- See your own hospital access
University Hospital of North Midland
NORMAL WORKING HOURS
Monday–Friday
- 0830–1730 hr
- Histology: 0900–1730 hr
Saturday
- Histology: no service
- Biochemistry: 0830–1300 hr
- for specialist advice, contact clinical scientist
- Haematology: 0900–1300 hr
- Microbiology: 0830–1700 hr
- if sending an urgent sample, contact microbiology
- Virology: 0830–1300 hr
URGENT/OUT-OF-HOURS SERVICE
Specimens
- Clearly mark all urgent requests ‘urgent’
- Include patient’s name (or emergency ID), date of birth, unit number, consultant, ward and time of specimen
- essential for electronic reporting of results
- All requests must contain clinical information relevant to investigation requested
- Where request or sample containers are inadequately completed/labelled or illegible, this may result in investigation(s) not being performed
Request: written or phone?
- If sending an urgent microbiology sample, contact microbiology
- Otherwise, do not bleep biomedical scientist (BMS)
- unless results are clinically very urgent and need to be telephoned
Results: VDU or phone?
- Results will be phoned only if:
- delay likely in transmitting results to VDU
- BMS has already agreed to phone
- results alert BMS to possibility that immediate action may be required
Transport of samples
- For urgent and out of hours specimens, contact transport
INVESTIGATIONS AVAILABLE OUT-OF-HOURS
- Be certain that investigation will influence immediate clinical management
- if BMS is in any doubt about relevance of request, they will ask SpR or more senior doctor to contact clinician on-call for relevant laboratory specialty
Select which department
Blood transfusion
Written Request
- Group and save
- Crossmatch of red cells
- Direct Coombs test
Phone
- Urgent transfusion required, phone
- If massive haemorrhage, activate MHP - see Massive haemorrhage protocol
- Unless discussed, antenatal samples and direct antiglobulin test (DAT) are only processed during routine working hours
Haematology
Written Request
- Full blood count (FBC) including differential WBC
- International normalised ratio (INR)
- Activated partial thromboplastin time (APTT)
- D-dimer for screening patients with suspected DVT or PE
- ESR
- Blood films for morphology
- Malarial parasites
- Infectious mononucleosis screen
- D-dimer with fibrinogen for assessment of DIC
- Fibrinogen
Phone
- In appropriate patients requiring urgent general anaesthesia, sickle cell screen
- require 1 hr prior notification
- For patients with suspected temporal arteritis or for paediatrics, ESR
Biochemistry
Written
- Amylase
- Cardiac troponin
- Liver function tests (LFT)
- Uric acid
- Serum or plasma U&E, osmolality
- Bone
- Thyroid function tests (TFT)
- Urine U&E, osmolality
- CRP
- BNP
- HCG
- Magnesium
- CSF protein and CSF glucose
- Therapeutic drug monitoring
- digoxin, phenytoin, carbamazepine, theophylline, valproic acid, lithium
- Toxicology investigations
- paracetamol, salicylate, iron
Phone
- CSF Xanthochromia
- Ammonia
- Lactate
- Urinary myoglobin
- Urinary PBG
- Tumour markers
- Parathyroid hormone
- Specialised toxicology requests directly to the Regional Toxicology Laboratory
- e.g. drugs of abuse, ethylene glycol, methanol
- for transport, phone. Requesting department will be charged
Microbiology
Limited routine service available
- Weekdays 1730–1930
- Saturday 0900–1700 hr
- Sunday 0900–1700 hr
- antimicrobial monitoring assays are batched and run at approximately 1100 and 1530 hr on Saturday, Sunday and Bank holidays
- phone laboratory during these times
- At all times, send samples (especially MRSA swabs) to laboratory promptly to ensure processing as soon as possible
Out-of-hours
- Contact BMS on phone for all requests until 2230 and after 2230 only for:
- CSF samples
- intra-operative specimens taken in theatre where a microscopy is urgently required
- joint aspirates
- ascitic fluids if spontaneous bacterial peritonitis suspected
- After 2230 hr, refer all other requests to on-call consultant medical microbiologist
Histology
- No out-of-hours service available
© 2022 The Bedside Clinical Guidelines Partnership.
Created by University Hospital North Midlands and Keele University School of Computing and Mathematics.
Research and development team: James Mitchell, Ed de Quincey, Charles Pantin, Naveed Mustfa