Quote from cherricka
Anyone out there with a great understanding and knowledge about Labs? I work in the country where it could be 45 minutes between houses, and longer to the "local" hospital, a term I use lightly.
I don't like the lab in the box. For the more popular tests I do regularly, how long can they sit in the car, and do they need icepack. Every time I call the lab tech, they give me different answers, so that is why I am asking all the smartest people I know!
For example: CBC, bmp/cmp hgb a1c, pt/inr, lipid panel, cpk, Dilantin, digoxin, Phenobarb tsh/ft4,alt ,ast, mag, uric acid are the ones I do the most.
Another thing I would like to find out is how much volume is needed for each test, so I know how few tubes I can draw.
Thanks in advance!
I never had to worry about this much, since I work the suburbs and city and am never too far from a hospital. So I will try to shed a little bit of light, but I am by no means an expert.
1. We had to use 3 labs, depending on if it was Medicare, or HMO. Each lab uses their own tubes, this can be extremely important when it comes to the PT/INR. So, as far as how much to put into each tube, you need to check with their policies, the lab whose tubes you use. I know there is a line on the label of most of the tubes I use, and a teeny tiny writing that says how many cc's are needed. If they give you baloney when you ask, ask if they have a package insert from the box the tubes come in, or ask for a policy on that test. Other than that I don't know what to say.
2. For bmp/cmp they have to be spun within 2 hours. If not, I believe it can become hemolyzed which will falsely elevate the potassium, and perhaps other components. So, I would imagine if you drive 45 min, someone better address that sample in the next hour, spin it at least.
3. I have always been taught to keep labs on ice, or in a cooler with a cool pack, but I am not sure if it is a must. On cold days, I use the cooler no ice, but hot scorching summer days, I am sure to use the ice pack.
4. I used to plan my labs to be first thing in the am or last in the day. So, if I had fasting labs, I went to that pt home first, got the labs, dropped off, then went into the office. We are lucky, we had a daily pick-up from the 2 HMO labs by 10am, and the Medicare by 11am. So, If I did it that way, I wouldn't need to go to the lab, just repport back into the office. Since my manager knew I preferred this, she usually gave me a call the day before, so I could get it together. She also lived down the street and dropped off charts and lab supplies for special labs she needed covered, like when another nurse was off, so I was just all-around lucky that way!
Other days, best laid plans go to heck! Those days you just figure your day will be disorganized no matter what and you just do the best you can.
Are there any satellite offices for the labs? We have a satellite in every township for the HMO labs.