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Hematology

General Information, Hematology

Cell Count Update – Specimen Rejection Criteria

The Spectrum Health Regional Laboratory Hematology Department has updated rejection criteria for the orderables, Cell Count w/ Differential, Body Fluid and Cell Count, Body Fluid.  Spectrum Health Hematology will no longer perform cell counts on specimens which are not from a sterile body cavity (e.g. wound drainage, abscess, pus, etc.).  Unacceptable specimens submitted to the Hematology Department for cell counts will not be performed and the test will be credited. Continue Reading

Hematology, Referral/Sendouts

Hemoglobin A1c Testing Update

For Hemoglobin A1c testing, Mayo Clinic Laboratory has switched to an Ion-Exchange High-Performance Liquid Chromatography (HPLC) method (Bio-RAD D100) which is the same method of A1c testing used at Spectrum Health Regional Laboratory.  They no longer offer the alternative method, boronate affinity chromatography, for A1c testing.

When A1c cannot be determined due to  interferences that affect the Bio-RAD 100 method, measurement of serum fructosamine is recommended (Mayo test FRUCT). Continue Reading

Hematology, Test Utilization

Pathologist Review – Reason for Review

Pathologist review of peripheral blood smear (#8367) will have an additional required field to complete upon ordering. We are striving to improve our test utilization, inter-provider communication, and accurate and timely result reporting. Providers will see a choice of the top 10 to 15 reasons for review, including such reasons as “anemia evaluation” and “look for blasts”. An option for “other, see comment” is available for any free text comments to the pathologist.

This change is anticipated to begin for all electronic ordering of this test on February 4, 2016

Any questions concerning these changes may be directed to Dr. Jennifer Stumph, Director of Hematology.

Hematology, Microbiology

Malaria Testing Update

Effective June 1, 2016, Malaria testing will be updated. Recommended first line testing for suspected malaria is called Malaria Rapid Screen which is a combination of a rapid BinaxNow test in Hematology and a blood smear review in Microbiology. The BinaxNow test has a reported sensitivity of 97.7% and specificity of 94.2% for detection of P. falciparum species if a patient has a parasitemia level of over 5000 parasites/uL; sensitivity is lower for other malaria species. The BinaxNow test is not reported to cross react with babesia species. BinaxNow testing will be available for all shifts in Hematology at the Spectrum Health Regional Laboratory. The specimen requirements are unchanged from previous malaria testing. Previous test “Malaria Smear for Protozoa” will be discontinued. Continue Reading

Hematology

Peripheral Blood Smear Reminder

As of January 12, 2016, pathologist review of peripheral blood smear ordered without accompanying CBC with differential will reflex to adding on a CBC and/or differential in the laboratory. Blood specimens that do not have a slide prepared need to be less than 6 hours old for a pathologist review to be added on.

This is due to the fact that older blood does not smear well and morphology is compromised, especially red cell morphology. This allows for a complete documentation of the patient’s CBC and differential findings in the electronic medical record and standardizes our process among the regional hospitals.

Any questions concerning Peripheral Blood Smear reflexes should be directed to Dr. Jennifer Stumph, Director of Hematology.