point was that having worked in both areas, each does not understand what the other does. When I worked in the lab I was forever sticking up for nurses because most of the time on my job was spent on the floors dealing with the most difficult specimen collections and seeing first hand what nurses were dealing with (this experience is how I decided to skip med/surg and ER altogether and go straight to ICU). I think it would be cool if nurses could spend a day in the lab to see exactly what they do there.

Please nobody get me wrong. I'm just an advocate for both, I guess.

sharann, BSN, RN · Feb 12, 2005

I absolutely did not take offense Begali!

fergus51 · Feb 12, 2005

Some places do differentiate between STAT (dire emergencies) and ASAP. It made a difference at my last hospital, but the lab here doesn't seem to differentiate so I will continue to be a pain in the butt and call if it's a true STAT. I think it helps them too, because they may not notice something has been sitting in the tube for a while if we don't call.

begalli · Feb 12, 2005

Fascinating post! Yes, I did learn something, thanks!

icyounurse, BSN, RN · Feb 12, 2005

we draw all our own labs, unless it is a bleeding time or blood cultures ot the pt is a very hard stick. then you wait an hour or so for lab.

ACNP-Ray · Feb 12, 2005

To our lab it seems to mean anywhere from 20 mintues to 1 hour from the original call order. This is crazy. I know they can be there fast(see it for ER)but from the ICU or the floor I noticed they take longer than acceptable.Maybe they are understaffed, don;t know, but I know that when I have a stat H/H on a bleeding post-op in PACU I want it drawn within 10 minutes.
AM I being too harsh?

For us it depends on whether it's a weekday or weekend. May take an hour on the weekday and perhaps an hour and a half or two on the weekends. If we have a pt on CVVHDF then we can always pull out our I-stat machine and run a fluid balance and ionized calcium on the pt. We also have these little pink signs that say "STAT Labs Pt on CVVHDF" that we stick in the bags with the labels/samples and that is supposed to be run first, but I rarely find that to be the case. The CBC's do come back the fastest though.

cube · Jun 30, 2007

You're exactly right. I was a medical technologist prior to becoming an rn and there are 100's of specimens that everyone wants stat. And what slows down most of the work is actually getting the blood, so if my patient is bleeding, I will ask someone in the unit who is free to rush my blood to the lab themselves (we don't have a pneumatic tube station, and our hospital is 850-bed!) after I draw it. The CBC will come off in about 1-2 min and the techs are really good at putting the really urgent samples first IF THEY KNOW THE SAMPLE IS ACTUALLY URGENT. When most of the samples that come into the lab that aren't timed are ordered stat, it is pretty hard to know which one is actually needed in a couple of minutes unless the lab technologist is told. Not the phlebotomist (person drawing the blood).

NcCareN4kids · Jul 1, 2007

In our lab there is a 15 min window before or after the requested time in which the lab should be drawn when ordered. the problem is when everyone is ordering test through out the day "stat" for none stat reasons (such as the patient wants to be discharged etc.) nothing is STAT. For the last 6 yrs I've watched our hosptial stuggle with a constant shortage of phlebotmists due to lack of funds. Our lab personal are often called to the ER to draw patients because they (the ER staff) are too busy to draw their own patients. On a good day the lab can help out. On the weekends if we have more than 3 persons available (two to run the floors and one to triage the workload) to run the whole hospital (L&D, NICU, both ICUs, CTRU, PACU, peds, ER, and the outpatient lab (afterhours) then we're thrilled. Its easy to assume that the lab personal are just sitting around doing nothing but please keep in mind this lil bit of information.... if the nursing staff is short staffed chances are so is the lab.

Each of us need to take a look at the big picture... what is in the best interest of the patient... waiting for the lab or just drawing the specimen and sending it down to the lab yourself?

Some years ago when I worked at Duke University I saw how they ran their lab. Labs were scheduled during the day and night and all STATs afterhours were collected either by the RN or the ordering physician You sure didn't see as many STATs ordered then.

Another thing to keep in mind. Although the lab may have recieved the tube of blood so many minutes ago that instrument might be in the middle of running other samples. It could take upward to 20 minutes for the insturment to be complete that cycle and the more time for the techs to certify it into the computer.

While working in the lab years ago I recieved a call from an RN upset because she hadn't rec'd the stat Protime result that she needed. She got the chemistries results that had been sent to the lab AFTER the Protime and she just couldn't understand why the lab had messed up. I told her twice, "Madam, the coag instrument is down and will be up in 10 more mins." "But I send that tube before the chemstries!" she said. To which I had to remind her.. we don't run the protimes on the same instruments as the chemistries!

JakeyWakey · Jul 2, 2007

I'm a phlebotomists at my local hospital. In our lab we have 15 minutes to draw the specimen, and have it ordered up in the computer, and back to the lab techs. We usually do pretty well. Our ER is just down the hall from the lab, so we generally get our draws within 5 minutes, ordering it up in the computer can take 1-2 minutes, then spinning the tubes can be about 3 minutes or so.... After the CLS get their hands on the tubes.. I don't know how long it takes after that... but we really try to be as fast as possible. At times we only have 1-2 phlebotomists working so we can get into situations where we can't respond as fast as we'd like. Sometimes stat draws outside of the ER take a little longer, just to get up to the different floors. I usually try to take the stairs to get up faster.