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Out of Hours Repertoire During the out of hours period, (i.e. after 8.00pm), tests should only be requested when the result is necessary for the immediate management of the patient, in accordance with agreed clinical profiles. Tests not included in these profiles should be discussed with the consultant in charge of the case and, if still required, then the head of department or the most senior member of staff available should be contacted to make the necessary arrangements. Glucose analysis will normally be undertaken within a few hours of collection, and the use of a serum sample is acceptable. Fluoride samples should be used for CSF, neonates, septicaemic patients or when more than two hours may lapse between collection and analysis. An ESR will only be carried out on special cases e.g.; suspected temporal arteritis or septic arthritis. FBC's on call will have the following machine parameters reported; Hb, WBC, platelets, RBC's with associated indices. A film will only be reported where appropriate or specifically requested. INR should be requested on oral anticoagulated patients, who are bleeding or bruising; APTT or heparinised patients bleeding or bruising; coagulation screen on suspected DIC or bleeding patients; Fibrinogen and XDP's should be requested on suspected DIC patients. Other test include malarial parasites, sickle screen, heterophile antibody screen, cross matching of blood for urgent surgery, haemorrhage or severe anaemia, including issue of fresh frozen plasma and platelets. Last edited 07/08/08 |