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Hospitalist

Hematology

Result Reporting Change of Nucleated Cells in Cerebrospinal Fluid (CSF) Counts

Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.

Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.

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Chemistry

Reference Range Update: ALT and AST

After consultation with our clinical partners, Spectrum Health West Michigan Laboratory will be adjusting the pediatric reference ranges for our new ALT and AST reagents in an effort to better serve our population.  Numerous academic studies were reviewed, and the values listed below were adopted on August 3, 2022: Continue Reading

Chemistry

Updates: Chemistry Reference Ranges

Effective August 2, 2022, reference ranges for the below tests will be updated to better align with the vendor’s recommendation and with Spectrum Health Lakeland Laboratory. Please click on the links below and scroll to the Reference Range field to see the updated ranges.

Lithium Level [LAB29]

PTH Intact [LAB108]

IgM Level [LAB72]

IgA Level [LAB73]

CA 125 Level [LAB155]

C4 Complement Level [LAB151]

C3 Complement Level [LAB152]

Albumin Level [LAB45]

Transferrin Level [LAB133]

Questions or inquiries may be directed to the “Contact Us” link above.

Microbiology, Test Utilization

Enteric Pathogens PCR Panel: New Order Criteria

The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing. Continue Reading

Chemistry, Test Spotlight

Reminder: Folate Test and Fasting

Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting.  Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.

Spectrum Health Laboratories recommends:

• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.

• Take normal dosages of medications unless the provider has instructed otherwise.

Click here for a list of tests the require or recommend fasting. Continue Reading

General Information, Hematology

Test Update: Cell Count with Differential, Body Fluid

Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids.   This component will be displayed in Epic as an absolute PMN count, body fluid.

• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.

• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).

• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).

• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.

• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS Continue Reading

Chemistry, General Information, Test Spotlight

Sysmex Urinalysis Series Go Live

In continued pursuit of alignment, regional market hospital labs have adopted the Sysmex-Siemens automated urinalysis system. This advanced platform elevates analytical control and automation, eliminates manual steps previously required from former systems, and offers the latest in digital particle imagery. Combined with exceptional service engineer support, this system represents a notable step forward in urinalysis performance. Continue Reading