Browsing Tag

Emergency Medicine

Microbiology, Test Utilization

Influenza Epidemic Testing Recommendations 2018

Influenza is currently widespread throughout the nation at epidemic proportions. During influenza epidemics, clinical assessment predicts the presence of influenza infection virtually as well as laboratory testing. Therefore, it is no longer necessary to perform viral testing on ambulatory patients who present with illness consistent with influenza before beginning antiviral treatment. Antiviral treatment for Influenza should be started as soon as possible to have a beneficial effect.

Shortages of supplies and medications frequently occur during Influenza epidemics. However, diagnosis of specific viral respiratory infection remains important for hospitalized patients.

Please follow the current recommendations:

  • Limit availability of viral transport media at ambulatory sites.
  • Emergency departments are to limit viral respiratory testing to patients expected to be admitted.
  • Do not perform testing for test of cure.

Thank you for your support during this time. Please direct any questions to Laboratory Services via the “contact us” link above.

Immunochemistry, Test Utilization

Test Utilization: Cardiolipin Antibody Testing

Listed below are the Cardiolipin Antibody tests available in the Spectrum Health Regional Laboratory (SHRL) catalog. Please review the tests and the recommended test utilities.

Cardiolipin IgA testing should not be ordered unless the patient is negative for IgM and IgG. It should be restricted to very specific clinical scenarios for the evaluation of patients with suspected APS (Antiphospholipid Antibody Syndrome). Cardiolipin IgA requests will be reviewed for presence or absence of IgM/IgG testing.

Questions may be directed to Dr. David Alter by using the contact us link above.

Microbiology, Test Utilization

Spectrum Health Regional Laboratory Discontinues Influenza Rapid Antigen Testing

There has been a minor change to the influenza testing methods performed by the Spectrum Health Regional Laboratory (SHRL) to improve the accuracy and timeliness of patient results, while simplifying the ordering process for providers. In past years during respiratory illness season, the lab performed influenza rapid antigen testing due to its low cost and rapid turnaround time, with negative specimens reflexed to PCR for confirmatory testing. Approximately 85% of specimens tested by a rapid antigen method typically reflexed, with those patients charged for performing both tests. Continue Reading

Hematology

Complete Blood Count (CBC) with Differential

As of March 17, 2016, immature granulocyte percentage up to 5% will now be reported on CBC with automated differential, without requiring a manual differential to be performed, if all other parameters allow verification. This is a change from our previous rule requiring manual differential at 3% immature granulocytes. This change should improve turnaround time, especially for patients in the Emergency Department setting. Some providers find the immature granulocyte percentage useful as a part of their algorithm in patients with possible sepsis. Immature granulocytes include cell types metamyelocytes, myelocytes and promyelocytes.

Any questions concerning immature granulocyte percentage in CBC with diff should be directed to Dr. Jennifer Stumph, Director of Hematology.

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.