The Chemistry Laboratory is a section of the Division of Clinical Pathology in the Department of Pathology at the University Medical Center. Chemistry consists of three units: Stat, General and Therapeutic Drug/Toxicology. The Chemistry Laboratory is inspected by the College of American Pathologists, therefore, policies and procedures are written in accordance with those standards.
Location: The Chemistry Laboratory is located in the hospital on the first floor, room S102
Telephone: Extension 42368
Any inquiries pertaining to this lab should be directed to the following:
- William Daley, MD, Director .................................................. Ext. 42374
- Patrick Kyle, PhD Associate Director..................................Ext. 42352
- Linda Smith, BS, MT(NCA), Chief Technologist ................ Ext. 42387
- Jesse Thomas, BS MT (AMT) MTSupervisor ................... Ext. 42337
Hours of Operation: The Chemistry Laboratory is staffed 24 hours a day, seven days a week.
Objective: The Chemistry Laboratory performs analyses of patient specimens for attending physicians, for the purpose of facilitating patient care.
A comprehensive quality control and quality assurance program is maintained on all analyses.
Consultations: If any problems should arise, or any special circumstances occur, please contact the section director at 42395. The pathology staff and residents are available 24 hours a day for problems. See current monthly call schedule for after hours, weekends and holidays.
STAT Results: Stat chemistry samples are processed as quickly as possible with preference given to the Emergency Room samples. Stat requests should be reserved for tests needed in life threatening situations. The phone extension for this area of chemistry is 42368.
Routine Request: The Chemistry Laboratory offers a variety of routine tests that are offered 24 hours/day, seven days/week. The phone extension for this area of chemistry is 42368.
Therapeutic Drug Monitoring/Toxicology Requests: The Chemistry Laboratory offers a wide menu of therapeutic and abused drugs. For peak and trough antibiotic levels, please indicate the draw time and the time of last dose of drug. All other drugs can be ordered Stat and are determined periodically with no published schedule. The Drugs of Abuse are qualitatively determined. The phone extension for this area of chemistry is 42366.
Collection of Specimens: Venous punctures are employed for all chemistries and therapeutic drugs. The exceptions are the urine drugs of abuse, CSF, and body fluids other than blood. All venous punctures can be performed by the laboratory's phlebotomy service. The phlebotomy service is operated seven days/week, 24 hours/day. Phlebotomists make scheduled rounds at collection category times (0600, 0800, 1000, 1200, 1400, 1600, 1800, 2000 and 2200). Tests ordered for a specific collection category must be entered in the computer 30 minutes prior to collection time, otherwise they will not appear on the phlebotomist collection list and will not be collected. Stat tests are to be of life threatening importance and ordered CBN or NLP. The phlebotomy service cannot be responsible for drawing tests ordered Stat. Tests ordered that fall under collection category CBN or NLP must be collected and delivered to the laboratory by patient care area personnel.
Samples must be labeled (legibly) and include patient name, correct 12 digit history number, time of draw, requisition number, and initials of person obtaining the test sample. For areas without the ability to order tests on the CRT, a test requisition card must accompany the properly labeled specimen. Tests for therapeutic drug monitoring must include draw time and time of administration of last dose of drug for proper interpretation of results. Routine specimens should be ordered for collection at 0600 (6 am), when possible, so as not to interfere with other work, e.g., x-ray studies, ECG, etc.
Body Fluids:
CSF: Lumbar puncture must be performed under conditions of strict asepsis since contamination of the specimen can occur readily and confuse the identification of the etiologic agent. Specimens should be collected in sterile containers which can be sealed with a screw cap in order to preclude leakage and loss or contamination of the contents. Cotton plugged or rubber stoppered tubes should not be used, and snap-top containers should be checked to ensure that a tight seal does occur and that some contents are not aerosolized on opening. Prompt transport of the specimen to the laboratory is mandatory.
Fluids other than CSF: As with the lumbar puncture, the percutaneous aspiration of pleural, pericardial, peritoneal and synovial fluids must be performed aseptically to avoid contamination and to prevent the accidental introduction of microorganisms into these anatomical spaces. The specimen should be immediately injected into a sterile tube
Reference Section:
Notice to all outreach facilities: The proper preservation of specimens is critical to accurate measurement. If your facility (by virtue of its location) will be sending specimens to UMC for arrival in excess of the time defined in the Laboratory Handbook for processing, you will need to prepare and store the specimen in a different manner and contact the specific lab for special instructions. For the Chemistry section the following are the most common tests in this lab requiring special preparation and preservation when there is a delay arriving in the UMC main laboratory.
- Ammonia - Must be collected in a green top and delivered immediately to the lab on ice.
- * Glucose - Red or green top containers. In non-gel separator tubes the glucose will decrease significantly after two hours of collection.
- Lactic Acid - Green or gray top tube. Must be drawn and delivered to lab immediately on ice. Specimen tubes must be at least half full.
- * Potassium (K+) - Red or green top tube. Stable for 8 hours.
- * CO 2 - Red or green top tube. This analyte is stable for 1 hour after the tube is opened.
- Carbamazepine - Red or green top. Stable for 4 hours after collection.
- Phenytoin - Red or green top. Stable for 4 hours after collection.
- Quinidine - Red or green top. Stable for 4 hours after collection.
- Tricyclie Antidepressants - Red or green top. Stable for 4 hours after collection.
* These tests are common in the Basic Metabolic panel (glucose, sodium, potassium, chloride, CO 2, BUN, creatinine, and calcium)