Complete specimen handling requirements are provided for each test in the Test Catalog section. Specimen type, minimum volume, storage temperature, and any special handling notes are included in this listing. The specimen volume requested ensures sufficient sample volume to allow repeat testing if needed. The minimum volume requested allows for testing without repeat. Storage temperature is specified as room temperature (18° to 22°C), refrigerated (4° to 7°C), or frozen (-20°C or colder).
Serum, Plasma, or Blood Collection
Draw blood in the appropriate color-coded vacuum tube indicated in the specimen handling requirements of the alphabetical test listing. For serum or plasma, obtain approximately 2 1/2 times the requested volume. For serum, allow the blood to clot at least 30 minutes and separate by centrifugation. For plasma, thoroughly mix the blood with the anticoagulant by gently inverting the tube five to ten times and separate by centrifugation. Transfer the serum, plasma, or whole blood to a plastic transport tube provided by Warde Medical Laboratory.
Please Note: lipemia, hemolysis and icteric samples may affect test results. Due to the concomitant effects, it may not be possible to predict whether this will increase or decrease results.
The following color-coded vacuum tubes are recommended unless otherwise indicated by the specimen handling requirements:
| Stopper Color | Additive | Primary Laboratory Use |
|---|---|---|
| Gray | Potassium Oxalate and Sodium Fluoride | For glucose determination |
| Green | Sodium Heparin | For plasma determination in chemistry |
| Lavender | Sodium or potassium EDTA | For whole blood hematology determination and blood bank testing |
| Light Blue | Sodium citrate | For coagulation determination |
| Red | None | For serum determination in chemistry, serology, and toxicology |
| Gold SST Red/Black | Separator Gel | For serum determination in chemistry and serology |
| Dark Blue, EDTA | Acid-washed with sodium EDTA | For trace elements determination |
| Dark Blue, no additive | Acid-washed with no preservative | For trace elements determination |
| Yellow | ACD Solution A | For blood bank studies, HLA phenotyping, DNA testing and Flow Cytometry |
| Varies | Special Collection Tubes | Some tests require specific tubes for proper analysis. Please contact WML to obtain the correct tubes for special applications. |
Frozen Samples
Frozen samples should not be submitted in glass containers. Submit frozen samples in plastic containers. If multiple tests are requested on frozen samples, submit a separate frozen sample for each test ordered.
Urine Collection
Most urine chemistry tests require a 24 hour collection. Preservatives to be used during the collection period are indicated in the specimen handling requirements for each test. Please caution the patient that the preservative may be toxic and caustic, and not to spill or discard the preservative.
The patient should be instructed to discard the first morning urine at exactly 7:00 a.m., but collect in the container all subsequent urine passed in the 24 hour period, making certain that the patient voids at exactly 7:00 a.m. of the second day and that this urine is also included in the 24 hour collection. Mix well before removing the required aliquot from the 24 hour collection. Do not send the entire urine collection. Indicate the 24 hour volume on the test request form and on the urine aliquot submitted. Adjust the pH if indicated in the specimen handling requirements.
Preparing Specimens for Transport
1. Warde Medical Laboratory requires the use of Standard Transport Tubes for specimen submission. These containers meet Department of Transportation (DOT) requirements for the transport of specimens and provide a leak-proof seal when screwed on properly. Do not snap the cap on and do not use parafilm. Upon request we will also supply
- amber colored plastic tubes for light sensitive samples
- screw-capped plastic urine containers
- screw-capped plastic stool containers
- various tubes and media for tests with special collection requirements.
- Please call WML Client Services for additional information.
2. Print a packing list for interfaced samples. Place samples in rack by appropriate temperature (room temperature, refrigerated, or frozen). Place racks of samples in the appropriate 13×15 specimens transport bags. Packing lists should be placed in a small plastic bag, and placed in the larger bag with the samples. The bagged racks of samples should then be stored in the appropriate temperature location for courier pickup.
3. Samples that are sent with manual requisitions should be bagged in individual 8×10 sample bags with the appropriate temperature designation. Place requisitions in the outside pocket of the bag. Place bagged samples in the appropriate temperature location for courier pickup.
4. When preparing and shipping medical specimens, the regulations set forth by the Department of Transportation (DOT) and the International Air Transport Association (IATA) must be followed. You should be aware that your test send-out area is considered the “shipper” when they send specimens to a reference laboratory. Therefore, your send-out area must understand and follow regulations for preparing or shipping Infectious Substances. Please refer to the DOT and IATA websites for additional information.
Unacceptable Specimens
To ensure optimum integrity of patient specimens from the time of collection until testing is completed and results reported, all specimens submitted to Warde Medical Laboratory for testing must be properly collected, labeled, processed, and transported. The following represents some reasons for specimen rejection or test cancellation, but is not all inclusive:
- Leaking specimens
- Improperly labeled specimens
- Inappropriate specimen type
- Specimens received in expired transport containers or media
- Glass tubes unless otherwise specified
- Syringes with needles attached
- Tubes from an automatic aliquot system with a “pop top” type of cap
- Transport tubes secured with parafilm
- Serum and plasma separator devices (SST and PST), unless otherwise specified. When a separator tube is used for collection, promptly centrifuge the specimen and pour the serum or plasma into a Warde Medical Laboratory Standardized Transport Tube
- Urine containers with tubing and needle
If the integrity of the sample prevents us from maintaining quality standards, a representative from the Client Services Department will notify a representative from your facility to request a new sample.
Specimen Labeling & Request Forms
Warde Medical laboratory provides specimen label printers for those clients with electronic interfaces. The specimen labels are printed with bar-coded patient demographics and unique accession numbers for positive patient identification.
For those clients without electronic interfaces, specimen labels and customized multi-part requisitions are provided. Please include the patient’s name on each specimen label. Extra labels are provided for ease of aliquoting specimens and record keeping. The request form has space provided for a variety of patient demographic information. Billing information may be provided in the separate billing section on the form.
Cancellations
A test may be cancelled without charge before the specimen has been assayed. Please notify the Client Services Department if a test request should need cancellation.
Test Additions
Warde Medical Laboratory holds most samples for ten days. Some specimens, such as positive forensic drug screen samples, are held for longer periods of time. Test additions can be made if sufficient volume is available after the initial tests are completed and if sample integrity is acceptable. Please contact the Client Services Department if an additional test is requested.
Test Reporting
The information system at Warde Medical Laboratory permits easy transmission of test reports directly to the client’s facility. Reports may be sent via electronic interface, secure fax or secure network printer.