basingstoke and north hampshire hospital pathology user handbook

Basingstoke and North Hampshire NHS Foundation Trust Revision: 7 Q-Pulse Filename: MP-GEN-HANDBK 

Basingstoke & North Hampshire Hospital 

Author: David Beacher Authorised by: N. Hutchinson 

PATHOLOGY DIRECTORATE Date of issue: 23 June 2011 Page 1 of 144 

BASINGSTOKE AND NORTH HAMPSHIRE HOSPITAL 

PATHOLOGY USER HANDBOOK 

Author 

: Pathology Collaboration 

: Co-ordinator: David Beacher 

Authorised By 

: Dr. N. HUTCHINSON (Clinical Director) 

Date of Next Revision : June 2012 

DO NOT USE AFTER : July 2012 

This document replaces revision 6 issued December 2010





PREFACE ..................................................................................... 3 

INTRODUCTION .......................................................................... 4 

PATHOLOGY MANAGEMENT ..................................................... 5 

General Pathology .............................................................................................. 5 

Blood Sciences ................................................................................................... 5 

Histopathology .................................................................................................... 6 

Medical Microbiology and Control of Infection .................................................... 6 

Hours of Business ............................................................................................... 7 

Pathology Supplies ................................................................................................. 8 

Electronic Requesting Through ICE ordercomms .................................................. 8 

Request cards ........................................................................................................ 8 

Blood collection .................................................................................................... 11 

Important things to remember when taking blood ............................................. 11 

Labelling of specimens/sample ......................................................................... 13 

Date and time of samples ................................................................................. 13 

High Risk specimens ......................................................................................... 14 

Specimen Transport ............................................................................................. 14 

Transport to the laboratory within the Hospital (Trust Staff) .............................. 14 

Transport of specimens from clinics and surgeries ........................................... 15 

Research and Development ................................................................................. 15 

Screening Programmes and other non-NHS work................................................ 15 

Availability of Results ............................................................................................ 16 

Turnaround Times ................................................................................................ 16 

Reports ................................................................................................................. 16 

Out-of-hours service ............................................................................................. 17 

DEPARTMENTAL SPECIFIC INFORMATION .............................20 

CHEMICAL PATHOLOGY ..........................................................20 

Andrology .......................................................................................................... 26 

HAEMATOLOGY AND BLOOD TRANSFUSION ........................28 

Anticoagulant Services ...................................................................................... 38 

HISTOPATHOLOGY ...................................................................40 

MORTUARY ................................................................................43 

MEDICAL MICROBIOLOGY .......................................................48 

How to get to Basingstoke & North Hampshire Hospital ........62 

Site Map ......................................................................................64 

TEST INDEX ...............................................................................65 

BACTERIOLOGY .............................................................................................. 65 

CHEMICAL PATHOLOGY ................................................................................ 71 

HAEMATOLOGY ............................................................................................ 135 

SEROLOGY .................................................................................................... 140





PREFACE 

This guide has been prepared to inform the users of Basingstoke & North 

Hampshire Hospital Pathology Laboratories of which services are available and how 

to obtain the services required. 

It is appreciated that with the ever increasing range of tests available it is difficult for 

the user to know which request form, specimen container, type of specimen and 

particular protocol is needed to obtain the specific investigation and result they 

require. Hopefully, this guide will address these difficulties. In addition to this type of 

information, the guide also contains lists of relevant telephone numbers to facilitate 

easy access to appropriate Consultants and other senior staff for advice as well as 

departmental numbers for result enquiries. 

Any laboratory is, to a large extent, only as good as the user allows it to be. It is 

important that all request forms and specimen containers are labelled properly with 

the relevant demographic and clinical details. Care must also be taken to follow any 

necessary protocol where a result could otherwise be adversely affected. If any 

doubt exists, it is advisable to contact the appropriate Consultant or department who 

will be pleased to provide the necessary information. 

Finally, any views that users may have about how this guide could be improved 

would be welcomed for incorporation into future editions. Please give these, 

preferably in writing to David Beacher, Quality Manager 

(mailto:David.Beacher@BNHFT.NHS.UK). 

Seventh edition June 2011 

Dr Nicki Hutchinson 

on behalf of the Pathology Directorate





INTRODUCTION 

The pathology directorate offers services in five Consultant led divisions, namely 

chemical pathology, haematology with transfusion, histopathology with mortuary 

facilities, specialist haemophilia and medical microbiology with infection control. The 

laboratories are located on the ground floor (Level B) of the theatre block in the main 

hospital with further facilities downstairs on A floor (mainly microbiology and 

mortuary). Clinical haemophilia services are based in a separate unit near 

Parklands. 

The directorate is an open-access service. Each department has to cope with a high 

workload and has to organise itself to provide urgent and emergency services as 

well as ensuring that all results reach the wards or GP surgeries with the minimum of 

delay. Because the type of work carried out varies considerably, some being labour 

intensive while some is automated, there are organisational differences from 

department to department. For example, there are different request cards for some 

departments and/or tests. If the appropriate request card is used and all the 

information required given, it enables the laboratory to provide an efficient service. 

Finally, remember you are always welcome to visit the laboratory and if the staff can 

put a face to a name, this can only help to improve communication and the service 

for your patients.





PATHOLOGY MANAGEMENT 

General Pathology 

For general enquiries, complaints, comments, or to discuss service 

requirements/contracts. 

Pathology Clinical Director, Dr. Nicki Hutchinson ext 3310 

Pathology General Manager, Katie Bolam ext 2788 

Pathology Quality Manager, David Beacher ext 3280 

Pathology office for general enquiries and results ext 4751 

Pathology administrator ext 3278 

Mr Alex Kelly, computer manager ext 3288 

Mr Shaun Goldsmith for ICE order comms issues: 07770967360 

Pathology department fax (in office) 01256 314905 

Blood Sciences 

Includes Pathology specimen reception, Phlebotomy services, Haematology and 

Chemical Pathology laboratories and Transfusion services. 

Mr Ian Savill, Blood Sciences laboratory manager ext 3283 

Chemical Pathology 

For consultant or technical advice including clinical advice and interpretation. 

Dr. Martyn Knapp, Consultant Clinical Biochemist ext 3270 or 3285 

Mr Robert Jupp, Consultant Clinical Biochemist ext 3270 or 3285 

Secretary ext 3278 

Mrs Catherine Wands, Lead BMS in Chemical Pathology ext 3284 

Miss Sarah Lewendon, Point of Care co-ordinator ext 3288 

Urgent requests or sweat tests (normal hours) ext 3284 

Andrology (semen analysis) ext 3324 

GTT appointments ext 4751 

Consultant advice is available 24 hours a day from the on-call Biochemist (contacted 

by the hospital switchboard). 

Haematology and Blood Transfusion 

For clinical or technical enquiries, requests for urgent work, to arrange special tests, 

or anticoagulant services including clinical advice and interpretation. 

Medical staff 

Dr Alison Milne, Consultant Haematologist ext 3297 

Mrs Helen Todd, secretary ext 3282 

Dr Sylwia Simpson, Consultant Haematologist ext 3296 

Dr. Katharine Lowndes, Consultant Haematologist ext 3282 

Dr Ashok Roy, Associate Specialist ext 3200





Mrs Gill Knight, secretary ext 3279 

Consultant clinical advice and interpretation is available 24 hours a day from the oncall 

Haematologist (contacted by bleep via the Hospital switchboard). 

Other Haematology and Blood Transfusion staff 

Mr Stephen Knight, Lead BMS in Haematology ext 3294 

Mr Roger Chant, Transfusion Specialist Practitioner ext 4756 

Dr Jane Needham, Principal BMS ext 3293 

Haematology/Coagulation laboratory ext 3294 

Transfusion laboratory ext 3290 

Urgent requests - Haematology/Coagulation ext 3292 

- Blood Transfusion ext 3290 

Sister Vicki Warburton, Anticoagulant Nurse Practitioner ext 3295 

Sister Jackie Schuster, Anticoagulant Nurse Practitioner ext 3295 

Sister Niamh MacIndoe, Anticoagulant Nurse Practitioner ext 3295 

Phlebotomy 

Mrs Jenny Dykes, Phlebotomy services and training ext 3961 

Histopathology 

For clinical advice and interpretation, technical advice, histology reports or to 

arrange urgent investigations 

Dr Hanan El-Mahallawi, Consultant Histopathologist ext 3298 

Dr Ian Ilesley Consultant Histopathologist ext 3302 

Dr Asmat Mustajab, Consultant Histopathologist ext 3301 

Consultant’s secretaries ext 3271, ext 3533, ext 3640 

Miss Alison Taylor, Department Manager ext 3280 

Laboratory enquiries ext 3300 

Mr William Chapman, Mortuary Manager ext 4749 

Histopathology fax 01256 313273 

NOTE – Please give four days notice of slide requests for MDT or other meetings 

Medical Microbiology and Control of Infection 

For consultant or technical advice, microbiology results, to arrange urgent 

investigations or for control of infection matters including clinical advice and 

interpretation. 

Dr Nicki Hutchinson, Consultant Medical Microbiologist (bleep 2305) ext 3310 

Dr Fatima El Bakri, Consultant Medical Microbiologist ext 3305 

Dr Jorge Cepeda, Consultant Medical Microbiologist ext 3308 

(Consultant on call available through switchboard out of hours) 

Mr Dave Thomas, Laboratory Manager ext 3311 


Infection Control (bleep2356) or contact senior infection control nurses:- 

Hazel Gray, Mobile: 07500990914 or Linda Swanson, Mobile: 0750099012





Hours of Business 

Chemical Pathology – 

Routine service Mon – Fri 08.00 – 20.00 

On call service at all other times including weekends 

Contact Chemical Pathology bleep 2303 

Andrology service 08.30 - 14.00 Monday to Thursday 

Point of Care Testing. Routine service Mon - Fri 09:00 - 17:30. On-call service at all 

other times, Point of Care Coordinator contact via switchboard 

Haematology – 


On call service at all other times including weekends 

Contact Haematology bleep 2304 

Phlebotomy - 

Phlebotomy outpatients Mon – Fri 08.00 – 17.00 

Phlebotomy service to BNHFT Wards Mon – Fri 07.00 – 11.00 

Contact Phlebotomy supervisor for further information on Ext 3291. 

Limited Saturday service for INPATIENTS ONLY, 07.00 – 11.00 

Limited Sunday service for INPATIENTS ONLY, 07.00 – 11.00 

(Limited relates to the following: Wessex Ward, E Floor and C Floor) 

Microbiology – 


Saturday 09.00 – 12.00 

On call service Mon – Fri 17.30 – 09.00 

Saturday 12.00 – Mon 09.00 

Contact Microbiology On call Biomedical Scientist: 

Monday to Sunday 9.00am Telephone: 07721 881673 

Sunday 9.00am – Monday 9.00am Telephone: 07887 794673 

Cellular Pathology – 

Routine service 09.00 – 17.15 

On call service: An on call service is available at the discretion of the Department 

Manager and the Consultant Pathologist 

Please contact the department via switchboard 

Mortuary – 


On call service at all other times including weekends





Pathology Supplies 

At the BNHFT a ward top-up system is operated by supplies. Additional stock may 

be ordered and collected directly from pathology stores during core hours. 

Outside BNHFT orders can be made by fax, email or writing. These are dispatched 

as promptly as possible. However, please allow three working days for delivery. 

Urgent orders may be dispatched the same day within working hours. Service 

users are advised not to hoard supplies as stock is date-coded and issued on a 

rotational basis. For further information please contact Pathology reception. 

Electronic Requesting Through ICE ordercomms 

Internal Hospital Test Requests 

Please follow the instruction detailed in the Trust standard operating procedure TP- 

GEN-ICEREQUEST, located on the Intranet, for requesting all Pathology tests. In 

the event of system failure please revert to the paper based request card system. 

GP Test Requests 

Please follow your local systems operating guide for requesting tests through the 

ICE system. There are 4 general GP systems covered, these are:- EMIS LV, EMIS 

PCS, VISION INPS & ISOFT. For EMIS LV, EMIS PCS & VISION Systems the ICE 

requesting procedure can be located on the GP section of the Trust Website. 

http://www.northhampshire.nhs.uk/gps-doctors/referral-guidance/-usefulinformation/gp-e-requesting/ 

If an interruption occurs with ICE then please revert to the paper request form as 

supplied 

Request cards 

The request card is a crucial document. It is usually the only link between the 

laboratory staff and the ward staff or general practitioner responsible for a patient on 

whom a test has been requested. For efficient processing, all the information 

requested must be given in a legible form. Accurate patient identification is 

obviously of vital importance and wherever possible, please use a computer printed 

patient label on cards or pots. Most computer labels are not suitable for use on 

blood tubes as they cause jams in the processing equipment. This is not the case 

however with those GP practices that print 2-dimensional bar coded patient ID labels 

when the small labels associated can be used on blood tubes without problems 

Requests for pathology tests will NOT be accepted unless there are three matching 

points of identification on both sample and request card. Acceptable data includes 

Full name, date of birth, NHS number, Hospital number or first line of the address. 

Incomplete or discrepant requests will be rejected and the requesting doctor 

informed. Laboratory staff are not authorised to make changes to cards or samples. 

NOTE there are slightly different and more stringent requirements for Blood 

Transfusion. Please specify specimen collection time and date on all samples and 

request cards. 

Clinical information is essential for validation and interpretation of results and to 

enable initiation of further investigations where appropriate. If insufficient information





is given, the Consultant Pathologists reserve the right to decline to perform the 

requested test. 

Request cards must be signed by a doctor or requesting practitioner. Please print 

your name at the bottom of the request form to ensure that you can be contacted 

promptly with significant results or problems. And finally, we can always perform tests 

but it is very difficult to send back reports if you don’t say who the consultant/GP is and 

where. 

Therefore the following legible information is required on the request card: 

• Patient's full name - surname and forename (initials are not acceptable) 

• Date of birth and sex of patient 

• NHS number and, if known, hospital number 

• Patient’s address including the postcode 

• Patient’s contact telephone number 

• The requesting clinician and location 

• Relevant clinical information and any drug therapy 

• The tests being requested 

• Type of specimen with the date and time it was collected 

• Indication if HIGH RISK status 

Additional information may be required for some investigations ie “Special 

Haematology, Thrombophilia and Ante natal screening”. Please see separate 

departmental sections. 

‘Unknown’ patients e.g. those admitted unconscious, unaccompanied and without 

documentation, should have their specimens identified with the casualty number. 

See the Trust Policy for Unconscious Patients. 

Regrettably, specimens will be discarded if they are inadequately labelled, if the 

patient’s identification is in doubt, or if they have leaked and/or been contaminated. 

Request cards for Blood Transfusion and/or blood grouping must have at least three 

identification points. 

Essential 

• Patient’s Full name - Surname and forename (initials are not acceptable) 

• Date of birth 

Plus one of the following 

• NHS number 

• Hospital number 

• or in exceptional circumstances , patient’s address including post code 

The labelling on the Request Card must match the labelling on the sample! 

Also required is Collector's signature, date and time of collection and the 

signature of the requesting doctor





EXCEPTIONS 

A&E shall use a unique patient number for patients who are brought in unconscious 

or unable to be identified. Follow trust procedure 

Sexual Health shall use the unique patient number and date of birth due to patient 

confidentiality. 

The Bone Bank shall use the Bone bank number and date of birth due to patient 


Specimen Collection / Sample Requirements 

It is important to use the correct specimen container and/or tube and take the 

sample at the appropriate time. If you have any doubts, please contact the 

department who will be happy to advise. Further information can be found in the 

departmental specific sections or in the test index at the rear of the handbook. 

Urgent requests 

All requests for work to be handled urgently must be made directly to the laboratory 

concerned by phone as soon as the sample is taken. It is the responsibility of the 

requesting doctor to take the sample and arrange for a porter to bring it to the 

laboratory (bleep charge hand porter on 1201). For Urgent samples from the 

community please discuss these with the relevant laboratory. 

Phlebotomy service 

Trained and experienced staff provide a phlebotomy service on the wards from 0700 

to 1100 hr Mon-Fri. They have to follow a strict timetable and are instructed ONLY to 

collect samples which have been requested on to the Phlebotomy Round through 

the ICE system before 06.30. The phlebotomists do not collect for emergency tests, 

which must be organised by the requesting doctor. 

Between 0800hr and 1700hr Mon-Fri a phlebotomy service is provided in the 

laboratory suite for ambulatory patients, both hospital and GP. Glucose tolerance 

tests are performed during the morning sessions and can be booked through the 

pathology office on ext 4751 (external line 01256 314751). 

Training 

Phlebotomy training is offered by the laboratory for nursing and phlebotomy staff 

within the district. A charge for this service is made to cover our costs. Contact Mr 

Ian Savill ext. 3283. 

Blood Tube supplies 

The laboratory supplies phlebotomy materials to wards and GP practices. A 

topping-up service is provided during the week to wards. GP practices should 

requisition stocks on the appropriate form. It is important that expiry dates on blood 

tubes are reviewed regularly and any stock that is close to the expiry date should be





returned to the Pathology laboratory where prompt use will prevent wastage. 

Blood collection 

Please use only Vacuette system to collect blood samples rather than using a 

needle and syringe. Artefactual results may be obtained when using a syringe and 

then decanting the blood into Vacuum tubes, it is much more expensive and less 

safe. Safety blood collection sets (butterflies) with 30cm tubing combined with a 

dedicated holder should be used to collect samples for Blood Cultures. Other tubes 

can be filled after the Blood Cultures using the same collection set, but it is 

imperative that the Blood Culture bottles are inoculated first. 

To ensure that requests are dealt with effectively, it is essential to comply with the 

following guidelines. Specimens should be placed in the appropriate containers 

which must be securely fastened. 

The vacuum tube system has many advantages: 

Mixing of the correct volume of blood and anticoagulant is instantaneous. 

Wide selection of bottles available with different volumes and anticoagulants. 

Syringes are not required and the volume of blood needed does not have to be calculated 

in advance. 

Closed sampling is safer on the wards and in the laboratory. 

Adaptors for use with butterflies are available for: 

'difficult veins' 

patients who cannot keep still 

situations where continued venous access is required 

Note the preferred order of tube use is ... 

Citrate samples 

Plain Gel Samples 

Heparinised samples 

EDTA samples 

EDTA samples 

Oxalate samples 

BLUE 

YELLOW/GOLD 

GREEN 

LAVENDER 

PINK 

GREY 

If you are not familiar with the system, or wish to have instruction, our phlebotomists will be 

happy to help you. 

Important things to remember when taking blood 

1. Those taking blood must have received appropriate training as defined by the 

National Patient Safety Agency guidelines. 

2. Identify patient correctly before taking blood. Ask patient to state their name 

and date of birth, check their identity bracelet if present. Ensure that all 

details match the request card. 

3. Use the correct blood tube for the test required. Mix the bottle gently after 

collection to ensure activation of any additive. Do not shake. 

4. The sequence of blood vacuum tube collection should be: 

BLUE, GOLD, GREEN, LAVENDER, PINK, GREY.





5. Do not remove tops to manually fill bottles. Vacuum tubes are not designed 

for use in this way and will leak. 

6. Gross errors occur when samples have been collected from an area that is 

receiving an intravenous infusion. Do not take samples from in-dwelling 

access devices unless specific training has been received. 

7. Needles and holders are for single use only and must be disposed of 

immediately into an adjacent sharps container. Needles must not be resheathed 

or removed from the holder. 

8. Take care to prevent needle stick injuries. If you do have a needle stick injury 

contact occupational health or the emergency department immediately. 

9. Under-filled/over filled coagulation (citrate) bottles will be rejected as results 

will be unreliable. 

10. Ensure complete identification is clearly written on the bottle immediately 

after taking samples. Do not pre-label tubes. If labels are used on cards 

ensure that they are on all layers of multi–part cards. 

11. High-risk patients. Both samples and cards must be identified with a ‘high 

risk’ label and each sample should be sealed in a separate plastic bag. 

High-risk groups can include patients suffering from, or thought to be suffering 

from, Hepatitis, CJD, HIV, TB, E coli 0157 and other notifiable diseases. Intravenous 

drug users and patients who have travelled abroad recently and 

present with unexplained high pyrexia should also be treated as high risk. 

12. All blood spillages must be cleaned up immediately. Gloves must be worn 

and special care taken with any broken plastic/glass. The contaminated area 

must be decontaminated with ViruSolve+ or a locally agreed disinfectant. 

13. Blood cannot be accepted by the laboratory without a request card/electronic 

request, which must be completed and signed by the requesting practitioner. 

Black ball point pen and clear printing must be used to ensure legibility. 

Blood Sciences cards are scanned, print one digit or letter within each entry 

box. 

14. Samples sent to the laboratory must arrive in a leak-proof container. Blood 

tubes should be placed in the plastic bag attached to the request card. We 

are unable to guarantee the processing of leaking samples. If not processed, 

these will be disposed of immediately and the requesting doctor informed. 

Patients will be contacted directly if the samples were taken by the 

laboratory. 

15. Samples should be delivered to the laboratory as soon as possible after 

collection. For some tests it is essential that the sample be received and 

processed within 30 minutes (See Test index). Coagulation assays must be 

performed within six hours of taking blood.





16. Requests for urgent tests must be notified directly to the department 

concerned (see phone numbers on pages 5 - 6). Samples must be collected 

or organised by the requesting doctor who must also arrange their delivery to 

the laboratory; within the hospital this can be done by bleeping the chargehand 

porter on 1201. Pathology phlebotomists will NOT collect urgent 

samples nor deliver them to the laboratory. 

17. It is the responsibility of the requesting doctor to ensure that all these 

requirements are met. The laboratory cannot accept the responsibility of 

changing any request card or sample identification. Incomplete request 

cards and incorrectly labelled samples will be brought to the attention of 

requesting doctors and discarded where appropriate. 

Labelling of specimens/sample 

Specimens must be identifiable. Unlabelled samples will not be processed and it is 

the requesting clinician’s responsibility to ensure that samples are labelled correctly. 

The minimum information required on the specimen label is three unique identifiers 

(see exceptions): 

• Patient’s Full Name - Surname and forename (initials are not acceptable) 

• Date of birth 

• NHS number or, if not available, Hospital number 

• In the absence of the NHS Number or Hospital Number the first line of 

address may be substituted. Post code only is not acceptable 

In addition Date, and time if appropriate, of collection 

ICE ordercomms labels MUST NOT BE USED on Transfusion samples 

Addressograph labels MUST NOT BE USED on Transfusion samples 

The container should be sealed in the bag attached to the combined pathology 

request card. Specimens should be transported to the laboratory as rapidly as 

possible after collection to ensure that no significant deterioration occurs before 

processing. 

EXCEPTIONS 

Microbiology requires a minimum of two points of ID for non ICE requests on 

samples rather than three. ICE requests should have minimum of three points of ID 

as above. 

A&E shall use a unique patient number for patients who are brought in unconscious 

or unable to be identified. They must also state sex and approximate age. 

Sexual Health shall use the unique patient number and date of birth due to patient 


The Bone Bank shall use the Bone bank number and date of birth due to patient 


Date and time of samples 

The date the specimen was taken is essential for the laboratory to asses whether 

there has been a delay in receipt of the sample. The 24-hour clock time on





specimens is preferred. Recording of sample time is especially important for blood 

glucose, Digoxin and other drug assays, as therapeutic drug monitoring may require 

dose related timing. Hormone profiles in women may also require the day in the 

menstrual cycle (if appropriate), for interpretation. 

High Risk specimens 

High-risk groups can include patients suffering from, or thought to be suffering from, 

Hepatitis, HIV, CJD, TB, E coli 0157 and other notifiable diseases. Intra-venous 

drug users and patients who have had recent foreign travel with unexplained high 

pyrexia should also be treated as high risk. 

Request forms and samples MUST be labelled with "Danger of Infection" labels, 

placed in a Bio-hazard bag and transported to the laboratory with care. 

To protect all healthcare workers, requests for investigations on high risk samples 

should be the minimum required for diagnosis and good patient management. Great 

care must be taken when obtaining specimens and equipment, such as needles and 

blades, must be immediately disposed of safely into approved sharps boxes. 

Should a spillage of blood, fluids or tissue occur, this should be made safe and 

disposed of appropriately. 

Specimen Transport 

Transport to the laboratory within the Hospital (Trust Staff) 

All specimens, in appropriate containers, inside the designated sealed specimen 

bags must be transported to the laboratory in either a sealed Transport Box or a 

standard Transport Tray. The tray or box must be clearly labelled with the 

International BIOHAZARD label and contact details in case of accident. 

Specimens should be transported to the laboratory as rapidly as possible after 

collection to ensure that no significant deterioration occurs before processing. 

It is not acceptable to carry specimens by hand or in a pocket at any time. 

During working hours all specimens should be delivered to Pathology reception. 

Portering service 

Community units: 

GP surgeries: 

Porters regularly collect samples from BNHFT wards 

during normal working hours 

A daily transport run is made to all of these for the 

collection of specimens. 

A daily transport run is made to all surgeries. 

Patients transporting their own samples are exempt from transport 

regulations, however packing/labelling instructions must be followed.





Transport of specimens from clinics and surgeries 

All pathology specimens must be placed in primary containers and labelled fully with 

three independent patient identifiers (Full name – Surname and Forename, DOB, 

and NHS number (see exceptions p13). If the NHS number is not available the 

Hospital number. In emergencies only the Patient’s first line of address may be 

utilised. Place the specimen into an approved sealed specimen bag with enough 

absorbent material to contain the entire sample should a leak occur. Place the 

request form into the side section of the bag if using ‘Ziplock bags’ (separate from 

the specimen - avoids contamination if spillage occurs). 

The patient details including all relevant clinical details must be written clearly onto 

the request form. 

Infection risk specimens must have a “Danger of Infection” sticker attached to the 

specimen(s) and the request form. 

Specimens should be transported to the laboratory as rapidly as possible after 

collection to ensure that no significant deterioration occurs before processing. 

All samples must be transported to the laboratory in a sealed Transport Box. The 

box must be clearly labelled with the International BIOHAZARD label, UN3373 

Biological Substance Category B diamond and contact details in case of 

accident/incident. 

If initial risk assessments of a patient indicate possible TSE or Hazard Group 4 

organisms i.e. Viral Haemorrhagic Fever the requesting doctor must contact 

the Consultant Microbiologist for advice before specimens are taken and 

dispatched. 

All transport drivers MUST carry ”instructions in writing” in accordance with the 

Transport of Dangerous Goods Regulations (ADR), Chapter 5 (section 5.4.3.4), 

within the vehicle while Pathology specimens are on board. 

NOTE: All van/car drivers must carry spill kits and gloves. (HSE “safe working 

and the prevention of infection in clinical laboratories and similar facilities” 

2003 Appendix 4, section 22) 

Research and Development 

It is the Department's policy to encourage appropriate research and development 

and to promote personal, professional development. Many of the medical and 

scientific staff take an active part in medical education and research. 

Screening Programmes and other non-NHS work 

The Department is involved in health screening programmes and is happy to provide 

quotations for individually tailored schemes and private work. Please contact the 

Blood Sciences Manager. 

The department is also involved in several non-NHS schemes and performs 

pathology testing that includes: 

Private hospitals 

Education courses 

DVLA 

Health screening 

Quality Control





Availability of Results 

The Departments endeavour to process all specimens received in the most timely 

and accurate way possible. Urgent results may be available within the hour, 

following prior discussion with the laboratory. Results for routine haematology and 

biochemistry tests are available via the Pathology computer within 4 – 8 hours. 

Most tests are performed the same day but some take several days and are 

performed in batches. Special investigations may be sent to other centres and 

these results can take two weeks, sometimes longer. 

Turnaround Times 

A full table of representative turnaround times is in the Test Index. Turnaround 

times are routinely monitored as part of the Laboratory’s Continual Quality 

Improvement Programme. 

Reports 

Grossly abnormal results will be telephoned. 

All pathology results are available on the ward terminals through the ICE result 

reporting module, and in times of ICE failure through the ward enquiry programme, 

as soon as they have been authorised for release. Please look here first before 

phoning the laboratory. Hard copy print outs of Chemical Pathology, Haematology 

and Microbiology results can be generated from these terminals to minimise risk of 

transcription errors. 

Standard format reports are computer generated several times a day and can be 

viewed through the ICE results reporting system for all GP surgeries that have 

access. This includes access to Hospital generated results giving GP’s access to full 

patient histories. Surgeries that are linked to the NHS Net and have EDI links have 

the results automatically sent to them, EXCEPT Histology/Cytology reports. Hard 

copies are still sent for Histology/cytology and for other departments if electronic 

transfer is not possible. 

The reference/normal or therapeutic ranges are quoted on the report form for most 

assays. These are current ranges and may supersede other listed ranges. 

A Clinisys WinPath pathology computer system is in use covering all disciplines 

including microbiology, histology, haematology, blood transfusion and chemical 

pathology. Access to the system is available on ward and clinic areas through the 

hospital network. 

WinPath supports a unique password for each user. New members of hospital staff 

requiring access should contact Mr Alex Kelly, computer manager, on ext 3288 for 

password privileges and training. 

An individual password is needed by each person removing blood from the blood 

bank. This will be arranged when attending the blood bank training session. Contact 

Mr Roger Chant ext. 4756.





All new house officers are given pathology computer training as part of the induction 

programme when password access will also be organised 

Out-of-hours service 

An 'on-call' service is provided by haematology, microbiology and chemical 

pathology staff outside routine laboratory hours and at weekends and bank holidays. 

The investigations provided by the 'on-call' service are limited to those shown below. 

Using the service 

Specimens for haematology and chemical pathology should be placed in the red box 

through the metal grille in pathology reception. Immediately results are available they 

will be entered on the computer so interrogate your VDU rather than telephoning the 

BMS. Please be tolerant in cases of delay as yours will not be the only patient 

requiring the service. 

All urgent microbiology specimens out of hours must be delivered to pathology 

reception as above but a doctor should always speak personally to the on-call 

microbiology BMS about the request. 

Service offered 

The work for Chemical Pathology and Haematology should be considered as two 

categories: 

• Investigations that are required to make immediate clinical decisions about 

the patient's management. For such requests it is essential to contact the on 

call biomedical scientist but do not do so until the blood has been taken 

and the samples collected by the porters. 

• Investigations that are required for less urgent clinical decision making/need 

to know within a few hours/should be available for next morning. For such 

requests there is no need to contact the biomedical scientist provided the 

samples are received in the laboratory before 2400 hrs. The on call staff 

remain in the department through the evening and weekend and will analyse 

all samples with tests on the list below whether they have been contacted or 

not. They also remain on site at night but may be resting so if tests are 

required after about 2400 hours but before next morning you should contact 

the relevant BMS on call. 

Ammonia, CSF and Troponin must always be notified 

For investigations other than those detailed below you may be asked to contact the 

appropriate Consultant Pathologist. The requesting doctor may also be asked to do 

this for listed tests if the request seems unreasonable. Non-urgent biochemistry 

requests may include other tests, but these will only be analysed: 

- if available on main analyser 

- if time permits 

otherwise samples will be secured and analysed next routine working day.





Requests for work with no element of clinical urgency must not be made outside 

normal working hours unless the patient will not be available in routine hours. 

The following investigations are available as out-of-hours tests: 


Serum Troponin Amylase Glucose 

Sodium Potassium Chloride * 

Creatinine Urea CRP 

Calcium Phosphate Magnesium 

Bilirubin ALT AST 

CPK DIG Lithium 

Paracetamol Salicylate Osmolality 

EDTA WB Ammonia 

Urine Sodium Potassium Osmolality 

CSF Glucose Protein 

Spectrophotometry ** 

* Chloride available only for paediatrics, or for cases of poisoning. 

** On call BMS will scan out of hours if urgent clinical decision needed but will 

reserve the right NOT to interpret scan if equivocal until seen by Consultant 

Biochemist 

Haematology and Blood Transfusion 

Microbiology 

Haemoglobin 

White cell count 

Platelets 

Haematocrit 

Cross-match 

Blood group 

Issue of Blood Products 

DCT 

ESR (specific conditions only) 

Malarial parasites Sickle test 

Prothrombin time/INR APTT. 

Thrombin time 

Fibrinogen 

D-Dimer (specific conditions only) 

Factor assays at request of Consultant haematologist only 

Issue of appropriate blood products 

CSF 

Examinations of fluids which are turbid or when meningitis 

is suspected and immediate treatment needs to be 

instigated. 

Microscopy Urgent microscopy of a specimen where it is considered 

necessary in order to attempt to make an immediate 

diagnosis of the bacterial cause, e.g. abscesses or septic 

arthritis. 

Blood culture Specimens should be collected by the medical staff and





placed in the incubator in the main pathology laboratory reception. 

NOTE: The collection site for Blood cultures MUST be cleaned using an 

alcohol wipe and allowed to dry immediately prior to specimen collection. 

The rubber bung on the top of the blood culture bottle MUST also be cleaned 

using an alcohol wipe prior to inoculation. 

On weekdays the majority of other specimens can be left overnight and cultured the 

next day. This does not significantly delay reports or decrease chances of pathogen 

isolation and enables clinicians to collect specimens before starting antibiotics. 

Such samples should be stored as follows: 

Urines 

Pus and other swabs 

Stools 

Sputum and exudates 

boric acid bottle room temperature out of direct sunlight 

transport medium room temperature 

refrigerator 

refrigerator 

At weekends and bank holidays a delay of several days can be avoided by 

inoculating non-urgent specimens. The on-call microbiology BMS will undertake this 

task but it is reasonable to allow such specimens to accumulate during the day and 

be dealt with as a batch in the evening. Please make it obvious that such specimens 

can be dealt with when convenient and differentiate them from any which require an 

immediate microscopy report and in the latter cases contact the BMS on call.





DEPARTMENTAL SPECIFIC INFORMATION 

CHEMICAL PATHOLOGY 

Outline of service 

The Department of Chemical Pathology provides a comprehensive clinical advisory 

and analytical service including: 

routine biochemistry such as electrolytes and investigation of renal, hepatic, 

bone and lipid disorders 

specialised biochemistry including therapeutic drug monitoring and toxicology, 

endocrinology and paediatric biochemistry 

emergency investigations, rapidly available by prior arrangement on a 24-hour 

basis 

andrology (semen analysis) a limited andrology service, including a post 

vasectomy service. 

We participate in national and international external Quality Assurance Schemes 

encompassing the analytical work of the department. 

A Consultant Biochemist is available for advice during normal working hours and on 

a 24 hour basis through the hospital switchboard. General practitioners and 

clinicians are encouraged to contact the laboratory for advice on appropriate tests, 

abnormal results, or further investigations whenever required. 

Hours of Service 

The department is open routinely from 0800 to 1730 hours Monday to Friday with a 

limited, extended operation through to 2000 hrs weekdays. All other periods are 

covered by the on call service. For further details see “Out-of-hours service”. 

Laboratory Organisation 

The laboratory is divided into automated and manual sections, offering about one 

hundred and fifty tests in house, which covers over 99% of requests. We also have 

access to a network of specialist referral laboratories offering a further range of three 

hundred or so tests. A clinical justification must be given for all tests, especially in 

the case of referred tests. If adequate clinical information is not provided, the 

Consultant may decline to carry out the investigation. 

The laboratory is extensively equipped with state-of-the-art analysers, enabling a 

greater range of tests to be performed on a daily basis and making other tests more 

readily available for the emergency on-call service. A further advantage is that





smaller blood samples are required for most investigations. 

“Profile requesting” in which large groups of tests are performed routinely and 

uncritically has been clearly shown to be at best unhelpful and at worst to increase 

morbidity by prompting unnecessary invasive procedures. Tests should be 

requested individually and for a purpose. 

Patient preparation 

Gender, age, diet, time of day, exercise, posture and prolonged venous occlusion are 

all factors that may influence some investigations. If in doubt, ask. 

Many drugs can interfere with tests. If in doubt, state which drugs your patient is 

taking. Further information on factors affecting individual tests may be found in the 

Test Index. 

Samples 

See also 'Phlebotomy' 

Please give time of sample collection (especially important if urgent or in case of 

blood glucose, cortisol, dynamic function tests, therapeutic drugs etc.). 

Please avoid delays in getting the blood samples to the laboratory. Some special 

samples have to be separated within 10 minutes of collection, as they are unstable. 

Do not refrigerate unseparated specimens. 

Blood specimen tubes 

Please refer to the test index for the full list of sample requirements. In general: 

1. Clotted blood is preferred for the majority of biochemistry investigations (gold 

topped vacuum tube) and is essential for lithium analysis. 

2. Fluoride-oxalate blood is needed for glucose or lactate (grey top vacuum 

tube). Within the hospital, clotted blood is accepted for glucose except for 

glucose tolerance tests. Outlying sites must use grey top tubes. 

3. EDTA blood is needed for HbA1c, ammonia, renin/aldosterone, ACTH and 

carbon monoxide (lavender top vacuum tube). 

4. For most combinations of tests, 4ml of clotted blood (gold top) will suffice. 

Paediatric samples 

Special tubes are available for paediatric use. Heparinised blood is acceptable for 

most tests as it yields more plasma from very small samples than clotted blood. 

Where applicable, please clearly indicate order of priority among tests when several 

are requested on samples of small volume 

(e.g. 1-Na/K; 2-Creatinine; 3-LFT). 

Blood samples that must be taken in the phlebotomy suite at BNHFT 

or from in-patients at BNHFT and brought immediately to pathology reception:





ACTH 

Ammonia 

Carboxy/Met haemoglobin 

Cryoglobulin 

G-1-P UT 

Gut hormones 

IGF1 

Lead/heavy metals 

PTH (Calcium at the same time) 

Renin/Aldosterone 

Tacrolimus, Everolimus, Serolimus 

Vitamins D 

Aldosterone/Renin 

Calcitonin 

C Peptide 

Cyclosporin 

Growth Hormone 

Hydroxybutyrate 

Insulin (Glucose at the same time) 

Methotrexate 

Porphyrins 

Retinol binding Protein 

Tryptase 

17 Hydroxyprogesterone 

Special tests and Dynamic Function Tests 

The above tests require special collection procedures. There are protocol sheets 

available from the laboratory for tests, some additional to those above, which may 

involve special patient preparation and/or the injection of hormones and serial 

specimen collections. Please contact the laboratory before taking a sample. The list 

is not exhaustive - if in doubt, ask 

Thyroid Function Testing 

For the routine assessment of thyroid function only TSH is performed as the first line 

test. Free T3 and/or free T4 will only be performed by the laboratory if the TSH 

concentration is outside the reference range or if specifically requested by the 

requesting clinician. It is therefore important that the requesting clinician specifically 

requests free T3 on all patients who are receiving or who have received treatment 

for thyrotoxicosis. Similarly, free T4 should always be specifically requested on 

patients with known or possible hypothalamic pituitary disease. 

Lithium 

Lithium has a narrow therapeutic range necessitating blood levels between 0.4 – 1.2 

mmol/L. The lower end of this range is used for elderly and infirm patients and the 

upper end for younger patients, particularly those being treated for an episode of 

mania. It is entirely possible for an elderly patient at the upper limit to experience 

toxicity. The NICE guidance is that when initiating long-term treatment, clinicians 

should aim for levels of 0.6 – 0.8 mmol/L, with higher levels possibly being of benefit 

for patients with predominantly manic symptoms. 

Antibiotic levels – Gentamicin and Vancomycin 

Use Chemical Pathology request protocol. Requests out of 

hours will be referred to the Consultant Microbiologist on call. 

Fluids 

Pleural, ascitic or drain fluids should be sent in a white top universal container. 

Calculi 

Calculi should be sent in a white top universal container. 

Please do not use boric acid (red top) containers as the stone fragments may be 

difficult to locate amongst the boric acid crystals. 

Faeces 

Faecal samples should be sent in a plain wide-mouthed lab container. The 

minimum of a grape-sized sample is required but do not fill the container more than





two-thirds full. 

Urine samples 

Bottles for 24 hour urine collections are issued by the laboratory together with an 

instruction sheet relevant to the test requested. The following are best performed on 

24-hour collections: 

Electrolytes Uric Acid Cortisol 

Creatinine clearance * Catecholamines/metabolites ** Calcium *** 

Phosphate *** Oxalate *** Citrate *** 

* Ensure 5 ml of clotted blood is collected within the 24 hours of the urine 

collection. This should be sent to the laboratory attached to the urine 

container. Outpatients should bring their 24 hour urine sample to the 

laboratory on the morning of final collection and have blood taken from them 

before they leave the laboratory. 

** Catecholamines/metabolites and 5HIAA should be collected into acetic acid. 

Special container available from laboratory as is a list of interfering drugs. 

*** Calcium, Phosphate, Citrate, Oxalate must be collected into hydrochloric acid. 

Special container available from laboratory, CARE required. 

Protein/creatinine ratios are a useful screen in place of 24 hour protein output and 

can give a rapid result in conditions such as pre-eclampsia. 

Most of these tests can also be performed on spot samples for paediatric patients 

when the ratio to creatinine will be reported. 

All other commonly requested urine investigations require random urine samples. A 

plain 'universal' container is required (white top), not one containing boric acid (red 

top). 

Reference Ranges and Turnaround Times 

Please refer to the test index. These are also available on the ward enquiry computer 

terminals alongside the results. 

Sample storage and Time Limit for requesting Additional Tests 

The laboratory stores blood samples for 48 hours after the final report has been 

issued. 

Requests for retrospective testing on blood samples is not recommended but will be 

considered if the request is made within 36 hours of sample collection. 

Samples that may be required for further investigations or forensic reasons can be 

stored for several months but it is important that a specific request is made by the 

doctor to the laboratory staff to keep such samples.





Telephoned Results 

Results falling below the lower limit or above the upper limit given in table below will 

be telephoned. 

Analyte 

Lower action 

limit 

Sodium (mmol/L) 125 155 

Upper action limit 

Potassium (mmol/L) 2.8 6.0 (see below) 

Glucose (mmol/L) 2.5 25.0 

Urea 

(mmol/L) 

30.0 (OPD/GP or in-patient 1 st result) 

10.0 if patient less than 16yrs old 

Creatinine 

(umol/L) 

Calcium-corrected (mmol/L) 1.80 3.20 

Phosphate (mmol/L) 0.30 

Magnesium (mmol/L) 0.40 

AST (IU/L) 800 

ALT (IU/L) 800 

400 (OPD/GP or in-patient 1 st result) 

200 if patient less than 16 yrs old 

Bilirubin (umol/L) 300 (Paediatric only) 

CK (IU/L) 3000 

Amylase (IU/L) 500 (OPD/GP or in-patient 1 st result) 

Digoxin (ug/L) 3.0 

Phenytoin (mg/L) 25 

Theophylline (mg/L) 25 

Phenobarbitone (mg/L) 70 

Carbamazepine (mg/L) 15 

Lithium (mmol/L) 1.2 

Triglycerides (mmol/L) 20.0 

CRP (mg/L) 400 (OPD/GP or in-patient 1 st result) 

Free T3 (pmol/L) 30 

Free T4 (pmol/L) 5 

Cortisol (When not post dex) 

(nmol/L) 100 

Troponin (ug/L) 0.05 (GP/OPD only) 

Ammonia 

(umol/L) 

Bile Acids (umol/L) 14.0 

100 (Neonate 0 – 3 days 

47 (> 3 days, 1 st result)





Useful clinical information - Common causes of spurious results 

Please ensure that you follow instructions when collecting and storing samples. 

Inappropriate sample collection, storage and transport can interfere with a number of 

results. Some examples are given in the table below: 

Problem Common causes Effect 

Inappropriate collection 

site 

Sample taken from drip arm Increased drip analyte 

e.g. K , Glucose 

Dilution effect, low results 

Incorrect container or 

anticoagulant 

No fluoride oxalate 

E.D.T.A. contamination 

Li sample collected into Li 

Heparin 

Decreased glucose 

Decreased Ca and Alk P 

Increased K 

Increased Li 

Incorrect tube fill/mixing 

Delay in separation of 

serum/plasma 

Labile analytes 

Storage 

Haemolysis 

overnight storage 

delay in transit 

Not immediately separated 

and frozen 

Biochemistry samples in a 

fridge 

Expelling blood through a 

needle into the tube 

Vigorous shaking 

Extremes of temperature 

ALL analytes may be 

compromised 

Increased K, PO4, LDH 

Decreased ACTH, Insulin, 

C Peptide and Gastrin 

Increased K 

Increased K, PO4, AST, LDH, 

Iron, Par, CPK, TP, Trig 

Decreased AMY, ALP





Andrology 

The Andrology Laboratory is an integral part of the Fertility Service offered within this 

hospital. Andrology investigations include basic semen analysis and semen 

assessment following vasectomy. 

Reference values for semen assessment are defined by the World Health 

Organization: Manual for the Examination and processing of Human Semen 

(FIFTH EDITION) 2009 and have been generated from several prospective, crosssectional 

studies of semen quality and fertility. The attached table provides lower 

reference values of semen characteristics of recent fathers, whose partner became 

pregnant within 12 months of stopping use of contraception. 

Parameter 

Semen volume (ml) >1.5 

Total sperm number (106 per ejaculate) >39 

Sperm concentration (106 per ml) >15 

Total motility (PR+ NP, %) >40 

Progressive motility (PR, %) >32 

Sperm morphology (normal forms, %) >4 

pH ≥ 7.2 

*MAR test (motile spermatozoa with bound particles, %) 50% positive) 

**Vitality (live spermatozoa, %) >58 

Lower reference mean 

Cooper TG et al. (2009) World Health Organization reference values for human 

semen characteristics. Human Reproduction Update. 

High viscosity samples can interfere with sperm motility and concentration 

*The mixed anti-globulin reaction or MAR test uses IgG- coated latex particles 

and anti-serum to human IgG. In the presence of spermatozoa with IgG 

antibodies the spermatozoa adhere to the latex particles. WHO considers that 

testing for IgG antibodies is adequate, since IgA antibodies almost never occur 

with out IgG antibodies. Low sperm concentrations and / or reduced sperm 

motility can give unrepresentative results and will not be reported. 

**Test only performed if the number of immotile sperm is greater than 50% 

It is important to note that semen characteristics are highly variable, both within and 

among men, and are not the sole determinants of a couple’s fertility; the ranges 

therefore provide only a guide to a man’s fertility status.





THE SERVICE: 

• The Fertility laboratory has been a CPA enrolled laboratory since 2005 

• Member of the UK national NEQAS quality control scheme since 1998 

• Samples are received by appointment only, enabling prompt analysis within a 

limited time window 

• Early morning appointments are available, offering as little disruption as 

possible in a friendly, relaxed surroundings 

• The Fertility department is open between 08.30am and 15.00pm Monday to 

Thursday with a 24hr answering service to pick up messages 

• Client confidentiality and wellbeing is paramount 

• Samples are initially analysed within one hour of receipt and generally 

reported within 3 working days 

For further information, specimen requirements and request forms please 

contact: 

Denise Riddell MSc FIBMS 

Senior Biomedical Scientist Andrology Unit 

Tel: 01256 313352 

E- mail: fertility.services@bnhft.nhs.uk





HAEMATOLOGY AND BLOOD TRANSFUSION 

Haematology Section 

The haematology section provides a clinical diagnostic and therapeutic monitoring 

service, covering haematology coagulation and anticoagulation services 

Coagulation services 

The laboratory provides a comprehensive diagnostic and therapeutic monitoring 

service for haemostasis and thrombotic disorders and services a designated 

haemophilia comprehensive care centre. 

Requests are examined to ensure appropriate tests are performed and additional 

specialised tests added when indicated. It is therefore essential that appropriate 

clinical details are provided on the request form to facilitate this. Please do not 

hesitate to contact the laboratory for scientific or clinical advice. 

Samples 

It is essential that the correct specimen container is used with correct volume of 

blood. This is to ensure the correct blood-to-anticoagulant ratio. The standard 

Vacuette bottle in use for coagulation tests requires the addition of 3.0 ml blood to 

give a final volume of 3.5 ml. Please only use Vacuette needles and let the tube fill 

until it stops naturally. Do not fill with needle and syringe. A special 1.0 ml bottle can 

be requested and made up in the laboratory for paediatric samples when the larger 

blood volume cannot be obtained; however, there may be insufficient volume to 

provide all necessary tests. 

Please note: tests for haemostasis or thrombosis WILL NOT be performed on 

under-filled, over-filled, haemolysed, clotted specimens or unlabelled or incorrectly 

labelled specimens. 

NB: Phlebotomy tuition and/or practice is available in the laboratory bleeding area 

by prior appointment. 

Routine samples should be transported to the laboratory as soon as possible, but 

within 4 hours at most. Requests for retrospective testing on blood samples is not 

recommended but will be considered if the request is made within 12 hours of 

sample collection. 

Patients for platelet function testing need to be bled in the laboratory. This test is 

performed by appointment. 

Samples for investigations of bleeding and thrombotic disorders should ideally be 

taken in the laboratory to enable rapid freezing and processing of sample as 

appropriate.





Blood Transfusion Section 

Roger Chant Transfusion Specialist Practitioner Ext 4756 

Dr Sylwia Simpson Lead Consultant For Transfusion Ext 3296 

Transfusion laboratory Ext 3290 

The Blood Transfusion Issue Blood Bank is located on B Floor in the Pathology 

Department. There is a locked door via the reception area. The code for this door 

will be found at each ward station. All blood issued for transfusion, Emergency O Rh 

D Negative Blood, Fresh Frozen Plasma and Cryo Precipitate will be found in this 

Blood Bank. Platelets need to be stored at room temperature and so will be found on 

the bench next to the Blood Bank Register. 

Blood and Blood Component Traceability 

From November 2005, the EU Directives have made it essential for all Trusts to be 

able to trace blood and blood component transfusions from vein to vein, ie donor to 

recipient. 

In this Trust the requirement is met by use of the Blood Transfusion Report which 

staff involved MUST complete and sign. Each unit must be checked at the bedside 

and report signed that the patient has received the unit of blood with the date and 

time of start and finish. All the essential observations must be documented on this 

sheet and the bottom copy returned to the Transfusion Department when the 

transfusion is complete. Failure to complete and record this information makes the 

Trust liable in criminal law. 

Please ensure that this confirmation of all blood and blood components transfused is 

recorded and the bottom sheet returned to the Transfusion Department immediately 

after the transfusion. 

Grouping and Crossmatching 

The laboratory has a fully automated analyser for processing Blood Group and 

Antibody Screens, on Trust Patients and antenatal requests. Crossmatches for 

operations are only performed according to the blood order schedule (see 

“Indications of blood transfusion requests”) otherwise the sample is held for a Group 

and Save. Deviations from the blood order schedule must be accompanied by a 

valid reason on the request form. Patients scheduled for major operations should 

have a group and screen sample taken at the pre-operative assessment clinic for 

testing, the request for crossmatch may then be taken on admission (usually the day 

before the operation) unless otherwise stated on the report. Failure to take a group 

and screen sample at pre-operative assessment may cause a delay in providing 

compatible blood to cover the operation, if the patient has atypical antibodies. 

Emergency crossmatches are performed as soon as the sample is received in the 

laboratory. It is essential to phone the laboratory when an emergency crossmatch is 

required.





Emergency O Rh D Negative Blood 

Two units of emergency O Rh D Negative blood are held in the blood issues fridge in 

Pathology. When required they should be taken in the cool box provided. They must 

be returned to the blood bank immediately if they are not used. It is essential to 

complete the labels on these units of blood and return them to the Blood 

Transfusion Department if the blood is used, in order to complete the audit trail. The 

Blood Transfusion department MUST be informed when they are taken so that they 

can be replaced. 

The Blood Transfusion Department is served by the National Blood Service Centre 

at Southampton. There is a daily routine delivery of blood and blood products. The 

orders have to be placed by 09.30am on the date of delivery. Urgent deliveries will 

be made at any time by BTS if we run short of blood, however these will be generate 

an additional charge. If blood is required urgently it can be requested blood by “blue 

light” and it will be with us within 45 minutes. Orders for platelets should be in the 

laboratory by 09.30am each day so that the Transfusion Department can plan their 

workload effectively. 

For more details on blood transfusion in clinical practice see “Standards in Blood 

Transfusion Practice”, a copy of this document is held on each ward area. 

Sample Required for the Transfusion Department 

Group and Save 

6 mL EDTA 

Crossmatch (incl. Group & save) 6 mL EDTA 

Ante-Natal Blood Group & antibodies 6 mL EDTA 

Antibody Screen 

6 mL EDTA 

Direct Coombs Test 

6 mL EDTA or 3 ml EDTA 

Kleihauer 

3 mL EDTA 

Cold agglutinin titre 6 mL EDTA (to be kept at 37 o C) 

Immune Haemolysins 

6 mL EDTA 

Warm auto antibodies (incl. Eluate) 6 mL EDTA and 3 x 3ml EDTA 

Drug related antibodies 

6 mL EDTA 

Donath Landsteiner 

6 mL EDTA and 2 x 3ml EDTA 

Antibody titres 

6 mL EDTA 

Anti-D quantitation 

6 mL EDTA 

HLA antibodies 

6 mL EDTA7-10ml clotted 

Platelet antibodies 

20mL EDTA and 10ml clotted blood 

HLA B27 

6 mL EDTA 

HLA Typing 

12 mL EDTA 

HLA A,B,Cw 

12 mL EDTA 

HLA DR, DQ 

12 mLEDTA 

HLA B28 

6 mL EDTA





Useful clinical information - Common causes of spurious results 


Inappropriate sample collection, storage and transport can interfere with a number of 

results. Some examples are given in the table below: 


Inappropriate collection 

site 

Sample taken from drip 

arm 

Incorrect tube fill/mixing Failure to adequately mix 

the sample 

Delay in sending the overnight storage 

sample to the laboratory delay in transit 

Will dilute any antibody present 

which may be missed on the 

crossmatch 

May result in clots in the sample 

making it invalid for 

crossmatching 

May reduce some antibody 

activity, or cause haemolysis 

making the sample unsuitable for 

testing 

Haemolysis 

Incorrect container or 

anticoagulant 

Sample taken from 

wrong patient 

Expelling blood through a 


Vigorous shaking 

Extremes of temperature 

Plain bottle, or any bottle 

other than an EDTA 

sample 

Bad phlebotomy 

technique, / patient 

identification 

Haemolysed samples are 

unsuitable for crossmatching 

Unsuitable for testing 

Wrong blood which could lead to 

clinical incident 

Tests carried out 

-Full ABO cell and serum grouping and rapid ABO cell grouping 

-Full Rh D grouping with two anti D's and rapid spin Rh D grouping 

-Partial D testing and genotyping when appropriate, but not routinely 

-Antibody screening by gel column technology 

-Kleihauer tests 

-Direct Coombs test, broad spectrum and split fractions 

-Cross matching 

-Identification of atypical blood group antibodies. 

-Antibody titres 

-Cold agglutinin titres 

-Donath Landsteiner test





-Haemolysin tests 

-Preparation and examination of eluates 

-Examination and identification of drug related antibodies 

-Group A sub typing, i.e. A2, A3, Ax. 

-Autoabsorption tests for auto immune haemolytic anaemia 

Turnaround Times 24 hrs 

Emergency Crossmatch 

20 minutes 

Full Crossmatch 

60 minutes 

Full Crossmatch from a Group and Save 30 minutes 

The following tests are referred to the National Blood Service at Filton: 

-Difficult antibody investigations and rare blood group confirmations 

-Quantitation of Anti-D and Anti-c 

Allo absorbtion tests fro Auto immune haemolytic anaemia 

Routine Request Turnaround Times 10 days 

Urgent Request Turnaround Times 12 hours 

Sample Reception 

NHS Blood and Transplant – Filton 

FAO: Red Cell Immunology 

500 North Bristol Park 

Filton 

Bristol RB34 7QH 

The Following Test is sent to the Blood Group Reference Laboratory 

-Foetal Grouping 

Turnaround Times 

14 days 

Dr Peter Martin 

International Blood Group Reference Laboratory 

500 North Bristol Park 

Filton 

Bristol RB34 7QH 

The following tests are referred to the Histocompatibility and Immunogenetics 

Laboratory at the National Blood Service Tooting 

-White cell and platelet antibodies 

-HLA B27 - Monday till Thursday 

-Other Specific HLAs – Monday - Thursday 

-HLA typing - only by prior arrangement. 

Turnaround times 21 days





Sample Reception 

National Blood Service - Tooting Centre 

FAO: Histocompatibility and Immunogenetics 

Cranmere Terrace 

Tooting 

London SW17 0RB 

Request card and sample requirements 

All request cards and samples submitted to the Blood Transfusion Department must 

be correctly filled in with three points of identification: 

• full name 

• date of birth 

• hospital number/ NHS number/AE number and/or first line of address 

Also required is Collector's signature, date and time of collection and the 

signature of the requesting doctor 

All requests for the following tests must be made on the pink Blood Transfusion 

request card: 

-group and save serum 

-group and crossmatch 

-request for any blood products. 

All other requests may be made on the normal pathology request card. 

All specimens sent to the Blood Transfusion Department must be clearly identifiable 

and labelled with the following information: 

• surname and forename 

• date of birth 

• date and time of sample 

• hospital number/ NHS number/AE number and/or first line of address 

• ward if applicable. 

see under 'The Request Card' on page 8 and Labelling of Samples on page 13 for 

further information. Incomplete request cards and/or samples will not be accepted. 

Addressograph labels are not acceptable on any samples. 

Unlabelled samples will not be accepted under any circumstances. They will be 

disposed of to protect patients. Inadequately labelled specimens will also not be 

accepted. 

Accident & Emergency “unknown” patients 

There is a numbering system in the Emergency Department to label samples from





any patients who are unable to be identified. The sex of the patient must be added 

to the request card and an approximate age if not known. This system must be used 

so that the patient can be clearly identified in the Emergency Department and when 

they get to theatres. Failure to use the system will result in confusion and delay. 

The Blood Transfusion Department staff will not add any information to request 

cards or specimens. If an unconscious patient is subsequently identified, the 

Department will continue to use the emergency number until a new request card and 

specimen of blood are received with the patient's full identification. 

All blood crossmatched using the emergency number will be withdrawn after 12 

hours unless the patient is still not identified. 

Hospital Blood Bank 

All crossmatched blood is stored in the Blood Bank in the Pathology Department at 4 

degrees centigrade which has special alarm systems to protect the blood. It is not 

permitted to store blood in any other fridge throughout the hospital. Only one unit of 

blood should be taken at a time unless two drips are being used. 

There is a cool box provided for theatre use only, when more than one unit of blood 

is required because of a difficult surgical procedure. Blood may be kept in this box 

for up to four hours. Any unused blood must be returned as soon as possible. This 

cool box MUST be used when taking emergency O Rh D Negative blood. 

Provision of Blood Products 

The Blood Transfusion laboratory provides the following blood products which must 

be requested using the pink Transfusion request card. Current guidelines must be 

adhered to. 

-fresh frozen plasma 

-cryoprecipitate 

-platelet concentrate 

-iv immunoglobulin 

-human albumin 

a) 4.5% 500 mL, 250 mL 

b) 20% 100 mL 

-Factor VIII and Factor IX. 

-other specialised factor products 

-C1 esterase inhibitor 

Immunoglobulin Anti-D 

Immunoglobulin Anti-D is issued by the Transfusion laboratory to all Rh negative 

women who give birth to a Rh positive infant. The following possible sensitisation 

events should also receive anti D in Rh D Negative women in the prevention of HDN, 

250 IU before 20 weeks and 500 IU after 20 weeks: 

-still birth 

-APH 

-amniocentesis





Prophylactic Anti-D 

-trauma in pregnancy 

-abruptio placentae 

-turning a breech 

-TOP 

-threatened abortion 

-miscarriage/Inevitable abortion (unless





Blood Transfusion. All staff attending will receive a certificate of training, and a log on 

code for the computer system. Contact Mr Roger Chant for training information or 

book on the MLE website. 

Antenatal Antibody Clinic 

Pregnant ladies with antibodies should be referred to the Transfusion Specialist 

Practitioner Roger Chant who will discuss with them the nature and problems 

associated with the antibodies. Appointments can be made via ext 4756 or ext 3290 

Indications for Blood Transfusion Requests 

General Surgery 

Patients to Group and Save: 

Abdominoplasty 

Amputation of Leg - Above and Below Knee 

Angiography 

Angioplasty 

Bowel Resection 

Breast Reduction 

Breast Excision 

Cholangiogram 

Cholecystectomy laparotomy/laparoscopy Common Bile Duct Exploration 

Closure of Colostomy / Revision Embolectomy 

Endoscopy 

Grafting of Burns 

Haemorrhoidectomy 

Hartmans/Reversal 

Hemicolectomy 

Hiatus Hernia Repair 

Ileostomy/Revision Ileostomy Laparoscopy 

Laparotomy 

Liver Biopsy 

Liver Resection 

Low Anterior Resection 

Mastectomy 

Myelogram 

Oesophageal Dilation 

Open Pleural / Lung Biopsy 

Parathyroidectomy 

Perforated Ulcer 

Pyeloplasty 

Radical Open Prostatectomy 

Rectopexy 

Polypectomies 

Sclerotherapy 

Tonsillectomy 

Thyroidectomy - Partial / Total Tracheotomy 

TUR Prostate 

TUR Bladder Tumour 

Ureterolithotomy 

Vagotomy/Highly Selective Vagotomy 

Varicose Vein Removal 

Patients to Crossmatch: 

Abdo Perineal Resection 

Adrenalectomy 

Anterior Resection 

Aortic Aneurysm Repair 

Aorto Femoral Bypass 

Axillo Femoral Bypass 

Bifemoral Bypass 

Colectomy 

Cystectomy 

Femoro Popliteal Bypass 

Gastrectomy / Partial 

2 Units 

3 Units 

2 Units 

4 Units 

2 Units 

2 Units 

2 Units 

2 Units 

2 Units 

2 Units 

2 Units





Laryngectomy 

Lobectomy / Pnemonectomy 

Nephrectomy 

Oesophagectomy 

Oesophagogastrectectomy 

Patients to Crossmatch (cont’d): 

General Surgery 

Panproctocolectomy 

Parks Pouch 

Pseudomyxoma 

Renal Transplant 

Splenectomy 

Whipples Operation 

2 Units 

2 Units 

2 Units 

4 Units 

4 Units 

2 Units 

2 Units 

4 Units 

2 Units 

2 Units 

4 Units 

Obstetrics 


APH 

Breech 

Foetal Distress 

Grand Multi Para 

PET / Hypertension 

Placenta Previa Standby Type minor 

Retained Placenta 

Twins / Triplets 

Abruption 

Caesarian Section 

Forceps 

Induction of Labour 

Previous PPH / APH 

Repeat LSCS 

Trial of Scar / Labour 

Unstable Lie 


LSCS with Hb Less Than 100 g/L 

LSCS with Rare Antibodies 

Placenta Previa Standby Type major 

Placenta Previa LSCS Type minor 

Placenta Previa LSCS Type major 

2 Units 

2 Units 

2 Units 

2 Units 

4 Units 

Gynaecology 


Aldridge Sling 

Colposuspension 

Dilation and Curettage 

Foetal Death 

Molar Pregnancy 

Oophorectomy Simple 

Pelvic Floor Repair 

Hysterectomy 

Tubal Surgery 

Ectopic Pregnancy 

Laparotomy 

Termination of Pregnancy 

Cone Biopsy 

ERPC 

Incomplete Miscarriage 

Myomectomy 

Ovarian Cyst / Mass 

Reversal of Sterilization 

Trans Cervical Endometrial Resection 

Vaginal Repair 

Salpingectomy






Oophorectomy Radical 

Pelvic Exenteration 

Ruptured Ectopic 

Vulvectomy 

Wertheims Hysterectomy 

2 Units 

4 Units 

2 Units 

2 Units 

2 Units 

Orthopaedics 


ACL 

Arthroscopy 

Bone Grafting 

Discectomy 

Fracture Neck of Femur* 

Internal Fixation of Humerus 

Internal Fixation of Ankle 

Laminectomy 

Removal of Metalwork 

Spinal Decompression 

Total Hip Replacement 

Amputation Below Knee 

Austin Moore 

Decompression 

Dynamic Hip Screw* 

Internal Fixation of Tibia / Fibula 

Internal Fixation of Radius / Ulna 

Internal Fixation of Patella 

Osteotomy Tibial / Femoral 

Spinal Fusion 

Spinal Block 

Total Knee Replacement** 

*unless significantly anaemic 

**Autologous blood salvage technique available, see “Standards in 

Transfusion 

Practice document for details 


Fracture Shaft of Femur 

Osteotomy Pelvic 

Bilat Hip Replacement 

Revision Hip Replacement 

Bilat Knee Replacement 

Revision Knee Replacement 

Traumatic Above Knee Amputation 

"Aggressive" Spinal Decompression 

2 Units 

2 Units 

3 Units 

3 Units 

2 Units 

2 Units 

2 Units 

2 Units 

Anticoagulant Services 

The Haematology Department provides a comprehensive anticoagulant outpatient 

monitoring service through a team of experienced Consultant, nursing and scientific 

staff. The laboratory utilises a computerised anticoagulant management 

programme, which facilitates warfarin dosing, makes appointments and records 

length of treatment and clinical and drug histories for all patients. The laboratory 

provides a report to patients GP on each visit with details of INR, current dosage and 

the next appointment. Patients receive their Anticoagulation letter with





recommended dosage by return of post. When results indicate (eg large dose 

changes or raised INR results), patients are contacted immediately by telephone if 

possible. 

Clinics 

All new patients attend the anticoagulant clinic at the Haemophilia Centre for their 

first INR check and are seen by the Nurse Practitioner who will also see GP 

referrals. Subsequently the patient may continue to attend a hospital-based clinic or 

be bled at their GP surgery, with their sample and warfarin request sent to the 

laboratory. If attending the hospital, patients only need to see the Nurse Practitioner 

when they have an anticoagulant related problem or if unstable. All other hospital 

and GP patients have their warfarin dosage returned by post. 

Referral for Out-patient Anticoagulant Monitoring 

To enable the department to provide safe and appropriate anticoagulant monitoring, 

it is MANDATORY that the following information is sent to the Anticoagulant Nurse 

Practitioners c/o Pathology Office, prior to the patients appointment date at the 

anticoagulant clinic. If patients have been started on anticoagulant therapy by their 

GP this information MUST accompany first sample sent to the laboratory. Please fill 

in anticoagulant chart or send letter providing ALL the following information: 

-Patients name, address, telephone number and hospital number, NHS number 

-Indication for anticoagulant therapy, history, previous thromboembolism 

episodes 

-Target INR 

-Duration of anticoagulation 

-Other medication 

-GP name and address 

-Intercurrent illnesses, e.g. ulcer, hypertension 

-Previous warfarin dosages up to date first seen in anticoagulant clinic 

Hospital Clinic times 

Basingstoke and North Hampshire Hospital Monday and Thursday 0900–1200 hrs 

Alton Community Hospital Wednesday 0900–1030 hrs 

GPs are encouraged to bleed anticoagulant patients on a Wednesday but if this is 

difficult, please avoid Fridays.





HISTOPATHOLOGY 

Outline of service 

The Histopathology Department offers a routine histology service including 

immunohistochemistry, Her-2, non-gynaecological cytology and a rapid service for 

frozen sections. It also liaises with the mortuary service who perform post mortem 

examinations. 

Normal hours of service 

Histology - Monday to Friday 0900 to 1715 hrs 

Mortuary - Monday to Friday 0800 to 1600 hrs 

Samples and labelling 

Interpretation of a specimen is highly subjective and dependent upon the information 

supplied with the specimen. The request card must be completed fully and legibly. 

The absence of clinical details may prevent the issuing of a meaningful report. 

Incorrect or inadequate patient details will result in a delay as the specimen will be 

returned to the sender for verification or alteration. As part of obtaining informed 

consent for surgery and histology investigations, your patient must be aware that 

blocks and slides are archived for future review should this be necessary and may 

contribute to good laboratory practice procedures such as quality control, audit and 

teaching. 

It is an essential requirement for Histopathology investigations that the requesting 

clinician signs and dates the request card to indicate that informed consent has 

been given. 

Where several specimens are sent from one patient, the specimens must be clearly 

identified together with the request card. All specimen labelling MUST BE on the 

container, NOT on the lid. 

If there is a danger of infection, e.g. TB, hepatitis, HIV, the specimen and the 

request card must be clearly labelled. 

Routine Histology Specimens 

Specimens for routine histology should be placed in at least three times their volume 

of 10% buffered formalin. 

Routine Cytology Specimens 

Non-Gynae Cytology specimens including Joint fluids, urines and sputum should be 

collected in 30-60ml non sterile universal white top containers 

All cervical smears (Gynae Cytology) are examined at RHCH Winchester. 

Where there is a Danger of Infection (e.g. tuberculosis, hepatitis B, HIV positive), the 

specimen container and the request card must be so identified. Specimens and





request cards will normally be transported in the plastic bags provided, but special 

care to ensure that this is so will be needed where there is Danger of Infection. 

Please discuss such cases with the Consultant Pathologist before such specimens 

are sent - a risk assessment will need to be made before the work is carried out. 

Pleural, ascitic fluid and cyst aspirates:- 

A small amount (20 to 30 mL of the fluid) should be sent to the laboratory as quickly 

as possible. Please do not send the whole drain bag to the laboratory. Where delay 

is likely, e.g. over the week-end, store in a 4 o C refrigerator. 

FNA sample requirements:- 

Slides – Slides MUST be labelled with TWO points of patient identification as a 

minimum (Full name and NHS/Hospital number or DOB). This should be written on 

the slide in pencil prior to applying fixative. 

Aspirates – 30/60ml non-sterile universal container with patient information written in 

pen as above. 

Training in FNA slide preparation is available by contacting the Histopathology 

Department manager on ext 3280. 

Urgent Specimens 

Urgent specimens should be clearly marked as URGENT and delivered to the 

laboratory as soon as possible. For small specimens a report will normally be issued 

the next working day. 

The sample must arrive in the laboratory by 5pm at the latest for next day results. 

Same-day reporting may be possible on small biopsies provided this is discussed 

with the Consultant Pathologist prior to sending the specimen and the specimen is 

received in the laboratory before 1100 hrs. 

Frozen Sections 

Specimens for frozen sections must be placed into a suitable container without 

formalin or any other preservative or liquid. 

Frozen sections must be booked at least 24 hours in advance to ensure a 

Consultant Histopathologist is available. The nature of the clinical problem should 

be discussed with the Pathologist at the time of booking to ensure optimum 

interpretation. The case should be first on the operating list and the laboratory 

MUST be informed if the frozen section is cancelled. 

Where possible, unplanned frozen sections will be accommodated, but the 

laboratory must be telephoned prior to sending the specimen. The Consultant 

Histopathologist may wish to discuss the nature of the problem briefly with the 

surgeon/anaesthetist concerned at this time. 

The specimen MUST be handed to a member of staff within the Histology





Laboratory. It must not be left at Pathology Reception or elsewhere within the 

laboratory. Please write the extension number to which the report is to be phoned 

clearly on the request card. 

Where there is a danger of infection, frozen sections will not normally be performed 

in order to reduce the risk of exposure of laboratory staff to infectious material and to 

avoid the withdrawal of the frozen section service for 24 hours whilst the cryostat is 

decontaminated. 

Direct Immunofluorescence (Skin Biopsies) 

A fixative solution is available from the laboratory for these samples. Once collected 

they should be sent to the laboratory as soon as possible. 

Post Mortems 

See 'Mortuary'. 

Reports 

Reports are available from the Ward Enquiry System. Printed reports, where 

necessary, are sent out on the same day that the report is available on the 

computer. 

The Consultants preliminary findings may be discussed prior to the issue of the final 

report if clinically required. 

Turnaround times 

The departments Turnaround time targets are as follows: 

• Diagnostic Biopsies – 90% in 5 days 

• All other Histology – 90% in 10 days 

• FNA Cytology – 90% in 5 days 

• All other Cytology – 90% in 5 days 

Specimens requiring decalcification will take longer, possibly up to several 

weeks. Larger or more complex specimens may take longer. 

HISTOLOGY routine reference laboratories 

HER2, EGFR and KRAS testing are referred to Source Bioscience, 1 Orchard Place, 

Nottingham Business Park, Nottingham. NG8 6PX. TAT 14 DAYS 

Lymphoma referrals are sent to Cellular Pathology, Level E, Southampton General 

Hospital, Tremona Road, Southampton. SO16 6YD. TAT 28 DAYS





MORTUARY 

Deaths in hospital 

You will normally be asked to certify death promptly, whether by day or night. If 

relatives are present you should see them with the nurse in charge who will support 

you and will then know what has been said. The body is then laid out, with hands 

placed by the patients’ sides, eyes and mouth closed where possible and all drains, 

catheters lines and cannulas left in situ. The Notification of Death form is then filled 

out with the blue copy attached to the patients shroud and the green to the sheet 

they are wrapped in. A wristband with the patients details must be placed on both 

the wrist and the ankle. Where there is a danger of infection (Hepatitis B, HIV, 

Tuberculosis etc.) the body is placed in a leak-proof body-bag, and marked with a 

'Danger of Infection' label attached to the outside of the body-bag. For a list of 

infections that require body-bags please see the trust infection control policies. 

Please note that both MRSA and C. Difficile Patients DO NOT require body-bags. 

For reasons of confidentiality the nature of the infection is not stated. On receipt of 

the patient in the Mortuary, the Pathology Technicians will contact the ward to 

ascertain the nature of the infection, this is necessary as Exposure Prone 

Procedures may need to be undertaken. The precise nature of the infection is not 

passed to the Funeral Director; however they are informed a danger of infection is 

present and that embalming should not be carried out. 

Having recorded the fact of death you must decide whether you can accept 

"jurisdiction" over the death and can complete a Death Certificate. This means that 

you have treated the patient within the last fourteen days, that death has not been 

from an industrial cause, from an accident or overdose or is unexpected as from 

unknown causes or has occurred during an operation or before recovery from an 

anaesthetic. Such deaths must be referred to the Coroner. See Deaths to be 

reported to the Coroner (p45). 

Death Certificates 

Please deal with death certificates before you start on other work in the morning. It 

is the policy of the Hospital that when relatives arrive following a death, all personal 

items, together with the Death Certificate are ready and waiting. Relatives will 

normally be seen by the Patients & Relative Support Manager, extension 4777, 

bleep 1100. Relatives must not be asked to return later to collect the death 

certificate. 

Death Certificates for infants dying within 28 days of birth are to be issued from the 

book entitled "Medical Certificate of the Cause of Death of Live born Children Dying 

within the First 28 days of Life". 

Cremation Papers 

The Patient & Relative Support Managers also handle cremation papers. Please 

complete promptly and do not leave them in the Information Room. It should be 

remembered that the forms have to be at the Crematorium 24 hours before the





actual cremation takes place. For a Cremation paper to be completed, two parts 

must be filled out by two different Doctors. The first doctor will need to be one who 

treated the patient during their last illness. This will usually, but not always, be the 

doctor completing the death certificate. The second doctor must be on a different 

team to the first and have at least five years registration with the GMC. Both Doctors 

will need to have performed an external examination of the patient after death. This 

usually takes place within the Mortuary but can be undertaken on the ward. To make 

an external examination in the Mortuary, the department must be contacted on 

ext.4749 to arrange a suitable time. 

Pacemakers 

Should a pacemaker be fitted, this must be removed before cremation. This will be 

done at the Funeral Directors. If you are completing a Cremation Paper it must be 

indicated that a Pacemaker is in situ but that it has not been removed. Please ask 

The Patients & Relative Support Manager (ext 4777, bleep 1100) or the Mortuary 

(ext.4749) for further advice if necessary. 

Routine Post Mortems 

For a Routine Post Mortem to be requested you must be able to certify the death. If 

not the case should be referred to the Coroner for a Coroners Post Mortem. Should 

a routine Post Mortem be requested, a signed appropriate consent will be required 

(normally obtained by your consultant). The Patients' & Relative Support Manager, 

(ext 4777, bleep 1100) will arrange for the relatives to be spoken to in the office on B 

level (normally between 0900 to 1200 hr). Wherever possible we avoid relatives 

having to return to the ward. They deal with patient’s personal possessions and 

advising relatives about registering the death with the Registrar, the death certificate, 

funeral and cremation arrangements. The Patients & Relative Support Manager will 

always be willing to advise you. 

The patient's notes together with the completed request form and signed permission 

from the next of kin are forwarded by the Patient & Relative Support Manager to the 

Mortuary. It is the responsibility of the Doctor to ensure prompt transfer of the 

patient notes etc. to the Patient & Relative Support Manager to avoid delay and 

distress to relatives anxious to proceed with funeral arrangements. Please put the 

signed consent form attached to the front of the patient's notes with the PM request 

form in an envelope and "post" through the letter box provided in the Patient & 

Relative Support Manager office outside normal working hours. Failure to carry out 

this procedure may result in the request being overlooked or delayed, leading to 

added distress to the relatives. 

Post mortems will normally be performed the morning of the next working day after 

the paper work is received in the mortuary. 

The Death Certificate must be completed before the Post Mortem so that relatives 

are not delayed organising the funeral. Provided the box on the death certificate is 

marked, the OPCS will write to the Pathologist at a later date asking whether the PM 

findings alter the certified cause(s) of death. This information is then used for 

statistical purposes only.





Please write your name and bleep number clearly so that you can be invited to 

attend. If it is not possible for you to attend, the Pathologist will normally bleep you 

with the findings later. A written report is sent to the consultant with a copy to the 

patient's GP, provided this information is given on the request form. 

Danger of Infection 

Please contact the Consultant Histopathologist where there is a known or suspected 

infection (e.g. Hepatitis B, C, HIV, and Tuberculosis). A Post Mortem will not 

normally be carried out. A risk assessment will be made and a modified procedure 

may be possible. The request form should be clearly marked. 

Deaths to be reported to the Coroner 

You cannot accept jurisdiction (i.e. cannot complete a death certificate) for deaths 

resulting from: 

- Fractures or other injury resulting from road traffic accidents or other 

accidents. 

- Drugs, toxins, or alcohol poisoning. 

- Privation or neglect. 

- Recovery from anaesthetic. 

- Prisoners or patients held under Sections of the Mental Health Act. 

- Occupational disease e.g. asbestosis 

- Intra-operative deaths. 

- Suicides 

These cases must be referred to the Coroner (Mr. A. Bradley, 01256 478119), or the 

Coroner's Officer at Basingstoke Police Station (01256 405015). There is no rule 

that deaths within 24 hours of admission must be reported to the Coroner provided 

you are sure of the cause of death. If in doubt please do not be afraid to contact the 

Coroner, he will be only too happy to advise you. Please do not delay - contact the 

Coroner as soon as possible after 9 a.m. 

Once the death has been accepted by the Coroner he has jurisdiction over the death 

and he writes the Death Certificate. He may ask for a Post Mortem to be performed 

and for which consent from relatives is not required. Once the Coroner has ordered 

a Post Mortem this is then required by law and the relatives are unable to intervene. 

Form G28 is then completed by the Coroner's Officer. The information needed by 

the Officer is obtained from the patient's notes and interviews with relatives etc. 

conducted normally from the Patients & Relative Support Manager on B. Level. 

There should be no need for police officers to come to the ward except occasionally 

at weekends. 

Post mortems for the Coroner are normally performed the morning after receipt of 

the G28. Unless it is likely that there will be an inquest, the consultant and/or GP will 

be sent a copy of the report.





An inquest is usually held where death is from unnatural causes (e.g. trauma). You 

may be asked for a statement (through the Patient & Relative Support Officer). On 

rare occasions you may be asked to attend the inquest; if so always inform your 

consultant. 

Foetuses 

Foetuses 

All Foetuses under 14 weeks must be taken to Histology. Foetuses delivered out of 

normal hours should be refrigerated at 4 degrees Celsius in the department and sent 

to Histopathology at 09:00hr the next working day. 

The Mortuary at the Basingstoke and North Hampshire Hospital will be the receiving 

area for all specimens over 14 weeks. Foetuses will not be accepted without a 

pregnancy loss and infant death form, Infant Release form, Notification Plan and a 

completed Pathology request form if it is required for Histology. All foetuses must be 

sent fresh without formalin. If private burial is required it MUST be noted on the 

request card. 

Parental consent is required before Histological examination can be carried out and 

a completed Post Mortem consent form must be sent with the request card with any 

other documents according to the current protocols. The placenta should 

accompany (also sent fresh). If the foetus needs a Post Mortem examination it will 

be sent to Southampton General University Hospital. Results will usually be known 

two weeks after the foetus has been sent. 

Viewings 

During Core hours 

Viewings can be arranged between the hours of 10:00am and 16:00pm and should 

be arranged via the Patient & Relative Support Manager (ext.4777 Bleep 1100). 

They will then contact the Mortuary to arrange a specific time for the relatives to 

attend. Viewings are assigned 45 minute sessions in the Mortuary to attempt to 

accommodate all requests. The 45 minute session is when the relatives may be 

within the viewing area and does not start from when they arrive on site. Late 

arrivals may be allowed an extra 15 minutes depending on workload. The last 

available time for a viewing will be at 15:15. 

Allowance is made for the Maternal and Child Health Division and times may be 

booked outside these hours with prior arrangement with the Mortuary (ext. 4749) 

Outside of Core Hours 

An out of hours viewing service operates on weekends and Bank Holidays between 

11:00 and 16:00. Monday to Friday all viewing arrangements must be made within 

the core hours.





Viewing arrangements discussed outside of these times will be solely at the 

discretion of the on call Pathology Technician due to other essential Trust 

commitments provided by the Mortuary department. 

A minimum of 1 hours notice must be given before any arrangement can take place 

out of hours. 

To arrange a viewing out of hours the on call Pathology Technician must be 

contacted through the Hospital Bleep Holder on bleep 1436. Once a time has been 

arranged the relatives should make themselves known to the receptionist at the 

Hospital main entrance on B floor. The On call Pathology Technician will then meet 

the relatives at the main entrance and escort them to the Mortuary. 

When arranging a viewing you must clearly indicate that the time agreed is the time 

that the relatives should be at the main entrance, and that the appointment is for 45 

minutes.





MEDICAL MICROBIOLOGY 

Medical Microbiology and Control of Infection contact details 

For consultant clinical advice and interpretation of results or laboratory technical 

advice, microbiology results, to arrange urgent investigations or for control of 

infection matters. 

Dr Nicki Hutchinson, Consultant Medical Microbiologist, infection control lead 

(bleep 2305), ext 3310 

Dr Fatima El Bakri, Consultant Medical Microbiologist ext 3305 

Dr Jorge Cepeeda, Consultant Medical Microbiologist ext 3308 

(Consultant on call available through switchboard out of hours) 

Mr Dave Thomas, Laboratory Manager ext 3311 


Senior Control of Infection Nurse (bleep 2364), ext 6774 or 3734 

Outline of Service 

The medical microbiology department offers a full range of investigations in 

bacteriology, mycology, serology, parasitology, virology and PCR based testing 

through its in-house facilities and links to referral centres. 

It provides a 24 hour, 7 day urgent service for rapid clinical decision making. 

Normal working hours are 0900 – 1730hrs Monday - Friday 

The department is headed by three Consultant Microbiologists who are always 

available for clinical advice. A Consultant Microbiologist also leads the Infection 

Control service with a senior and two junior infection control nurses. 

'Mass Screening' should not be instituted without prior discussion with the Senior 

Nurse Infection Control or a Consultant Medical Microbiologist. 

Control of Infection 

The infection control team provide a pro-active ward based service for the 

Basingstoke and North Hampshire Hospitals NHS Trust and are also available to 

give advice on all infection control issues, such as screening for MRSA, isolation of 

infectious patients. The nurses are available on bleeps 2364, 2365 and 2366 

between the 0700 and 1700 hours. At other times contact the on-call Consultant 

Microbiologist for advice





On-call services 

Monday – Friday 5.30pm – 9.00am Telephone: 07721881673 

Saturday – Sunday 9.00am Telephone: 07721881673 

Sunday – Monday 9.00am Telephone: 07887794673 

Sample requirements - Microbiology 

If reliable results are to be obtained, the following points should be observed when 

taking specimens: 

• All specimens must be labelled with the patient's full name, date of birth and 

date and time of collection. 

• They must be accompanied by properly completed request cards which state 

the NHS number/hospital number, name and date of birth of the patient, 

the ward or surgery, the name of requesting medical officer, the nature of the 

specimen and the site from which it was taken, the clinical diagnosis and 

duration of illness, the nature of any antibiotic therapy (including recent or 

intended treatment) and finally the investigation required. Separate 

specimens must have separate request cards. 

• Specimens for microbiological investigations must never be in contact with 

any antiseptics or disinfectants, e.g. Hibitane, or preservatives, e.g. Formalin. 

• All specimens for culture must be sent to the laboratory immediately after 

collection. Whenever possible specimens should be sent early in the day so 

that there is time to examine them during normal working hours. The 

laboratory must be notified when urgent specimens are being sent. 

• All specimens and request cards from patients who are HIV-antibody positive, 

suffering from Hepatitis B or C or Tuberculosis, or patients who may have 

these conditions, must be labelled with 'Danger of Infection' stickers. These 

specimens must be sent in a sealed plastic bag. 

• Specimens must be sent in proper laboratory containers which are available 

from Pathology Reception. The laboratory will refuse to investigate any 

pecimens received in improper containers or hazardous conditions. 

If there is any doubt about an investigation, or an investigation not listed below is 

required, please consult the laboratory before obtaining a sample. 

Specimen Collection/Sample Requirements 

Best results are obtained when an appropriate, well taken specimen, in the correct 

container, is delivered to the laboratory promptly with the relevant clinical information 

on the request form. Further information regarding the collection of specimens can 

be found in the test index.





• Microbiology samples MUST be accompanied by a request form stating the 

following information: 

o Clinical details including travel history 

o Any antimicrobial therapy 

o Date of onset and duration of illness 

o The anatomical site of any wound 

o Useful epidemiological information e.g. In cases of diarrhoea, 

occupation of adults, nursery or school of children, any occupational or 

recreational risks 

• Leaking samples will not normally be processed 

Requesting Extra tests 

Extra tests on samples maybe requested within 48hrs of the sample collection, 

however, additional investigations will only be carried out as deemed appropriate by 

the Clinical Microbiologist. 

Individual test details 

For full test details see test index. 

Actinomycosis 

Blood culture 

Pus in a sterile container is essential. Swabs are extremely 

unreliable 

Reports usually ready within 2weeks. 

Use only BacT-Alert bottles. 

Clean the collection site and the rubber bungs of the blood 

culture bottles with alcohol wipes prior to specimen 

collection and allow to dry. 

Blood from adults should be split into aerobic and anaerobic 

bottles. NOTE – fill anaerobic bottle first unless using safety 

collection sets/butterfly needles then fill aerobic bottle first 

due to air in the tubing. 

A single Paediatric bottle should always be used for children. 

Do not remove the bar codes from the bottles nor obscure them 

with labels. 

Reports usually ready within 24 hours but some organisms take 

longer 

Cerebro-spinal fluid Collect 0.3 mL into a fluoride oxalate tube (for glucose) 

and 0.5 mL into 3 or 4 separate sterile plastic universal 

containers. Universals No. 2 and 3 are sent to us for the 

bacterial and viral studies. The fluoride oxalate sample and 

universal No. 1 (which may be contaminated with skin 

organisms) should be sent directly to Chemical Pathology. 

NOTE – if spectrophotometry for xanthochromia required, 

collect a fourth universal containing 1 mL CSF and send to 

Chemical Pathology.





Always contact the laboratory when sending a CSF 

Microscopy will be phoned as soon as possible. 

Culture usually ready within 24-48hr. 

Faeces (for microscopy and/or culture) 

For ova, cysts and parasites, hot stools are not necessary. The 

specimens for both microscopy and culture must be sent in a 

standard screw-capped container, available from Pathology 

reception. Select a sample of stool not contaminated with urine. 

Make sure the top is screwed on tightly to prevent leakage. 

Place container in self-sealing plastic bag and deliver to the 

laboratory. 

For threadworm ova - see separate entry. Rectal swabs should 

only be sent if faeces are unobtainable. 

Relevant information required: 

- the age of the patient 

- whether the patient has been abroad and where? 

- date of onset of illness 

- antibiotic therapy especially if Cl. difficile is suspected 

Unless otherwise indicated, specimens will only be cultured for 

Salmonella, Shigella, Campylobacter and E. coli 0157. The 

investigation of Rotavirus, Norovirus and Adenovirus will be 

carried out on appropriate stools. Cl. difficile toxin will only be 

investigated after Microbiology Consultant/Infection Control 

review. 

Microscopy reports usually ready same day. Culture up to 3 

days 

Fungi 

Scrapings of the skin, nail clippings, plucked hair, etc. should be 

placed in folded clean black paper and sent to the laboratory in 

a labelled paper envelope. 

Reports usually ready: Microscopy 1 week. Culture 2-3 weeks 

Genital Specimens 

Gonorrhoea 

Female: Cervical and urethral (NOT high vaginal) swabs 

should be sent. Suspicion of gonorrhoea must be 

indicated on the request cards. 

Reports usually ready within 2 days 

Male: Urethral swabs should be sent. Suspicion of 

gonorrhoea must be indicated on the request cards. 


Trichomonas vaginalis 

High vaginal swabs. Diagnosed microscopically. 

Reports usually ready within 1 – 2 days 

Gardnerella vaginalis/ bacterial vaginosis 

High vaginal swabs. Diagnosed microscopically.






Candida 

High vaginal swabs. Diagnosed microscopically and on 

culture 


Chlamydia 

Endocervical swabs for female patients and urethral 

swabs from males. The swabs must be “Chlamydia 

swab” and placed into the correct transport medium. A 

NAAT test performed on the first void urine is now the 

standard test. 


Antibiotic levels – Gentamicin, Tobramycin, Teicoplanin and Vancomycin 

Gentamicin and Vancomycin levels are performed by Blood 

Sciences. 

Tobramycin and Teicoplanin are referred by Microbiology. Use 

microbiology request card. Samples must reach the laboratory 

by 1100 hr. Requests out of hours will be referred to the 

Consultant Microbiologist on call. 

Reports usually ready by 1400hr. 

Respiratory Syncytial Virus 

Nasopharyngeal aspirates should be sent. Do not send mucoid 

specimens as these give uninterpretable results. Please consult 

the laboratory before sending specimens for investigation. This 

test is only available during late autumn and winter. 

Reports usually ready within same day 

Serous fluids These should be sent in sterile laboratory container e.g. 

universals and NOT histology pots (these are not sterile, may 

contain formalin and are not leakproof). 


Sputum (for tuberculosis see below) 

For routine microscopy, culture and sensitivity, collect sputum 

sample, the result of deep cough (preferably early morning) into 

a plastic screw-capped container available from Pathology 

reception for this purpose. Non-purulent, salivary specimens will 

not be examined, nor will specimens which are more than 12 

hours old. NOTE – to exclude TB, three consecutive early 

morning sputa must be sent for testing 

In patients with a severe pneumonia, consider sending urine for 

pneumococcal and legionella antigen testing. 


Surgical (eg biopsies and tissue samples) 

These should be sent in sterile laboratory containers. If the 

specimen is small and in danger of drying out, add a little





normal saline to it. DO NOT send specimens for microbiological 

investigation in formalin. 


Swabs 

NOTE - if pus is available, send this in a sterile laboratory 

container rather than a swab. 

Transwabs should always be used but special ear, nose and 

throat swabs are available if a small swab is needed. All these 

swabs are available from Pathology reception. Inoculated swabs 

should be kept at room temperature out of direct sunlight. Note: 

swabs have expiry dates; please use oldest stock first. 

With ‘ wound’ swabs it is very important to state the site and 

nature of the wound, be it a cut, bite, operation wound etc. and 

also the type of operation that has been performed as this will 

help us differentiate between commensals and pathogens. A 

commensal in one site could well be a pathogen in another. 


Threadworm ova (Sellotape slide) 

If threadworms are suspected, a sellotape slide should be 

obtained as follows. Obtain a glass slide. Apply a single strip of 

sellotape (2 inches long) to the anal area first thing in the 

morning before washing or passing faeces. Stick sellotape FLAT 

on the slide without folds and label the end of the slide. Place 

the slide in a slide box (available from the laboratory) and send 

to the laboratory. 

Reports usually ready within 24 hours 

Tuberculosis 

Sputum - The result of a deep cough (preferably early morning) 

should be collected in a sterile plastic screw-capped container, 

available from Pathology reception. 

Reports usually ready within 3-8 weeks. Antimicrobial 

sensitivities take another 4-8 weeks. Microscopy 1-2 days. 

Urine Culture - Three consecutive early-morning specimens of 

200ml each are required. Bottles available from Pathology 

reception. 


sensitivities take another 4-8 weeks 

Other specimens - e.g. bronchial brushes, serous, (pleural) 

and peritoneal fluid CSF and pus. These should be collected in 

sterile containers, e.g. universals. 


sensitivities take another 4-8 weeks 

Body Tissues - Again in sterile containers and if in danger of 

drying out, add a little sterile normal saline. 


sensitivities take another 4-8 weeks





NOTE – samples can be fast tracked for TB PCR when clinically 

indicated. 

Urines (for TB see above) 

A clean urine specimen, if possible midstream, should be 

collected directly into a sterile plastic boric acid bottle marked 

'For Bacteriological Use Only'. This bottle contains boric acid 

crystals as a preservative - DO NOT WASH THESE OUT. 

These bottles MUST ALWAYS and ONLY be used for the 

diagnosis of urinary tract infections 

Details of antibiotic therapy is vital for correct interpretation of 

results. 

After collection the sample should be kept at room temperature 

and out of direct sunlight until arrival at the laboratory. 

Reports usually ready within 1-2 days 

Viral cultures 

Viral swabs for Herpes (HSV) investigations are conducted in 

house, whilst other viral investigations are conducted at a 

reference laboratory 

Whooping cough Special culture medium is used for the culture of Bordetella. 

Therefore it is very important to give prior warning to the 

laboratory so that such medium can be prepared. Pernasal 

swabs (available from the laboratory) should be taken and 

inoculated directly onto culture medium. This should then be 

returned to the laboratory as soon as possible. 

Culture is of little value if symptoms have been present for more 

than one week or if erythromycin has been given. 

Reports usually ready within – at least 3 days 

Worms 

Whole worms or segments should be sent in a glass or plastic 

container. 

Reports usually ready within 24 hours 

Sample requirements - Serology 

For all serological investigations send 10 ml of clotted blood i.e. in a plain bottle with 

no anticoagulant). The following tests are performed at The Basingstoke and North 

Hampshire Hospital. 

Hepatitis A IgM For diagnosis of acute illness. State date of onset of hepatitis 

/jaundice. 

Reports usually ready within 1 day 

Hepatitis A Total Post vaccination or for confirmation of past infection 

Reports usually ready within 2-3 days 

Hepatitis B Surface Antigen 

State risk factors (unless routine screening in pregnancy) 

Reports usually ready within 1 day





Hepatitis B Surface Antibody 

State date and number of immunisations. 

Reports usually ready within 1 week unless needle stick injuries 

which will be ready within 48 hours 

Hepatitis B Core Antibody 

For detection of previous infection or natural immunity 

Reports usually ready within 1 week 

Hepatitis B e Antigen 

To determine level of infectivity 


Hepatitis B e Antibody 

To determine level of infectivity 


Hepatitis C Antibody State risk factors (otherwise test will not be done) 


HIV Antibody 

State risk factors (unless routine screening in pregnancy) 


Rubella Screening Only used for evidence of past infection 


Syphilis Serology State symptoms and whether there is a past history of 

Treponemal infection. 


Lyme Disease Serology (screen only) 

State whether history of tick bite and date of onset of rash or 

other symptoms. 


Influenza Rapid Diagnostic Test 

Only available after discussion with Consultant Microbiologist 

Toxoplasma Serology (screen only) 

There is no value in routine screening in pregnancy. 


Varicella/ZosterVirus antibody 

Used only for pregnant women and immunosuppressed patients 

who have been exposed to infection. 


Helicobacter Faecal Antigen Testing






CMV IgG Antibody As clinically indicated 


CMV IgM Antibody As clinically indicated 


Norovirus 

EBV Capsid 

EBV Nuclear 

Other tests 

For use in outbreaks 


For clinical diagnosis of acute disease 

Reports usually ready within 2 weeks 

As above 

All other serological test are performed at reference 

laboratories. 10mL clotted blood should be sent and must be 

accompanied by a separate request card for each test 

requested. 

Request cards must have full clinical details. Especially 

important is the date of onset of the illness. Any specimen 

without full detailed history of illness or the date of onset will not 

be forwarded. If possible, acute and convalescent sera should 

be sent. (Convalescent sera should not be collected earlier 

than 10 days after the onset of the illness.) 

Special note on Meningococcal Serology and PCR 

In order to confirm the diagnosis of meningococcal disease in 

patients who have already received antibiotics the following are 

necessary: 

- An acute specimen of clotted blood taken around the time of admission. 

- An EDTA sample of blood taken on admission. 

- A convalescent specimen of clotted blood taken about seven 

days after the onset of symptoms. 

Communicable Diseases 

These tests are carried out at Manchester PHL 

The following diseases (or suspicion of) are notifiable by law to the Consultant in 

Communicable Disease Control; the clinician who considers or diagnoses the 

infection is responsible for the notification. Persistent carriers of typhoid bacilli and 

other Salmonellae should also be reported. For optimal in-hospital infection 

control, the Infection Control Team must also be informed.





List of Notifiable Diseases (2010) 

• Acute Encephalitis - bacterial and viral 

• Acute Meningitis 

• Acute Poliomyelitis 

• Acute Infectious Hepatitis 

• Anthrax 

• Botulism 

• Brucellosis 

• Cholera 

• Diphtheria 

• Enteric fever 

• Food Poisoning (or suspected food poisoning) 

• Haemolytic Uraemic Syndrome (HUS) 

• Infectious bloody diarrhoea 

• Invasive Group A Streptococcal disease and Scarlet Fever 

• Legionnaires’ Disease 

• Leprosy 

• Malaria 

• Measles 

• Meningococcal septicaemia 

• Mumps 

• Plague 

• Rabies 

• Rubella 

• SARS 

• Smallpox 

• Tetanus 

• Tuberculosis - pulmonary and non-pulmonary 

• Typhus 

• Viral Haemorrhagic Fevers (VHF) 

• Viral hepatitis 

• Whooping Cough 

• Yellow Fever 

As of April 2010, it is no longer a requirement to notify the following diseases: 

dysentery, ophthalmia neonatorum, leptospirosis and relapsing fever. 

Notification should be made by telephone in the first instance followed by notification 

on the official form to: 

Hampshire & Isle of Wight HPU 

Unit 8 

Fulcrum 2 

Solent Way 

Whiteley 

Farham 

PO15 7FN 

Tel: 0845 055 2022 

Fax: 0845 504 0448 

Email: hiowhpu@hpa.org.uk





To contact a public health doctor in an emergency out of hours; in the evenings, at 

weekends or during bank holidays, please call: 02380 77 72 22 

Notification by phone only must also be made to the Infection Control Department 

(Ext. 6774). Out of hours contact the on-call Medical Microbiologist. The Infection 

Control Department should also be informed of any diseases/pathogens not listed 

here which present a risk of hospital acquired infection e.g. MRSA, Group A 

Streptococcus in a wound etc. 

Reports 

Reports on all specimens are issued to the requesting medical officer immediately 

the investigations are completed. They can also be seen on the hospital computer 

system as soon as they have been authorised. Telephone the Department only in 

cases of urgency. Results thought to be important will be telephoned to the 

requesting doctor, usually by a Consultant Microbiologist. Under no circumstances 

will results be given directly to patients. 

In addition to final results, the following can be found on the computer as soon as 

they have been processed: 

-CSF microscopy 

-the status of blood cultures 

Please use this facility as it saves time for both you and the laboratory. 

Availability of Results 

Please refer to the test index for individual turnaround times. 

• Urgent microscopy results 

• Rapid antigen detection tests 

• Some urgent blood tests with prior arrangement 

• Routine investigations 

• Non routine investigations 

• Referral tests 

2 hours 

4 hours 

Same day 

2-3 days 

3-7 days 

14days 

Results of urgent clinical or public health significance will be telephoned to the 

requesting clinician. These include: 

• Positive blood cultures 

• Microscopy of non routine cerebrospinal fluids 

• Detection of AFB 

• Significant isolates from faeces samples 

• Positive CD tests 

• Isolates of Group A streptococci 

• Isolates of Group B streptococci from neonates, pre and post 

delivery HVS 

• Gentamicin assay results 

• MRSA on initial isolation





Common causes of spurious results 


Inappropriate sample collection, storage and transport can interfere with a 

number of results. Some examples are given in the table below: 

Bacteriology 


Delay in transport/ incorrect 

post collection 

storage 

Samples not refrigerated 

Incorrect container 

Blue trans swab for 

virus/chlamydia 

Overgrowth of growing 

bacteria 

Overgrowth of bacteria 

Unsterile container 

Virus/chlamydia swab for 

bacteria 

Household jars medicine 

containers camera film 

pots 

Bacteria killed by container 

ingredients 

Contamination or bacteria 

killed by previous contents. 

These containers are also 

unsafe due to potential 

breakages/leakage in 

transport 

Leaking samples 

Lack of appropriate 

clinical details 

Non laboratory approved 

container 

No reference to foreign travel. 

No reference to pregnancy. 

No reference to antibiotic 

allergies. 

No reference to 

past/current/intended 

antibiotics 

Health hazard to all 

surgery, transport and 

pathology staff 

Appropriate tests not 

performed. 

In complete/misleading 

results and comments 

Serology 


Haemolysis 

Expelling blood through Inaccuracy in many tests. 


Incorrect container 

Unable to perform tests 

Lipaemic 

Inaccuracy in many tests





MICROBIOLOGY ROUTINE REFERENCE LABORATORIES 

Cambridge PHL 

Box 26 

Addenbrookes Hospital 

Hills Road 

Cambridge 

C42 2QW 

CPA Ref. 1071 

HPA 

Microbiology Lab, Level B 

Southampton General 

Hospital 

Southampton 

SO16 6YD 

CPA Ref. 2838 

Leptospira Reference Unit 

Public Health Laboratory 

County Hospital 

Hereford 

HR1 2ER 

CPA Ref. 1180 

Singleton Hospital 

Sgeti 

Swansea 

SA2 8QA 

CPA Ref. 2913 

HPA Virus Reference Division 

Central Public Health 

Laboratory 

61 Colindale Avenue 

London 

NW9 5HT 

CPA Ref. 1883 

Manchester Medical 

Microbiology 

Partnership, PO Box 209 

Manchester Royal Infirmary 

Manchester 

M13 9WZ 

CPA Ref. 0635 

Centre for applied Microbiology 

& Research, Porton Down 

Salisbury 

Wiltshire 

SP4 0JG 

CPA Ref. 1612 

Dept. of Microbiology 

Leeds General Infirmary 

Great George Street 

Leeds 

LS1 3EX 

CPA Ref: 0061 

Laboratory of Enteric 

Pathogens 

Central Public Health 

Laboratory 

61 Colindale Avenue 

London 

NW9 5HT 

CPA Ref. 1683 

Birmingham Heartlands 

Hospital 

Bordesley Green East 

Birmingham 

B9 5ST 

CPA Ref. 0818 

Department of Clinical 

Microbiology 

Queen Alexandra Hospital 

Cosham 

Portsmouth 

CPA Ref. 0989





PHONED RESULTS SHEET: please photocopy and use 

Patient’s name ................................. DOB ............ NHS/Hospital No: ....................... 

Consultant/GP…………….. Ward ……………… 

Date................... Time...................... Signed/Received by ……………………………. 

HAEMATOLOGY BIOCHEMISTRY MICROBIOLOGY 

Haemoglobin 

g/d 

White cell count 

10 9 /lL 

Platelet count 

x10 9 /L 

ESR 

mm/hr 

Neutrophils 

%10 9 /L 

Lymphocytes 

%10 9 /L 

Monocytes 

%10 9 /L 

Eosinophils 

%10 9 /L 

Glandular Fever 

MCV 

fl 

Haematocrit 

10 9 /L 

Reticulocytes 

10 9 /L 

Sickle test 

COAGULATION: 

PT 

secs 

PTT 

secs 

Fibrinogen 

g/l 

D-Dimer 

Warfarin dose 

Next appointment 

TRANSFUSION: 

Group 

Rhesus 

DCT 

Kleihauer 

Sodium 

mmol/L 

Potassium 

mmol/L 

Urea 

mmol/L 

Creatinine 

umol/L 

Alk Phos 

IU/L 

Bilirubin 

umol/L 

ALT (SGPT) 

IU/L 

Calcium 

mmol/L 

Phosphate 

mmol/L 

Magnesium 

mmol/L 

CRP 

mg/L 

Glucose 

mmol/L 

Iron 

umol/L 

Uric Acid 

mmol/L 

Cholesterol 

mmol/L 

HDL Chol 

mmol/L 

Triglyceride 

mmol/L 

CK 

IU/L 

Amylase 

IU/L 

LDH 

IU/L 

GGT 

IU/L 

Tot Protein 

g/L 

Albumin 

g/L 

Globulin 

g/L 

TSH 

mu/L 

Specimen: 

MICROSCOPY: 

White cells 

Red cells 

Epithelial cells 

Casts 

Organisms: 

CULTURE: 

ANTIBIOTIC Sensitivity: 

Penicillin 

Erythromycin 

Flucloxacillin 

Amoxycillin 

Augmentin 

Cefalexin 

Nitrofurantoin 

Trimethoprim 

Other tests: 

Other tests Troponin Gentamicin ug/l





How to get to Basingstoke & North Hampshire Hospital 

The hospital is located on the A340, Aldermaston Road in 

Basingstoke: follow the Hospital signs from the Ring Road. 

By car: There are a number of parking areas available: there is a drop off point and 

a number of disabled parking spaces available outside the main entrance. Please 

allow extra time on arrival, as parking is sometimes difficult. Public car parks are now 

barrier controlled and a pay on exit scheme has been introduced. 

0 to 1 hour - £1.00 

1 hour 1 min to 2 hours - £2.00 

2 hours 1 min to 4 hours - £3.00 

4 hours 1 min to 6 hours - £4.00 

6 hours 1 min to 24 hours - £5.00 maximum fee 

There is no charge for disabled parking in the bays marked for this purpose. Please 

ensure you display your Blue Badge. 

Cars that ‘enter’ between 19:50 and 05:59 inclusive stay free (regardless of time of 

exit).This is to ensure that night shift workers and visitors can park safely next to the 

buildings. 

The Foundation Trust is serviced by regular buses from 

Basingstoke town centre: 

Bus numbers 32 and 32a from Newbury calls at Newbury Bus Station; Chandos 

Road; Wendan Road; Sandleford Rise; Newbury Tesco; Newtown,A339,A34 Junct.; 

Greenham Park East; Headley The Harrow Public House; Kingsclere Square; 

Wolverton Pond; Rooksdown cross roads and Basingstoke and North Hampshire 

NHS Foundation Trust. 

Bus number 45 from Sherfield calls at Bramley Station; Post Office; Bramley 

Church; The Vyne; Sherborne St. John and Basingstoke and North Hampshire 

Foundation Trust. 

See www.stagecoachbus.com for up to date timetables. 

Click here for Basingstoke bus routes 

Need any help getting to hospital? 

Neighbourcare: www.neighbourcare.org.uk 

Basingstoke Community Transport: 01256 320501 or www.bct.me.uk 

www.hants.gov.uk/passengertransport





Traveline is a service which allows you to plan your journey by giving you all the 

times and routes you need to get to the hospital without using your car. 

You can access the information by going to www.traveline.info 

Alternatively, if you prefer to speak to someone, call 0871 200 22 33. Calls cost 10p 

per minute (plus network extra if calling from a mobile).

Basingstoke and North Hampshire NHS Foundation Trust Revision: 7 


Author: David Beacher 

Q-Pulse Filename: MP-GEN-HANDBK 

Authorised by: N. Hutchinson 


Site Map







TEST INDEX 

BACTERIOLOGY 

TEST SAMPLE & COLLECTION INSTRUCTIONS COMMON 

Adenovirus and 

Rotavirus 

Aspirates and fluids 

from normally 

sterile sites 

Blood cultures 

Liquid stool in 60ml sterile container 

INDICATIONS 

Diarrhoea in 

children under 3 

years 

25ml sterile universal container (white top). 2 

Venous blood is collected aseptically into blood culture bottles. Take 

before antimicrobials are given if possible. Clean site and bungs of 

bottle(s) with alcohol wipe and allow to dry before collection. 

Adult: approx. 5-10ml blood into each bottle. 

Child: approx. 0.5- 4.0ml blood into one paediatric bottle. 

Septicaemia, 

pneumonia, 

endocarditis, 

meningitis, 

pyrexia. 

Bronchial washings 60ml sterile container or 25ml sterile universal container (white top). 2 

Broncho-alveolar 60ml sterile container or 25ml sterile universal container (white top). 2 

lavage 

Cerebrospinal fluid 

(CSF) 

Cervical swab 

For cell count, gram staining and culture send 0.5 -1mL CSF in each of 

four 25ml sterile universal containers (white top). If meningitis is 

suspected contact the laboratory and send the specimens immediately. 

Send specimens 2 and 3 to micro and 1 and 4 to biochemistry for 

protein (including SAH examination if appropriate). 

Endocervical swabs are required for gonococcal or chlamydial 

investigations. For gonorrhoea use a bacterial swab (blue top). 

Urethral, rectal and throat swabs may also be collected. 

Meningitis, 

subarachnoid 

haemorrhage 

(SAH), 

encephalitis. 

Pelvic 

inflammatory 

disease, vaginal 

discharge, 

suspected STD. 

TURNAROUND 

(working days) 

2 

Preliminary 

report: 2 

Full report 6 

Microscopy: 0.5 

Culture: 2 

2








INDICATIONS 

Chlamydia Males: >20ml urine sample in a 25ml sterile universal container. The Pelvic 

patient should not have passed urine in the hour prior to collection or inflammatory 

Urethral swab in Chlamydia transport medium. 

disease, urethritis. 

Females: urethral/endocervical swabs in chlamydia transport medium 

or urine in a 25ml sterile universal container. 

TURNAROUND 


5 

Clostridium difficile 

toxin 

Liquid stool in 60ml sterile container 

Testing performed on in-patient samples and community patients over 

60 years of age ONLY. 

Diarrhoea 1 

25ml sterile universal container (white top) or lens case. 14 

Contact lens and 

lens fluid 

Ear swab A bacterial swab (blue top). Ear infection, otitis 

media, otitis 

externa. 

Eye swab Routine culture: a bacterial swab (blue top). Conjunctivitis 2 

Faeces 

For bacteriology, parasitology and virology: 

with the wooden spatula provided transfer a grape sized portion or 

equivalent volume of fluid into a 60ml sterile container. 

Clostridium difficile toxin detection is only performed on semi solid and 

liquid samples. Follow up testing is rarely required. 

Diarrhoea, gastroenteritis 

and 

outbreaks. 

3 

Hair Refer to mycology. 

High vaginal swab 

Collect a swab (blue top) for candida, trichomonas vaginalis, bacterial 

vaginosis and bacterial pathogens. For PID, chlamydia and 

gonorrhoea investigations see cervical swab. 

Vaginal discharge, 

SROM. 

2 

2








INDICATIONS 

TURNAROUND 


Intrauterine device Send in a 60ml sterile container. 2 

(IUCD) 

IV line tips Aseptically place the terminal 5-10cm of the tip into a 25ml sterile Line infection, 2 

universal container. 

septicaemia. 

Joint fluid 

For microscopy and culture. Send in a 25ml sterile universal container Arthritis, infection, 2 

(white top). 

Crystals performed by Histopathology. 

gout. 

Legionella antigen 25ml sterile universal container. Atypical 

1 

pneumonia 

Legionella culture 

(sputum) 

Sputum from deep expectoration and not saliva is required. Saliva will 

not be processed. Collect into a 60ml sterile container. 

Atypical 

pneumonia. 

5 

Mouth swab A bacterial swab (blue top). Oral candidiasis. 2 

MRSA screening 

2 

swabs 

Mycology 

Nail Refer to mycology. 

A bacterial swab (blue top). 

For hospital patients refer to the Hospital Infection Control Policy. For 

community patients, screening is only normally required for known 

positive patients prior to elective surgery. 

For skin, hair and nail clippings use black card or paper. 

Skin: Scrape skin with a blunt scalpel from the active edge of the 

lesion. 

Nail: Cut small pieces of the nail using clippers. 

Hair: Forceps may be needed to remove body hairs. Infected hair 

stumps are easily removed by scraping with a scalpel. 

A bacterial swab (blue top).is used for candida infections. 

Dermatophyte 

infections. 

Microsocopy: 2 

Culture: 21








INDICATIONS 

TURNAROUND 


Nasal swab A bacterial swab (blue top). Specific organism 2 

screen, eg MRSA, 

Staph aureus. 

Nasopharyngeal Traps containing a specimen should be sealed using a loop of tubing Respiratory tract 2 

aspirate 

alternatively use a 25ml sterile universal. 

infection 

Pleural fluid 25ml sterile universal container (white top). 2 

Pneumococcal 25ml sterile universal container (white top). 

Atypical 

0.5 

antigen (urine). By prior arrangement with the laboratory. 

pneumonia. 

Pus 

Transfer into a sterile universal container. Only use a bacterial swab in 

charcoal transport medium when pus cannot be obtained. 

Infected site 2 (culture for 

anaerobes 5 

days) 

RSV Nasopharyngeal aspirate into a 60ml sterile container. 0.5 

Saliva testing (for 

Measles, Mumps 

and Rubella) 

Please contact the Microbiology laboratory on 01256 313309/13 Rash Referred 

specimen 

21 Days 

Schistosoma 

parasites 

(Urine) 

Recommended method: Collect the last few drops of urine from each 

micturition over a 24 hour period in a plain 25ml sterile universal 

container. 

Acceptable alternative: Collect a random specimen ideally between 

12.00 and 15.00 hours after light exercise (e.g. 20 rapid knee bends) to 

maximise the release of eggs. 

Sellotape slide Refer to Threadworm. 

Seminal fluid for 25ml sterile universal container (white top). 

culture 

(Bilharzia) 

Travel to endemic 

area 

Blood in seminal 

fluid 

1 

2








INDICATIONS 

Sputum 

Sputum samples are best collected in the morning. It is important that Chest infection, 

the specimens submitted for examination are true sputum and not pneumonia. 

saliva, or contaminated with food. Sputum from deep expectoration is 

required. Saliva will not be processed. Collect into a 60ml sterile 

container. 

Threadworm 

Throat swab 

Collect the sample in the morning before the patient has washed. 

Press the sellotape onto the peri-anal skin firmly. Remove and stick 

the sellotape flat onto a clean microscope slide (sticky side down) 

keeping as flat as possible . Place this in a slide box. 

For bacterial investigation send a bacterial swab (blue top). 

Anal 

irritation/itching. 

TURNAROUND 


2 

1 

Pharyngitis 2 

For virology investigations send a viral swab (green top) 

Tissue and biopsies Sterile container. If the sample is small add sterile saline to prevent it 

drying out. 

Tuberculosis The best samples are early morning sputum, pus or tissue in a 60ml 

sterile container. 

Only collect urine when renal tuberculosis is suspected; collect the 

complete early morning specimen in 250ml containers on three 

consecutive days. 

Urethral swab For the investigation of gonorrhoea use a bacterial (blue top). and 

transport to the laboratory immediately. 

For the investigation of Chlamydia use a Chlamydia swab in Chlamydia 

transport medium. 

Virology referred 

sample 21 Days 

Infected site 7 

Night sweats, low 

grade fever. 

Renal TB. 

Microscopy: 1 

Culture: up to 40 

days 

2








INDICATIONS 

Urine 

MSU, CSU, supra pubic aspirate, ileal conduit specimens are all UTI, haematuria, 

collected into red top 20ml sterile universal containers containing the fever, 

preservative boric acid (red top). 

inflammatory 

To collect an MSU allow the first part of the urine to be voided. Collect response. 

the mid-part of the sample then void the remainder of the specimen. 

CSU’s are only appropriate when clinical indication of fever, rigors or 

supra pubic pain are present. CSU’s will NOT be processed without 

these clinical indications given on the request card. 

Viral 

Viral swab (green top) 

HSV 

PCR tests are now used. Each test is specific for each virus. Please 

state clinical details and/or virus suspected. 

TURNAROUND 


1 

In-house 5 days 

Referred 

specimens 

21 days 

Wound and ulcer 

swabs 

A bacterial swab (blue top). 

Collect as much material from the infected site as possible avoiding 

contamination from surrounding areas. 

Ulcer swabs are only appropriate when signs of severe clinical 

infections are present. 

Infection at local 

site. 

2 

(culture for 

anaerobes 5 

days)







CHEMICAL PATHOLOGY 

TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

0M-6M 0.8 - 1.8 

Alpha 1 Antitrypsin 

(AAT) 

Gold Top 

Vacuette 

4mL 

Serum 

7M-5Y 1.1 - 2.2 

6Y-10Y 1.4 - 2.3 

11Y-15Y 1.2 - 2.0 

>16Y 1.1 - 2.1 

g/L 24 HOURS 

Angiotensin 

converting enzyme 

(ACE) 

Gold Top 

Vacuette 

4mL Serum 20 - 95 IU/L 

Lab Note: SAS -20°C 


Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

10 DAYS 

Acetylcholine 

receptor Abs 

Gold Top 

Vacuette 

4mL Serum 0 - 5 nmol/L 


MGAB 

Immunology 

Churchill Hospital 

Headington 

Oxford 

OX3 7LJ 

01865 225995 

18 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC 

ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Adrenocorticotrophic 

Hormone 

(ACTH) 

Lavender 

Top Vacuette 

3mL 

EDTA 

Plasma 

0 - 40 ng/L 

TO LAB AT ONCE 

- SAMPLE MUST 

BE FROZEN 

WITHIN 30 

MINUTES 


Plasma ACTH 

concentrations may 

be affected by 

stress / acute 

illness and reduced 

in patients on 

corticosteroid 

therapy 

Specialist 

Biochemistry 

Mail Point 8 Level C 

South Block 

Southampton 

General Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

14 DAYS 

Acylcarnitines 

(see 

Carnitines) 

Acetylcholinesterase 

Adrenal antibodies 

Lavender 

Top Vacuette 

Gold Top 

Vacuette 

3mL 

EDTA 

Whole 

Blood 

>160 dau/L 

4mL Serum _ _ 


ADAB 

Health and Safety 

Laboratory 

Harper Hill 

Buxton 

Derbyshire 

SK17 9JN 

01298 218099 

Sheffield Protein 

Department of 

Immunology 

Protein Reference 

Unit 

PO Box 894 

Sheffield S5 7YT 

01142 715552 

14 DAYS 

14 DAYS







TEST 

Alphafoetoprotein 

(AFP) 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 0 - 10 kU/L 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

Serum AFP levels 

are raised during 

pregnancy and in 

the neonatal patient 

REFERRAL 

LABORATORY 

(INC 

ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

Auto Immune Profile 

(AIP) 

Gold Top 

Vacuette 

4mL Serum 10 DAYS 

Albumin 

Gold Top 

Vacuette 

4mL Serum 32 - 48 g/L 4 HOURS 

Albumin - urine 

(micro albumin - 

Albumin Creatinine 

Ratio) 

Alcohol - blood 

Alcohol - urine 

Aldosterone 

Plain 

(white top) 

Universal 

Gold Top 

Vacuette 

Plain (white 

top)Universal 

Lavender 

Top Vacuette 

10 mL Urine 

4mL 

Serum 

0 - 3.0 

Legal driving 

limit < 800 

mg/L 

mg/L 

10mL Urine mg/L 

3mL 

EDTA 

Plasma 

Adult: Supine 







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE RANGES 

Children: 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC 

ADDRESS) 

TURN – 

AROUND 

(working 

days) 

0 - 3yr 145-320 

4 - 6yr 150-380 

7 - 9yr 175-420 

10 -11yr 135-530 

12-13yr (M) 200-495 

Alkaline 

Phosphatase 

Gold Top 

Vacuette 

4mL 

Serum 

12-13 yr (F) 105-420 

14-15yr (M) 130-525 

14-15yr (F) 70-230 

16-19yr (M) 65-260 

16-19yr (F) 50-130 

Adult: 

20 - 59yr (M) 40 - 105 

20 - 59yr(F) 35 - 110 

IU/L 

Alk Phos levels are 

physically increased 

in neonates, 

children, 

adolescents and 

pregnancy. In vitro 

haemolysis will 

falsely decrease 

results 

4 HOURS 

60 - 79yr (M) 40 - 105 

60 - 79yr (F) 40 - 115 

80 - 89yr (M) 40 - 120 

80 - 89yr (F) 40 - 125 

>89yr (M) 40 - 140 

>89yr (F) 40 - 130







TEST 

Alkaline 

phosphatase 

- bone 

SPECIMEN 

CONTAINER 

see Alk Phos 

Isoenzyme 

VOLUME 

NEEDED 

SAMPLE 

TYPE 


UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Alk Phos 

Isoenzymes 

Alpha 1 

antitrypsin 

phenotype 

ALT 

Aluminium 

Amino acids 

- serum 

quantitative 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL Serum 

4mL Serum 

4mL 

Serum 

0 – 12yr 0 - 40 

>12yrs 0 - 60 

4mL Serum < 0.4 umol/L 

4mL Serum 

Lab Note: Load tray 

AND SAS -20°C 



Department of 

Immunology 

Protein Reference Unit 

PO Box 894 

Sheffield 

S5 7YT 

01142 715552 

10 DAYS 

14 DAYS 

IU/L 4 HOURS 



Trace Metals Unit 


Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 


Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

10 DAYS 

14 DAYS







TEST 

Amino acids - 

urine 

quantitative 

Amiodarone 

SPECIMEN 

CONTAINER 

Plain (white 

top) 

Universal 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

20 mL Urine 

REFERENCE 

RANGES 

UNITS 

4mL Serum 0.6 - 2.5 mg/L 

SPECIAL 

PRECAUTIONS 

Random sample 

Lab Note: Univ -20ºC 


KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


Level D 

South Block 

Southampton 


Tremona Road 

Southampton 

SO16 6YD 

02380 796427 


Royal Hampshire 


Romsey Rd 

Winchester 

SO22 5DG 

01962 824287 

01962824288 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

14 DAYS 

Ammonia 

Amniocentesis 

Amylase - serum 

Amylase - urine 

Lavender 

Top Vacuette 

Plain (white 

top) 

Universal 

Gold Top 

Vacuette 

Plain (white 

top) 

Universal 

3mL 

10mL 

EDTA 

Whole 

blood 

Amniotic 

fluid 

0 - 47 

3D 0 - 100 umol/L 


MUST BE IN LAB 

WITHIN 30 

MINUTES 

Lab Note:Manual BMS 

Results returned 

direct to requesting 

physician 

Lab Note: Univ 4ºC 

There is assay 

interference from 

haemolysis 

Wessex Regional 

Genetics 

Laboratory 

Salisbury District 

Hospital 

Odstock 

Salisbury SP2 8BJ 

01722 429080 

1 HOUR 

21 days 

Results 

returned 

direct to 

requesting 

physician 

4 HOURS 

Urine 0 - 650 IU/L Random sample 4 HOURS







TEST 

Amyloid A 

Anaphylactic 

reaction 

(Serum Tryptase) 

Androstenedione 

Anti Mullerian 

Hormone 

Antinuclear 

Antibodies 

(ANA) 

Antineutrophil 

Cytoplasm 

Antibody 

(ANCA) 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

or 

Lavender 

Top Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum < 20 mg/L 

4mL 

or 

3mL 

4mL 

Serum 

or 

EDTA 

Plasma 

Serum 

Serum 

4mL Serum 

2 - 14 ug/L 

M 2.1 - 10.8 

F 1.0 - 11.5 

discuss with 

Consultant 

Biochemist 

4mL Serum _ _ 

SPECIAL 

PRECAUTIONS 


TO LAB AT ONCE - 

SAMPLE MUST BE 

FROZEN WITHIN 30 

MINUTES 

Take first sample at 

once, repeat at 3 & 24 

hrs 

Lab Note : SAS -20ºC 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


Department of 

Immunology 


Unit 

PO Box 894 


01142 715552 


Department of 

Immunology 


Unit 

PO Box 894 


01142 715552 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

14 DAYS 

nmol/L 10 DAYS 


Lab Note: Imm 4°C 

ANAE 

Lab Note: SAS 4°C 

ANCA 

Dept of Clinical 

Biochemistry 

Macewen Building 

Glasgow Royal 

Infirmary 

Glasgow, G4 0SF 

0141 211 4638 

Southampton 

Immunology 

Level C Mailpoint 8 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

21 DAYS 

10 DAYS 

10 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Antinuclear 

Factor (ANF) 

Gold Top 

Vacuette 

4mL Serum 

Lab Note: Imm 4°C 

ANAE 

10 DAYS 

Antimitochondrial 

Antibodies 

Gold Top 

Vacuette 

4mL Serum 0 - 5 u/mL 


LIV 

Southampton 

Immunology 


Southampton 


Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

10 DAYS 

Aquaporin-4 

Antibodies 

Gold Top 

Vacuette 

4mL Serum 

Lab Note: SAS - 20°C 

Immunology 


Headington 

Oxford 

OX3 7LJ 

01865 225995 

28 DAYS 

Asialotransferrin 

see Beta-2 

transferrin 

AST Serum 0 - 40 IU/L 

aTPO Serum 

Bence Jones 

Protein 

Plain (white 

top) 

Universal 

10mL Urine 

see Thyroid 

Antibodies 

Early morning urine 

preferred 

Lab Note: White top 

Vacuette, Advia 2. 

Univ to Manual Lab 

In vitro 

haemolysis will 

falsely elevate 

results 

4 HOURS 

10 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC 

ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Beta-2 

Microglobulin 

Beta-2 

Transferrin 

Bicarbonate 

Bile acids 

Bile Pigments 

Bilirubin - adult 

Bilirubin – direct 

or conjugated 

Bilirubin - 

paediatric 

Bilirubin - urine 

Gold Top 

Vacuette 

Plain (white 

top) 

Universal 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Plain (white 

top) 

Universal 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL Serum 0.0 -1.7 ug/mL 14 DAYS 

Nasal 

fluid 


Neuroimmunology 

Room 917 

Institute of 

Neurology 

Queen Square 

London 

WC1N 3BG 

02078 373611 

extn 3814 

14 DAYS 

4mL Serum 22 - 31 mmol/L To lab same day 24 HOURS 

4mL Serum 0 - 14 umol/L To lab same day 24 HOURS 

10 mL Urine 24 HOURS 

4mL Serum 0 - 17 umol/L 



see Bile 

Pigments 

Haemolysis will 


results 



results 



results 

4 HOURS 

4 HOURS 

4 HOURS 

24 HOURS







TEST 

Biotinidase 

SPECIMEN 

CONTAINER 

Green Top 

Vacuette 

see B-Type 

BNP 

Natriuretic 

Peptide 

See Bence 

BJP 

Jones Protein 

Bone alkaline See Alk Phos 

phosphatase Iso enzymes 

Bone Turnover See UDPD 

B-Type 

Natriuretic 

Peptide 

C Peptide 

Lavender Top 

Vacuette 

Gold Top 

Vacuette 

plus 

Grey Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 


4mL Plasma 2.0 – 6.0 

3mL 

1 x 4 mL 

plus 

1 x 4 mL 

EDTA 

plasma 

Serum 

plus 

Fluoride 

oxalate 

plasma 

for 

glucose 

M < 45 0 – 29 

F < 45 0 – 36 

M 45 - 54 0 – 33 

F 45 - 54 0 – 57 

M 55 - 64 0 – 39 

F 55 - 64 0 – 76 

M 65 - 74 0 – 68 

F 65 - 74 0 – 76 

M 75Y + 0 – 121 

F 75Y + 0 – 167 

UNITS 

umol /L / 

min 

pg/mL 

< 480 ug/mL 

SPECIAL 

PRECAUTIONS 

Consultant 

confirmation 

required – 

contact lab 


To lab same day 

Note : Centaur-20ºC 



FROZEN WITHIN 1 

HOUR 


Lab Note: FLOX to track 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Clinical Biochemistry 

Bristol Royal Infirmary 

Marlborough Street 

BRISTOL 

BS2 8HW 

0117 928 2590 

Specialist 

Biochemistry 


South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

10 DAYS 

14 DAYS







TEST 

C1 esterase 

inhibitor 

C3 

C4 

CA 125 

CA 15-3 

CA 19-9 

Cadmium - urine 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Plain (white 

top) universal 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 0.15 – 0.35 g/L 

SPECIAL 

PRECAUTIONS 

Lab Note: C 3 & C4 first 


KEY FACTORS 

Not indicated 

if C4 is within normal 

limits 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Southampton 

Immunology 


Southampton 


Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

4mL Serum 0.9 - 1.5 g/L 24 HOURS 





levels may be 

increased during 

menstruation 

Medical Oncology 

Charing Cross 

Hospital 

Fulham Palace 

Road 

London W6 8RF 

0208 8461468 

24 HOURS 

10 DAYS 

4mL Serum 0 - 33 kU/L 14 DAYS 

10mL Urine < 1.3 

nmol / 

mmolCr 




Level D 

South Block 

Southampton 


Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

14 DAYS







TEST 

Cadmium - 

blood 

SPECIMEN 

CONTAINER 

Lavender top 

Vacuette 

VOLUME 

NEEDED 

3mL 

SAMPLE 

TYPE 

EDTA 

Whole 

Blood 

REFERENCE 

RANGES 

UNITS 

< 1.3 nmol/L 

SPECIAL 

PRECAUTIONS 

Lab Note: WB 4ºC 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 



Level D 

South Block 


Hospital Tremona 

Road 

Southampton 

SO16 6YD 

02380 796237 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

Caeruloplasmin 

Calcitonin 

Calcium 

(as Corrected 

Calcium) 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL 

4mL 

Serum 

Serum 

0 – 4M 0.08 – 0.23 

5M – 1Y 0.12 – 0.35 

2Y – 10Y 0.20 – 0.40 

11Y – 13Y 0.15 – 0.23 

>13Y - Adult 0.2 - 0.45 

Male 0 - 8.4 

Female 0 - 5.0 

4mL Serum 2.12 - 2.62 

g/L 24 HOURS 

ng/L 

mmol/ 

L 

A.M. FASTING 

TO LAB AT 

ONCE - 

SAMPLE MUST 

BE FROZEN IN 

20 MINUTES 

Lab: 2 x SAS -20°C 

Levels may be 

artifactually 

increased by 

torniquet during 

venesection 

Specialist 

Biochemistry 


South Block 


Hospital Tremona 

Road 

Southampton 

SO16 6YD 

02380 798717 

21 DAYS 

4 HOURS







TEST 

Calcium – 24hr 

urine 

SPECIMEN 

CONTAINER 

Plain 24h container 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

Urine 

(24h) 

REFERENCE 

RANGES 

UNITS 

2.5 - 7.5 mmol/d 

SPECIAL 

PRECAUTIONS 

24 hour collection 

Lab: White top 

vacuette,Advia tray 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

Calcium – 

random urine 

Plain (white top) 

universal 

4mL Urine mmol/L 



Measure 

Creatinine as well 

24 HOURS 

Calculus 

Carbamazepine 

Carbon 

Monoxide 

Carboxyhaemoglobin 

Cardiac 

enzymes 


universal 

Gold Top 

Vacuette 

see 

Carboxyhaemoglobin 

Lavender Top 

Vacuette 

Stone 

4mL Serum 4.0 - 12.0 mg/L 

3mL 

EDTA 

Whole 

Blood 

1 - 5 % 

Lab:Dry,Univ 4ºC 

Sample should be 

taken pre dose 


Take sample 

before oxygen is 

given 

Lab Note: Manual BMS 

If not possible to 

obtain a pre-dose 

sample, 

standardise 

sample times for 

comparison 

purposes 

Smokers may 

have levels up to 

and greater than 

10% 


Royal Hampshire 


Romsey Rd 

Winchester 

SO22 5DG 

01962 824287 

01962824288 

21 DAYS 

24 HOURS 

4 HOURS 

See Troponin 4 HOURS







TEST 

Carnitine 

Carnitines 

SPECIMEN 

CONTAINER 

Green Top 

Vacuette 

Blood spot 

form 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

4mL Plasma 

Blood 

spot 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 


Lab Note: SAS Desk 

KEY FACTORS 

Do not fold 

or refrigerate 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Clinical Chemistry and 

Molecular Genetics 

Children's Hospital 

Western Bank 

Sheffield S10 2TH 

0114 2717445 




Western Bank 


0114 2717445 

TURN – 

AROUND 

(working 

days) 

4 WEEKS 

4 WEEKS 

Catecholamines see VMA 10 DAYS 

Southampton 

Immunology 

Mailpoint 8 Level C 

CCP antibodies 


Gold Top 

4mL Serum 0 - 7 U/mL 

Hospital 10 DAYS 

Vacuette 

Tremona Road 

Southampton 

Lab Note : SAS 4ºC 

SO16 6YD 

CCP 

02380 796615 

CEA 

Gold Top 

Vacuette 

4mL Serum 0 - 5 ug/L 24 HOURS 

Cell-Sept see MMF 

Centromere 

Gold Top 

Vacuette 

4mL Serum _ _ 


CENT 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

10 DAYS







TEST 

Chloride 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4mL Serum 96 - 106 mmol/L 4 HOURS 

Chloride - sweat Plain 2mL Tube Sweat < 40 mmol/L 

CONTACT LAB 

TO BOOK 

APPOINTMENT 

24 HOURS 

Chloride - urine 


Universal 



vacuette, Advia tray 

4 HOURS 

Cholesterol 

Cholesterol: 

HDL Ratio 

Cholinesterase 

Cholinesterase 

(for toxicology) 

Chorionic 

gonadotrophin 

Chromogranin A 

Chromium 

Chromosomes 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

see Pseudocholinesterase 

see Acetylcholinesterase 

4mL Serum < 5.0 mmol/L 4 HOURS 

4mL Serum < 4.0 4HOURS 

28 DAYS 

see HCG 24 HOURS 

see Gut 

Hormones 

Dark Blue 

Vacuette 

Green Top 

Vacuette 

6mL 

4mL 

Whole 

Blood 

Whole 

Blood 

Lithium 

Heparin 

MHRA 

Action Limit 

> 135 

nmol/L 

Lab NB: HIP screen 

Whole Blood 4ºC 


direct to 

requesting 

physician 




Level D South Block 

Southampton Gen Hosp 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 


Genetics Laboratory 


Hospital 

Odstock 

Salisbury 

SP2 8BJ 

01722 429080 

5 WEEKS 

14 DAYS 

28 DAYS







TEST 

Citrate 

CK 

SPECIMEN 

CONTAINER 

Acid 24h 

Bottle 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

SAMPLE 

TYPE 

Urine 

See 

Creatine 

Kinase 

REFERENCE 

RANGES 

M 0.6 – 4.8 

F 1.3 – 6.0 

UNITS 

mmol/d 

SPECIAL 

PRECAUTIONS 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


UCL Hospitals 

3 rd Floor 

60 Whitfield Street 

London W1T 4EU 

0845 1555000 

Ext 9405 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

4 HOURS 

Clobazam 

Gold Top 

Vacuette 

4mL Serum < 200 ug/L 


Medical Toxicology 

Unit 

4 th Floor 

North Wing 

St Thomas’ Hospital 

London SE1 7EH 

02071 888689 

10 DAYS 

Clozapine 

Gold Top 

Vacuette 

4mL Serum 0.35 – 0.60 mg/L 


Dept. of Clinical 

Biochemistry 

Kings College Hospital 

Denmark Hill 

London 

SE5 9RS 

020 3299 5881 10 DAYS 

Cobalt 

Dark Blue 

Vacuette 

6mL 

Whole 

Blood 

MHRA 

Action Limit 

>120 

nmol/L 

Lab NB: HIP Screen 

Whole Blood SAS 4ºC 




Southampton Gen 

Hosp 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

14 DAYS







TEST 

Coeliac screen 

Coeliac screen 

(Follow up) 

Conductivity 

Connective 

Tissue 

Antibodies 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Plain 2mL 

Tube 

Gold Top 

Vacuette 

Complement see C3 & C4 

Copper - 

serum 

Copper - urine 

Cortisol - 

serum 

Dark Blue 

Vacuette 

VOLUME 

NEEDED 

SAMPLE TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4mL Serum Lab Note: COEL 4°C 10 DAYS 

4mL Serum 

Sweat < 80 mmol/L 

Lab Note: if positive 

SAS 4°C 

CONTACT LAB 

TO BOOK 

APPOINTMENT 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

21 DAYS 

24 

HOURS 

4mL Serum Lab Note: ANAE 4°C 10 DAYS 

6mL 

Plasma 

12 – 26 

umol/L 

Plain 24h 

bottle Urine < 0.9 umol/d 

Gold Top 

Vacuette 

4mL Serum 119 – 619 nmol/L 

Must be bled in 

Phlebotomy 

Lab NB: Teklab -20ºC 

Li Hep may be used for 

Paeds 



Levels may be 

affected by stress, 

diurnal rhythm and 

corticosteroid 

therapy 




So’ton General Hosp 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 




So’ton General Hosp 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

14 DAYS 

14 DAYS 

24 

HOURS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Cortisol - 

urine 

Cotinine 

CPK 

Creatine 

kinase 

Creatinine 

Creatinine 

Plain 24h 

bottle 

Plain (white 

top) 

Universal 

See Creatine 

Kinase 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Plain 24h 

bottle 

10mL Urine 

4mL 

4mL 

Urine 55 - 250 nmol/d 

Serum 

Serum 

0 -1mth 0 - 244 

2mth-15Y 0-220 

Adult M 0 – 195 

Adult F 0 – 170 

18y(adult) 62 - 124 

IU/L 

umol/L 

Urine 9 - 27 mmol/d 



Levels may be 

affected by stress 

and corticosteroid 

therapy 

Strong interference 

from haemolysis 


West Park Hospital 

Epsom 

Surrey 

KT19 8PB 

01372 734724 

Dept of Chemical 

Pathology Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

10 DAYS 

10 DAYS 

4 HOURS 

Adult males with 

increased muscle 

mass may have 

slightly elevated 

serum 

4 HOURS 

concentrations 

without underlying 

renal pathology 


universal 24 HOURS







TEST 

Creatinine 

Clearance 

SPECIMEN 

CONTAINER 

Plain 24h 

bottle 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

Urine 90 - 120 mLs/min 

SPECIAL 

PRECAUTIONS 

Serum sample also 

needed 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

Cross Links 

CRP 

Cryoglobulins 

CSF Protein 

Cyclosporin A: 

Cystic fibrosis 

gene screen 

C-reactive 

protein 

Gold Top 

Vacuette 

Gold Top 

Vacuette & 

Lavender Top 

Vacuette 

Plain (white 


Lavender Top 

Vacuette 

Lavender Top 

Vacuette 

See UDPD 

4mL Serum 0 - 5 mg/L 4 HOURS 

4mL 

& 

3mL 

Serum & 

EDTA Plasma 

COLLECT WARMED 

TUBES IN WARMED 

FLASK 

FROM LAB. 

IMMEDIATELY 

TAKE SAMPLES. 

RETURN SAMPLES 

TO LAB IN FLASK 

IMMEDIATELY. 

Lab NB: Manual BMS 

May be 

referred as 

follow up to 

in-house 

findings 


2nd Floor, Jenner Wing 

St George's Hospital 

Medical School 

Cranmer Terrace 

LONDON SW17 0NH 

02087250025 

4 DAYS 

or 21days if 

referred 

1mL CSF 0.1 - 0.4 g/L 4 HOURS 

3mL 

3mL 

EDTA Whole 

blood 

EDTA Whole 

Blood 

see CRP 

ug/L 


Results returned direct 

to requesting physician 



Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 


Genetics Laboratoy 

Salisbury District Hospital 

Odstock 

Salisbury 

SP2 8BJ 

01722 429080 

7 DAYS 

6 WEEKS







TEST 

Dehydrocholesterol 

Desmethylclobazam 

DHEAS: 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

4mL Serum 


UNITS 

4mL Serum < 2000 ug/L 

4mL 

Serum 

Male 0 – 30d 1.0 – 10.2 

1m – 5m 0.1 – 2.8 

6m – 5y 0.1 – 2.2 

6y – 9y 0.2 – 2.7 

10y – 39y 3.3 – 17.4 

40y – 59y 1.9 – 14.4 

>60y 0.8 – 7.9 

Female 0 – 30d 1.0 – 10.2 

1m – 5m 0.1 – 2.8 

6m – 5y 0.1 – 2.2 

6y – 9y 0.2 – 2.7 

10y – 39y 1.0 – 11.7 

40y – 59y 1.0 – 11.7 

>60y 0.8 – 7.0 

SPECIAL 

PRECAUTIONS 



KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Newborn Screening & 

Biochemical Genetics 

Dept 

Southmead Hospital 

Westbury-on-Trym 

Bristol 

BS10 5NB 

0117 3235556 

Medical Toxicology 

Lab 

3 rd Floor, Block 7 

South Wing 


London 

SE1 7EH 

02071 888689 

TURN – 

AROUND 

(working 

days) 

5 WEEKS 

10 DAYS 

umol/L 14 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Diuretic screen 

Digoxin 

DNA antibodies 

DNA binding 

DNA Genetics 

Plain (white 

top) Universal 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Lavender Top 

Vacuette 

10mL Urine 

4mL Serum 0.6 - 2.0 ug/L 

4mL Serum 0 – 15 iu/mL 

4mL Serum 

3mL 

EDTA Whole 

Blood 


Take sample 6 

Hours post dose 


DNA 


DNA 



physician 


Regional Laboratory for 

Toxicology 

Dudley Road 

Winson Green 

Birmingham 

B18 7QH 

0121 507 6029 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 




Hospital 

Odstock 

Salisbury SP2 8BJ 

01722 429080 

14 DAYS 

24 HOURS 

10 DAYS 

10 DAYS 

6 WEEKS 

Results 

returned 

direct to 

requesting 

physician 

Dothiepin 

Gold Top 

Vacuette 

4mL Serum ug/L 


Contact Consultatnt 

Biochemsit







TEST 

Down's 

Syndrome 

Drugs of abuse 

screen 

Effusion 

screen 

eGFR: 

Kidney Damage 

Stage 1 

Kidney Damage 

Stage 2 

Kidney Damage 

Stage 3 

Kidney Damage 

Stage 4 

Kidney Damage 

Stage 5 

Elastase 

Electrolytes - 

serum 

SPECIMEN 

CONTAINER 


Universal 


Universal 

Plain 

(orange top) 

specimen pot 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

See Triple 

Test 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

10mL Urine 10 DAYS 

4mL Effusion 4 HOURS 

4mL 

90+ 

60-89 

Serum mLs/min calculated 

30-59 

15-29 

< 15 

Faeces > 200 ug/g 

Serum 

Na 134 - 147 

K 3.5 - 5.0 

Urea 2.6 - 6.0 

Creat 62 -124 

mmol/L 

Lab Note: -20ºC 

Multiply result by 

1.212 for Afro- 

Caribbean patients. 

See local guidelines 

for interpretation of 

results. 

Potassium levels are 

significantly increased 

by invitro haemolysis 

and delayed sample 

centrifugation. Levels 

may also be 

significantly raised in 

patients with high 

platelet count 


Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

4 HOURS 

10 DAYS 

4 HOURS







TEST 

Electrolytes - 

urine 

Electrophoresis 

Electrophoresis 

- urine 

Extractable 

Nuclear 

Antibodies 

(ENA) 

SPECIMEN 

CONTAINER 

Plain 24h bottle 

or 


Universal for 

Random 

sample 

Gold Top 

Vacuette 


Universal 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

10mL 

SAMPLE 

TYPE 

Urine 

REFERENCE 

RANGES 

Na 130 – 220 

K 25 – 100 

Urea 199 - 332 

UNITS 

mmol/d 

SPECIAL 

PRECAUTIONS 

24 h collection 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

4mL Serum Serum only 5 DAYS 

10mL Urine 5 DAYS 

4mL Serum NEGATIVE 

Lab Note : SAS 4ºC 

ENAS 

Endomyseal see Coeliac 

antibodies screen Lab Note: COEL 4°C 

Epanutin see Phenytoin 

Epidermal 

antibodies 

Gold Top 

Vacuette 

Epilim see Valproate 

4mL Serum 


PEMP 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

10 DAYS 

10 DAYS







TEST 

Erythropoietin 

Everolimus 

Executive 

screen 

Ferritin 

Flecainide 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Lavender Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 5.0 - 25.0 mu/mL 

3mL 

EDTA 

Whole 

Blood 

ng/mL 

SPECIAL 

PRECAUTIONS 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Department of Clinical 

Biochemistry 

King's College School 

of Medicine 

Denmark Hill 

London SE5 9RS 

020 3299 3856 

Analytical Unit 

St. Georges Hospital 

London 

SW17 0RE 

0208 725 5345 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

10 Days 

4mL Serum 4 HOURS 

4mL Serum 22 - 332 ug/L 3 DAYS 

4mL Serum 400 - 700 ug/L Lab Note : SAS -20ºC 



London 

SW17 0RE 

0208 725 5345 

14 DAYS 

FOB 

see Occult 

blood 

Folate 

Gold Top 

Vacuette 

4mL Serum 2.9 - 16.9 ug/L 3 DAYS 

Free light 

(Diagnostic 

chains: 

Range) 

Gold Top 

Kappa 4mL Serum 3.3 - 19.4 

Vacuette 

Lambda 5.7 - 26.3 

mg/L 10 DAYS 

Ratio 0.26 - 1.65







TEST 

Free PSA 

Free PSA % 

Free Fatty Acids 

Fructosamine 

FSH 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Grey top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

4mL 

SAMPLE 

TYPE 

Serum 

Fluoride 

Oxalate 

plasma 


10-18% 

Low diagnostic value 

18% Lower risk 

UNITS 

ug/L 


SPECIAL 

PRECAUTIONS 

% Lab Note : SAS -20ºC 


- SAMPLE MUST 

BE FROZEN IN 20 

MINUTES 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


Charing Cross Hospital 

Fulham Palace Road 

London W6 8RF 

0208 8461468 




Western Bank 


0114 2717445 


Royal United Hospital 

Area Central 

Laboratory 

Combe Park 

Bath BA1 3NG 

01225 824711 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

21 DAYS 

14 DAYS 

Pre pubertal 

Male 

Female: 

Follicular 

Mid cycle 

Luteal 

Post Menopausal 

Gold Top 

Vacuette 

4mL 

Serum 







TEST 

FT3 

FT4 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 3.5 - 6.5 pmol/L 

4mL Serum 10 - 19 pmol/L 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

Levels may be 

reduced in nonthyroidal 

illness 

Levels may be 

reduced in nonthyroidal 

illness 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

24 HOURS 

GAD 

antibodies 

Gold Top 

Vacuette 

4mL Serum







TEST 

Gammaglutamyl 

transpeptidase 

Ganglioside 

antibodies 

Gastric parietal 

cell Abs 

Gastrin 

GAWK 

GBM antibodies 

Gentamycin 

GGT 

GH 

Gliadin 

antibodies 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

see GGT 4 HOURS 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

see Gut 

Hormones 

see Gut 

Hormones 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

see Growth 

hormone 

see Coeliac 

screen 

4mL Serum 

4mL Serum _ _ 

4mL Serum 0 – 7.0 

4mL Serum mg/L 

4mL 

Serum 

M 0 - 60 

F 0 - 40 

IU/L 


GANG 


GPCA 


GBM 


COEL 

May be affected by 

invitro haemolyis 

Neuroimmunology Room 

917 

Institute of Neurology 

Queen Square 

London 

WC1N 3BG 

02078 373611 

extn 3814 

Southampton Immunology 



Hospital 

Tremona Road 

Southampton SO16 6YD 

02380 796615 




Hospital 

Tremona Road 


02380 796615 

4 WEEKS 

10 DAYS 

10 DAYS 

24 HOURS 

4 HOURS







TEST 

Globulin 

Glomerular 

basement 

membrane Abs 

Glucagon 

Glucose - CSF 

Glucose - fluid 

Glucose - plasma 

OGTT 

(Oral Glucose 

Tolerance Test) 

post 75g load 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Grey top 

Vacuette 

Grey Top 

Vacuette 

Grey Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4mL Serum 23 - 40 g/L 4 HOURS 

0.5mL 

4mL 

see GBM 

see Gut 

Hormones 

CSF 

60% Plasma 

level 

mmol/L 4 HOURS 

Fluid 4 HOURS 

Fluoride 

oxalate 

plasma 

3.8 - 6.0 mmol/L 

Fasting:







TEST 

Glucose - 

serum (BNHFT) 

Glycated 

haemoglobin 

Glycosamino 

glycans 

Growth 

hormone 

GTT (Glucose 

Tolerance Test) 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 3.8 - 6.0 mmol/L 

SPECIAL 

PRECAUTIONS 

Sample MUST be 

in lab within 2 

hours 

KEY 

FACTORS 

Patient should 

be fasting 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4 HOURS 

see HbA1 24 HOURS 

see Mucopolysaccharides 

Gold Top 

Vacuette 

Two Grey 

Top Vacuettes 

4mL Serum < 5 mu/L 

2 x 4mL 

Timed 

Fluoride 

Oxalate 

see glucose 


- SAMPLE MUST 


HOUR 


Two samples: 

Fasting and 2h post 

oral glucose - 

contact lab to make 

an appointment 

levels may be 

increased by 

stress or 

exercise 

Specialist Biochemistry 


South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

14 DAYS 

24 HOURS 

Gut Hormones 

Gastrin 0 - 40 

GAWK 0 -150 

Glucagon Large 

0 - 50 

EDTA 

Somatostatin Pink Top 6 mL 

0 - 150 

Plasma 

Pancreatic Vacuette 

0 - 300 

Polypeptide 

Vaso. Int. Pep 1.5 - 4.2 

Chromogranin A < 60 

pmol/L 

SAMPLES MUST 

BE COLLECTED 

FASTING . 

TRANSFER TO 

LAB 

IMMEDIATELY 

Lab Note: 2 x SAS -20°C 

Medical Oncology Dept. 



London 

W6 8RF 

0208 846 1468 

Via 

Hammersmith Hospital 

02083833949 

28 DAYS







TEST 

Haptoglobin 

HbA1 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Lavender Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

3mL 

SAMPLE 

TYPE 

Serum 

EDTA Whole 

Blood 

REFERENCE 

RANGES 

Male 0.5 – 2.0 

Female 0.4– 1.6 

6.5 - 7.5 

48 - 59 

HCG 

2d - 1w 

1.0 

Female >1.2 

SPECIAL 

PRECAUTIONS 



KEY FACTORS 

levels may be 

affected in 

patients with Hb 

variants or 

altered red cell 

turnover 

pregnancy 

Male patients 

REFERRAL 

LABORATORY 

(INC ADDRESS) 




Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 




London W6 8RF 

0208 8461468 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

48 HOURS 

24 HOURS 

14 DAYS 



HMAB 


Department of 

Immunology 


PO Box 894 


01142 715552 

14 DAYS







TEST 

Haemochromatosis 

(HFE Gene) 

Histone 

antibodies 

5HIAA 24 hr 

HLA 

antibodies 

HLA A,B,C 

phenotype 

SPECIMEN 

CONTAINER 

Lavender Top 

Vacuette 

Gold Top 

Vacuette 

Acidified 24h 

bottle 

Red Top 

Vacuette + Pink 

Top Vacuette 

Pink Top 

Vacuette 

VOLUME 

NEEDED 

3mL 

SAMPLE 

TYPE 

EDTA 

Whole 

Blood 

REFERENCE 

RANGES 

UNITS 

4mL Serum 0 - 5 u/mL 

4mL + 6mL 

3 x 6mL 

Urine 5 - 35 umol/d 

Plain 

Whole 

Blood + 

EDTA WB 

EDTA 

Whole 

Blood 

SPECIAL 

PRECAUTIONS 



physician 



ANAE 





physician 




physician 


KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Wessex Regional Genetics 

Lab 

Salisbury District Hospital 

Odstock 

Salisbury 

SP2 8BJ 

01722 429080 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 




Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

H&I Laboratory 

National Blood Service 

South Thames Centre 

75 Cranmer Terrace 

Tooting 

London WS17 0RB 

0208 258300 





Tooting 


0208 258301 

TURN – 

AROUND 

(working 

days) 

6 WEEKS 

Results 

returned 

direct to 

requesting 

physician 

8 WEEKS 

10 DAYS 

Results 

returned 

direct to 

requesting 

physician 

Results 

returned 

direct to 

requesting 

physician







TEST 

HLA B27 

HLA DP 

HLA DR,DQ 

Homovanillic 

acid 

Hormone Profile 

SPECIMEN 

CONTAINER 

PinkTop 

Vacuette 

Pink Top 

Vacuette 

Pink Top 

Vacuette 

see VMA 

VOLUME 

NEEDED 

6mL 

6mL 

3 x 6mL 

SAMPLE 

TYPE 

EDTA 

Whole 

Blood 

EDTA 

Whole 

Blood 

EDTA 

Whole 

Blood 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 



physician 




physician 




physician 


KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 





Tooting 


0208 258302 





Tooting 


0208 258303 





Tooting 


0208 258304 

TURN – 

AROUND 

(working 

days) 

Results 

returned 

direct to 

requesting 

physician 

Results 

returned 

direct to 

requesting 

physician 

Results 

returned 

direct to 

requesting 

physician 

Gold Top 

Vacuette 4mL Serum 72 HOURS 

Hu antibodies see Purkinje 


NEUR 

HVA See VMA 

Hydroxybutyrate 

Grey Top 

Vacuette 

4mL 

Fluoride 

Oxalate 

Plasma 



FROZEN IN 20 

MINUTES 




Childrens Hospital 

Western Bank 

Sheffield 

S10 2TH 

0114 271 7445 

21 DAYS







TEST 

Hydroxy - 

carbamazepine 

18 Hydroxycortisol 

17 Hydroxy - 

progesterone 

17 Hydroxy – 

progesterone 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Blood Spot 

card 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 15 - 35 mg/L 

4mL 

4mL 

Serum 

Blood spot 

Serum 

1.6 - 10.7 

(Ambulant) 

5 days 0 - 14 

nmol/L 

nmol/L 

SPECIAL 

PRECAUTIONS 



Lab Note: SAS Desk 


KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Medical Toxicology Unit 

4 th Floor 

North Wing 



02071 888689 


Mail Pint 8 Level C 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 


Mail Pont 8 Level C 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 


Mail Pint 8 Level C 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

10 DAYS 

21 DAYS 

21 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

IgA: 

cord blood 45yrs 0.8 - 4.0 


Department of 

IgD 

Immunology 

Gold Top 


Protein Reference Unit 21 DAYS 

Vacuette 

PO Box 894 



01142 715552 

IgE: 

0 – 12mths 0 - 11 

1y 0 - 29 

2 - 3y 0 - 43 

4 - 5y Gold Top 

0 - 52 

4mL Serum 

6 - 7y Vacuette 

0 - 56 

IU/L 24 HOURS 

8 - 10y 0 - 63 

11 - 12y 0 - 65 

13 - 14y 0 - 70 

>15y 0 - 81







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

IGF1 

Gold Top 

Vacuette 

4mL 

Serum 

Age related 

reference 

ranges apply 

ug/L 


- SAMPLE MUST 


MINUTES 




South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

14 DAYS 

IGF2 

IGFBP3 

Green Top 

Vacuette 

Gold Top 

Vacuette 

4mL Plasma nmol/L 

4mL Serum 0.7 – 4.4 mg/L 

Discuss with 

Consultant 

Biochemist 



Peptide Laboratory 

Royal Surrey County 

Hospital 

Egerton Rd 

Guildford GU2 5XX 

01483 406715 



Hospital 

Egerton Rd 


01483 406715 

14 DAYS 

14 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

IgG 

cord blood 5.2 - 18.0 

0 – 14days 5.0 - 17.0 

2 - 6wks 3.9 - 13.0 

7 - 11wks 2.1 - 7.7 

3 - 6mths 2.4 - 8.8 

7 - 9mths 3.0 - 9.0 

10mths – 1yr Gold Top 

3.0 - 10.9 

4mL Serum 

2yrs Vacuette 

3.1 - 13.8 

g/L 24 HOURS 

3yrs 3.7 - 15.8 

4 - 6yrs 4.9 - 16.1 

7 - 9yrs 5.4 - 16.1 

10 - 12yrs 5.4 - 16.1 

13 - 15yrs 5.4 - 16.1 

16 - 45yrs 6.0 - 16.0 

>45yrs 6.0 - 16.0 

IgG subclasses 

Gold Top 

Vacuette 

4mL Serum 10 DAYS 

IgG1 


15yrs (adult) Gold Top 

3.2 - 10.2 

4mL Serum 

IgG2 Vacuette 

g/L 


15yrs (adult) 1.2 - 6.6 








LONDON 

SW17 0NH 

02087250025 

14 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

IgG3 


15yrs (adult) 0.2 - 1.9 

IgG4 

cord blood 0 - 0.5 

15yrs (adult) 0 - 1.3 

SPECIAL 

PRECAUTIONS 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 







02087250025 







02087250025 

TURN – 

AROUND 

(working 

days) 

28 DAYS 

28 DAYS 

IgM 


0 – 14days 0.05 - 2.0 

2 - 6wks 0.08 - 0.4 

7 - 11wks 0.15 - 0.7 

3 - 6mths 0.2 - 1.0 

7 - 9mths 0.4 - 1.6 

10mths – 1yr Gold Top 

0.6 - 2.1 

4mL Serum 

2yrs Vacuette 

0.5 - 2.2 

g/L 4 HOURS 

3yrs 0.5 - 2.2 

4 - 6yrs 0.5 - 2.0 

7 - 9yrs 0.5 - 1.8 

10 - 12yrs 0.5 - 1.8 

13 - 15yrs 0.5 - 1.9 

16 - 45yrs 0.5 - 1.9 

>45yrs 0.5 - 2.0 

Igs 

Gold Top 

Vacuette 

Serum g/L 4 HOURS







TEST 

SPECIMEN 

CONTAINER 

Immunoglobulins see Igs 

Indirect immunofluorescence 

Inhibin B 

Insulin 

Glucose / Insulin 

Ratio 

Insulin antibodies 

Insulin like 

growth factor 1 

see Epidermal 

antibodies 

Gold Top 

Vacuette 

Gold Top 

Vacuette 


Grey Top 

Vacuette 

Gold Top 

Vacuette 

see IGF1 

VOLUME 

NEEDED 

4mL 

2 x 4mL 

SAMPLE 

TYPE 

Serum 

Serum 


Fluoride 

Oxalate 

Plasma 

REFERENCE 

RANGES 

Male 25 - 325; 

Female







TEST 

Intrinsic factor 

antibodies 

Iron 

Iron - urine 

Islet cell 

antibodies 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Plain 24h 

bottle 

Gold Top 

Vacuette 

Jo-1 antibodies see AIP 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 0 - 6.0 u/mL 

4mL 

Serum 

M 14.3 - 28.6 

F 12.5 - 25.0 

umol/L 

Urine 0.2 – 1.0 umol/d 


SPECIAL 

PRECAUTIONS 


IFAB 




ICAB 


ANAE 

KEY FACTORS 

Levels are 

artefactually 

increased by in 

vitro haemolysis 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 





Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 


Department of 

Immunology 


PO Box 894 


01142 715552 

TURN – 

AROUND 

(working 

days) 

18 DAYS 

4 HOURS 

10 DAYS 

14 DAYS 

K 

see 

Potassium 

4 HOURS







TEST 

Karyotype 

SPECIMEN 

CONTAINER 

Green Top 

Vacutte 

La antibodies see ENA 

Lactate 

Lactate 

dehydrogenase 

Lamotrigine 

Laxative screen 

LDH 

LDL 

LE Screen 

(SLE Screen) 

Grey Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

4mL 

SAMPLE 

TYPE 

Lithium 

Heparin 

Whole 

Blood 

Fluoride 

Oxalate 

Plasma 

REFERENCE 

RANGES 

0.6 - 2.4 

1 Day 0.0 - 3.7 

2 Days 0.0 - 2.7 

UNITS 

mmol/L 

SPECIAL 

PRECAUTIONS 



Lab NB: Advia BMS 

KEY FACTORS 


direct to 

requesting 

physician 

REFERRAL 

LABORATORY 

(INC ADDRESS) 




Hospital 

Odstock 

Salisbury 

SP2 8BJ 

01722 429080 

TURN – 

AROUND 

(working 

days) 

28 DAYS 

24 HOURS 

see LDH 4 HOURS 

Gold Top 

Vacuette 

Plain (white 

top) Universal 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 


3 x 10mL Urine 



Take 3 samples 

over 3 consecutive 

days 


Levels are 

reduced in 

patients on 

hrt/ocp and 

during 

pregnancy 


4 th Floor 

North Wing 



02071 888689 


West Park Hospital 

Epsom 

Surrey 

KT19 8PB 

01372 734724 

10 DAYS 

28 DAYS 

4 HOURS 

4mL Serum < 3.0 mmol/L Fasting sample 4 HOURS 

4mL Serum 

Lab Note: 4°C 

ANAE 

10 DAYS







TEST 

Lead 

Levetiracetam 

LFT 

SPECIMEN 

CONTAINER 

Lavender Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

3mL 

SAMPLE TYPE 

EDTA Whole 

blood 

4mL Serum 

4mL 

Serum 

REFERENCE 

RANGES 

UNITS 

< 0.5 umol/L 

ALB 32-48 

ALP 35 -140 

ALT 0 - 49 

BILI 0 - 17 

g/L 

IU/L 

IU/L 

Umol/L 

SPECIAL 

PRECAUTIONS 


Lab Note: SAS - 

20°C 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


Dept of Chemical Pathology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 


4 th Floor 

North Wing 



02071 888689 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

10 DAYS 

4 HOURS 

LH: 

Pre pubertal







TEST 

Lithium 

Liver Antibody 

Screen 

Liver/Kidney 

Microsomal Abs 

(LKM Abs) 

Lysosomal 

enzymes 

M2 antibodies 

Magnesium 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Lavender Top 

Vacuette or 

Green Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4mL Serum 0.4 - 1.2 mmol/L 4 HOURS 

4mL Serum _ _ 

4mL Serum _ _ 

3mL 

or 

4mL 

EDTA Whole 

Blood 

or Lith Hep 

Whole Blood 

4mL Serum _ _ 


LIV 


LIV 


Must be sent within 

24hrs 


AMM2 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796229 or 

02380 796650 




BRISTOL 

BS2 8HW 

0117 928 2590 

Southampton 

Immunology 


Soutthampton General 

Tremona Road 

Southampton 

SO16 4YD 

02380 796615 

10 DAYS 

10 DAYS 

14 DAYS 

10 DAYS 

4mL Serum 066 - 1.08 mmol/L 4 HOURS







TEST 

Mercury 

Mercury 

SPECIMEN 

CONTAINER 

Lavender Top 

Vacuette 

Plain (white 


VOLUME 

NEEDED 

3mL 

Methaemoglobin 3mL 

Methotrexate 

Microsomal 

antibodies 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

SAMPLE 

TYPE 

EDTA 

Whole 

Blood 

10mL Urine 

EDTA 

Whole 

Blood 

REFERENCE 

RANGES 

0.0 - 1.5 

UNITS 

nmol/L 

nmol / 

mmolCr 

4mL Serum umol/L 

4mL Serum 

SPECIAL 

PRECAUTIONS 


Random Sample 




BY ARRANGMENT 

ONLY - PLEASE 

CONTACT THE 

LAB BEFORE 

TAKING 



LIV 

KEY FACTORS 

ONLY available 

for high dose 

infusions 

REFERRAL 

LABORATORY 

(INC ADDRESS) 





Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 





Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

Dept of Chemical 

Pathology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796615 

TURN – 

AROUND 

(working 

days) 

18 DAYS 

18 DAYS 

24 HOURS 

6 HOURS if 

URGENT 

10 DAYS







TEST 

Mitochondrial 

antibodies 

Mycophenolate 

(MMF) 

Mucopolysaccharides 

Mycophenolate 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Lavender Top 

Vacuette 

Plain (white 


see MMF 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum _ _ 

3mL EDTA WB mg/L 

10mL Urine mg/mmol 

SPECIAL 

PRECAUTIONS 


LIV 




KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Southampton 

Immunology 



Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796229 or 02380 

796650 

Immunosuppressive 

Drug Monitoring 

Institute of Liver Studies 

King's College Hospital 

Denmark Hill 


0203 2993147 




BRISTOL 

BS2 8HW 

0117 928 2590 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

10 DAYS 

14 DAYS 

Myeloperoxidase 

antibodies 

Myoglobin 

see ANCA 

Plain (white 



ANCA 

U random Random Sample 24 HOURS 

Na see Sodium 4 HOURS 

Neurotensin 

Large 

Pink Top 

Vacuette 

1 x 6 mL 

EDTA 

Plasma 

0 - 100 pmol/L 

Contact Lab. 

Special request 

ONLY 

Lab NB : 2 xSAS -20ºC 

Patient must be 

fasting. 

Transfer sample 

to Lab 

immediately 

Medical Oncology Dept. 



London 

W6 8RF 

0208 846 1468 

28 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Neuronal 

Antibodies 

Gold Top 

Vacuette 

4mL Serum _ _ 


NEUR 


Department of Immunology 


PO Box 894 


01142 715552 

14 DAYS 

NMDA Antibodies 

Gold Top 

Vacuette 

4mL Serum 


Immunology 


Headington 

Oxford 

OX3 7LJ 

01865 225995 

21 DAYS 

Occult Blood 

Plain 

(orange top) 

Faeces 48 HOURS 

specimen pot 

Oestradiol 

Male < 191 

Female: 

Prepubertal Gold Top 







TEST 

Organic Acids 

SPECIMEN 

CONTAINER 

Plain (white 


VOLUME 

NEEDED 

SAMPLE 

TYPE 

10mL Urine 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 



KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 




Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

TURN – 

AROUND 

(working 

days) 

18 DAYS 

Osmolality - 

serum 

Gold Top 

Vacuette 

4mL Serum 280 - 295 

mosm / 

kg 

24 HOURS 

Osmolality - urine 

Ovarian 

antibodies 

Oxalate - urine 

Plain (white 


Gold Top 

Vacuette 

Acidified 24h 

container 

10mL Urine 40 - 1040 

mosm / 

kg 

4mL Serum _ _ 

Urine 

M 80 – 490 

F 40 - 320 

umol/d 

Random Sample. 

For Water 

Deprivation Test - 

contact Lab in 

advance 



OVAR 

24h Sample 



Dept of Immunology 


PO Box 894 


01142 715552 

Clinical Biochemistry UCL 

Hospitals 

3rd Floor, 

60 Whitfield St 

London W1T 4EU 

0845 155 5000 

Ext 9405 

24 HOURS 

14 DAYS 

10 DAYS







TEST 

P1NP 

Pancreatic 

Polypeptide 

Paracetamol 

Parathormone, 

parathyroid 

hormone 

Parietal cell 

antibodies 

PBG 

PCNP III 

Pemphigus/ 

Pemphigoid 

Antibodies 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

see Gut 

hormones 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 


UNITS 

4mL Serum ug/L 

4mL 

Serum 

Normal .200 

Toxic risk at 12hr >50 

SPECIAL 

PRECAUTIONS 


KEY 

FACTORS 

REFERRAL LABORATORY 

(INC ADDRESS) 

Dept. of Clinical Biochemistry 

4 th Floor Duncan Building 

Royal Liverpool University 

Hospital 

Prescott Street 

Liverpool L7 8XP 

0151 706 4230 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

mg/L 4 HOURS 

see PTH 24 HOURS 

Gold Top 

Vacuette 

see Porphyrins 

- urine 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL Serum 

4mL Serum 1.7 - 4.2 ug/L 

4mL Serum 


GPCA 



PEMP 




Hospital 

Tremona Road 


02380 796229 or 

02380 796650 

Dept of Chemical Pathology 



Hospital 

Tremona Road 


02380 796427 




Hospital 

Tremona Road 


02380 796615 

14 DAYS 

18 DAYS 

18 DAYS







TEST 

Phenobarbitone 

Phenytoin 

Free phenytoin 

Phosphate - 

serum 

Phosphate - urine 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 



4mL Serum 1.0 – 2.0 µg/mL 

4mL 

Serum 







TEST 

Porphobilinogen 

Porphyrins - 

blood 

Porphyrins - 

faeces 

Porphyrins - urine 

Potassium 

SPECIMEN 

CONTAINER 

see Porphyrins 

- urine 

Lavender Top 

Vacuette 

Plain 

(orange top) 

specimen pot 

Plain (white 


Gold Top 

Vacuette 

VOLUME 

NEEDED 

3mL 

SAMPLE 

TYPE 

EDTA 

Whole blood 

Faeces 

10mL Urine 

REFERENCE 

RANGES 

UNITS 


SPECIAL 

PRECAUTIONS 


Lab Note : -20ºC 

Random 

SAMPLES MUST 

BE KEPT IN THE 

DARK PRIOR TO 

ANALYSIS 

KEY FACTORS 

May be referred as 

follow up to inhouse 

findings 

Levels artefactully 

increased by invitro 

haemolysis and 

delayed sample 

centrifugation. 

Levels may also be 

artefactually raised 

in patients with 

high platelet count. 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Porphyria Service 

Department of Medical 

Biochemistry 

University Hospital of 

Wales 

Neath Park 

Cardiff, CF14 4XW 

0292 0743565 



Biochemistry 


Wales 

Neath Park 


0292 0743565 



Biochemistry 


Wales 

Neath Park 


0292 0743565 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

14 DAYS 

21 DAYS 

24 HOURS 

or 10 days if 

referred 

4 HOURS







TEST 

Potassium - urine 

Potassium - urine 

PR3 antibodies 

SPECIMEN 

CONTAINER 

Plain 24h 

container 


universal 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 



4mL Serum 0 - 9.0 u/mL 

SPECIAL 

PRECAUTIONS 

24h collection 


Vacuette, Advia tray 





ANCA 

KEY 

FACTORS 


(INC ADDRESS) 




Hospital 

Tremona Road 


02380 796229 or 

02380 796650 

TURN – 

AROUND 

(working 

days) 

24 HOURS 

24 HOURS 

10 DAYS 

Primidone 

see Phenobarbitone 

Pristanate See VLCFA 28 DAYS 

Procollagen III N- 

peptide 

see PCNP 10 DAYS 

Progesterone: 

Female mid luteal 

phase: 

Not lutenised 30 

Proinsulin 

Gold Top 

Vacuette 

plus 

Grey Top 

Vacuette 

4mL 

plus 

4mL 

Serum 

plus 

Fluoride 

Oxalate 

Plasma 



FROZEN WITHIN 

1 HOUR 


Take sample for 

glucose at the same 

time 

Contact 

Consultant 

Biochemist 


Royal Surrey County Hospital 

Egerton Rd 

Guildford 

GU2 5XX 

01483 406715 

21 DAYS







TEST 

Prolactin 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

SAMPLE 

TYPE 

Serum 

REFERENCE 

RANGES 

50 - 350 

In Pregnancy 206 - 2240 

Prostate specific 

antigen 

Protein - CSF 

Protein - fluid 

Protein - serum 

total 

Protein - urine 

24h 

Protein Creatinine 

Ratio 

Protein - urine 

random 

PSA 

UNITS 

µg/L 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

Levels may be 

physiologically 

elevated by 

stress, during 

pregnancy and 

in patients on 

anti psychotic 

drug therapy 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

72 HOURS 

see PSA 24 HOURS 

see CSF 

protein 

Plain (white 


0.1 - 0.4 g/L 4 HOURS 

5mL Fluid 24 HOURS 

Serum 

see Total 

Protein 

plain 24h bottle Urine 0 - 0.15 g/d 

Plain (white 


Plain (white 


Gold Top 

Vacuette 



universal 

24 HOURS 

10mL Urine 7 - 23 24 HOURS 

10mL Urine 0 - 0.10 g/L Random Sample 24 HOURS 

4mL 

Serum 

60 Yr 0-5.5 

ug/L 

Levels may be 

elevated in UTI, 

acute retention, 

post ejaculation 

(up to 48h) and 

post DRE (up to 

14 d) 

24 HOURS







TURN – 

REFERRAL 

SPECIMEN VOLUME SAMPLE REFERENCE 

SPECIAL 

AROUND 

TEST 

UNITS 

KEY FACTORS LABORATORY 

CONTAINER NEEDED TYPE RANGES 

PRECAUTIONS 

(INC ADDRESS) (working 

days) 

PSA - free see Free PSA 21 DAYS 

Pseudocholinesterase 

PTH 

PTH-related 

peptide 

Purkinje 

antibodies 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL Serum 600 – 1400 U/L 

4mL Serum 1.48 - 7.63 pmol/L 

SPECIAL SPECIAL 0.7 - 1.8 pmol/L 

Gold Top 

Vacuette 

Rapamune see Sirolimus 

RAST 

Gold Top 

Vacuette 

4mL Serum _ _ 

4mL Serum 



- SAMPLE MUST 

BE FROZEN 

WITHIN 1 HOUR 


CONTACT LAB - 

SPECIAL TUBE 

REQUIRED - BY 

ARRANGEMENT 

ONLY! 



NEUR 


100uL + 40uL each test 

Specific RAST 

allergens MUST 

be stated on 

request form 

Chemical Pathology Dept 

Royal Hampshire County 

Hospital 

Romsey Rd 

Winchester SO22 5DG 

01962 824287/8 


4 th Floor 

Duncan Building 

Royal Liverpool University 

Hospital 

Prescott Street 

LIVERPOOL 

L7 8XP 

0151 706 4230 


Department of 

Immunology 


PO Box 894 


01142 715552 

Department of 

Immunology 

Clinical Laboratory 


Hospital 

Egerton Road 


01483 464029 

21 DAYS 

24 HOURS 

5 WEEKS 

10 DAYS 

10 DAYS 

(RARE 

ALLERGENS 

28 DAYS)







TEST 

Red cell acetyl 

cholinesterase 

SPECIMEN 

CONTAINER 

Lavender Top 

Vacuette 

VOLUME 

NEEDED 

3mL 

SAMPLE 

TYPE 

EDTA 

Whole 

blood 

REFERENCE 

RANGES 

Reducing 

substances - 

faecal 

Reducing 

substances - 

urine 

Renin: 

Supine 2 - 30 

Ambulant 3 - 40 

Children: Lavender Top 

EDTA 

3mL 

< 7d Vacuette 

Plasma 4 - 340 

1wk - 1yr 4 - 100 

1 - 11yrs 4 - 85 

Reticulin 

antibodies 

UNITS 

>97 hu/L 

SPECIAL 

PRECAUTIONS 


KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Biomedical Sciences 

Group 

Health & Safety Lab 

Harper Hill 

Buxton 

Derbyshire SK17 9JN 

01298 218099 

TURN – 

AROUND 

(working 

days) 

28 DAYS 

see Sugars 10 DAYS 

see Sugars 10 DAYS 

mu/L 


- SAMPLE MUST 


MINUTES 


see Coeliac 

screen Lab Note: COEL 4°C 

Ri antibodies see Purkinje Lab Note: SAS -20°C 

NEUR 

Ro antibodies see ENA Lab Note: SAS 4°C 

ANAE 

RNP antibodies see ENA Lab Note: SAS 4°C 

ANAE 

Levels may be 

affected by 

posture, and 

antihypotensive 

or 

mineralosteroid 

drug therapy 



South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

14 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY 

FACTORS 


(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

SAA see Amyloid A 

Salicylate 

Gold Top 

Vacuette 

4mL 

Serum 

Analgesic 120 – 300 

Toxic Risk >400 

mg/L 4 HOURS 

Scl 70 antibodies see AIP 

Selenium 

Sex hormone binding 

globulin (SHBG) 

Sirolimus 

Skin antibodies 

Slophylline 

Dark Blue 

Vacuette 

Gold Top 

Vacuette 

Lavender Top 

Vacuette 

Gold Top 

Vacuette 

see 

Theophylline 

6mL Serum 0.8 - 2.0 umol/L 

4mL 

Serum 

3mL EDTA WB 

4mL Serum 

M 10 - 70 

F 30 - 120 


ANAE 






Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

14 DAYS 

nmol/L 7 DAYS 



PEMP 



London 

SW17 0RE 

0208 725 5345 




Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796229 or 

02380 796650 

14 DAYS 

10 DAYS







TEST 

Sm antibodies 

Smooth muscle 

antibodies 

Sodium 

Sodium - sweat 

Sodium - urine 

24h 

Sodium - urine 

SPECIMEN 

CONTAINER 

see Liver 

antibodies 

see Liver 

antibodies 

Gold Top 

Vacuette 

Plain 2mL 

Tube 

Plain 24h 

bottle 

Plain (white 


VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 


LIV 


LIV 

KEY 

FACTORS 


(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

4mL Serum 134 - 147 mmol/L 4 HOURS 

Sweat < 40 mmol/L 



CONTACT LAB TO 

BOOK 

APPOINTMENT 

24h Collection 






24 HOURS 

24 HOURS 

24 HOURS 

Somatomedin C see IGF1 

Somatostatin 

see Gut 

Hormones 

Specific IgE see RAST 10 DAYS 

SSA antibodies 

(Ro) 

SSB antibodies 

(La) 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

4mL Serum _ _ 

4mL Serum _ _ 


ANAE 


ANAE 




Hospital 

Tremona Road 


02380 796229 or 

02380 796650 




Hospital 

Tremona Road 


02380 796229 

or 02380 796650 

10 DAYS 

10 DAYS







TEST 

Steroid profile 

Sugars - faecal 

Sugars - urine 

SPECIMEN 

CONTAINER 

Plain (white 


or 24hr plain 

bottle 

Plain (orange 

top) specimen 

pot 

Plain (white 


VOLUME 

NEEDED 

SAMPLE 

TYPE 

10mL Urine 

Faeces 

10mL Urine 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 


or 

24hr collection 


Deliver to lab 

immediately 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

Dept. of Clinical 

Biochemistry 

Kings College Hospital 

Denmark Hill 

London 

SE5 9RS 

0203 299 3856 

TURN – 

AROUND 

(working 

days) 

28 DAYS 

10 DAYS 

Deliver 

immediately 10 DAYS 

Tacrolimus 

Tau protein 

Lavender Top 

Vacuette 

see Beta-2 

transferrin 

3mL 

EDTA 

Whole 

Blood 

Suggested 

therapeutic 

range 

1.0 – 12.0 

ug/L 


Immunosuppressive 

Drug Monitoring 

Insitute of Liver Studies 

King's College Hospital 

Denmark Hill 


0203 2993147 

10 DAYS 

Tegretol 

see 

Carbamazepine 

Testosterone 

Gold Top 

Vacuette 

4mL 

Serum 

M 10.0 - 35.0 

F 0.5 - 2.6 

24 HOURS







TEST 

Thyroglobulin 

& Anti - 

Thyroglobulin 

antibodies 

TFT 

Theophylline 

Thyroid 

peroxidase 

antibodies 

Tissue 

transglutaminase 

antibodies 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

VOLUME 

NEEDED 

4mL 

4mL 

SAMPLE 

TYPE 

Serum 

Serum 

REFERENCE 

RANGES 







TEST 

TMPG 

Tubular 

Reabsorption 

of Phosphate 

SPECIMEN 

CONTAINER 


Universal 

VOLUME 

NEEDED 

10mL 

SAMPLE 

TYPE 

Urine 

REFERENCE 

RANGES 

Birth 1.43–3.43 

3-5m 1.48-3.30 

6-23m 1.15-2.60 

2-15y 1.15-2.44 

Adult 0.80-1.35 

UNITS 

mmol/L 

glomerular 

fluid 

Topiramate Gold Top Vacuette 4mL Serum 5 - 20 mg/L 

Total Protein Gold Top Vacuette 4mL Serum 63 - 79 g/L 

Toxicology - 

General 

Screen 

TPMT 

Thiopurine 

methyl 

transferase 


universalplus 

Lavender Top 

Vacuette 

plus 

Gold Top Vacuette 

Lavender Top 

Vacuette 

10mL 

plus 

1 x 3mL 

plus 

1 x 4mL 

3mL 

Urine 

plus 

EDTA 

Whole Blood 

plus 

Serum 

EDTA Whole 

Blood 

Normal 26 - 50. 

Carrier 10 - 25. 

Deficiency







TEST 

Trace Metals 

SPECIMEN 

CONTAINER 

See Cu, Zn 

and Selenium 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Transferrin 

Transglutaminase 

antibodies 

Triglycerides 

1st or 2nd 

Trimester 

Screening 

Gold Top 


Vacuette 

see Coeliac 

10 DAYS 

screen Lab Note: COEL 4°C 

Patients must be 

Gold Top 

fasting. There is 


4 HOURS 

Vacuette 

some interference 

from haemolysis. 

See Triple 

Test 

Triple Test 

Trimethylamine 

Troponin I 

Red Top 

Vacuette 

Plain (white 


Gold Top 

Vacuette 

4mL Serum 

10mL Urine 


plus Stored -20°C 

(unless small sample 

when all sent to QAH) 


(Early morning 

urine preferred) 



Queen Alexandra 

Hospital 

Cosham 

Portsmouth 

PO6 3LY 

02392 286903 


Molecular Genetics, 


Western Bank 

Sheffield 

S10 2TH 

0114 2 71 7445 

10 DAYS 

6 WEEKS 

4mL Serum < 0.05 ug/L 4 HOURS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMP 

LE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY 

FACTORS 


(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Tryptase 

Gold Top 

Vacuette 

4mL Serum 2 - 14 ug/L 

Lab Note: SAS -20ºC 


Department of Immunology 


PO Box 894 


0114 2 715552 

14 DAYS 

TSH 

TSH receptor 

Antibodies 

TRAB 

UDPD 

Uniphylline 

see TFT 

Gold Top 

Vacuette 

Plain (white 


see 

Theophylline 

4mL Serum 

10mL Urine 3.0 - 7.4 


TRAB 



Firs Laboratories 

RSR Ltd 

Parc Ty Glas 

Llanishen 

Cardiff 

CF14 5DU 

029 2076 5550 



South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

24 HOURS 

14 DAYS 

18 DAYS 

Urea 

Gold Top 

Vacuette 


Levels are 

greatly 

reduced during 

pregnancy 

4 HOURS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

Urea - urine Plain 24h bottle Urine 199 - 332 mmol/d 

Uric acid - joint 

Uric acid - serum 


universal 

Gold Top 

Vacuette 

Joint 

Fluid 

SPECIAL 

PRECAUTIONS 




KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

24 HOURS 


4mL Serum 0.12 - 0.42 mmol/L 4 HOURS 

Uric acid - urine Plain 24h bottle Urine 1.48 - 4.43 mmol/d 

Urobilinogen 

Urine Steroid 

Profile (USP) 

U&E - serum 

See steroid 

profile 

Gold Top 

Vacuette 

4mL 

see Bile 

Pigments 

Serum 

U&E - urine Plain 24h bottle Urine 

Valproate 

Vancomycin 

Very long chain 

fatty acids 

Pristinic acid 

Phytanic acid 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Gold Top 

Vacuette 

Na 134 - 147 

K 3.5 - 5.0 

Urea 2.6 - 6.0 

Creat 62 -124 

Na 130 – 220 

K 25 – 100 

Urea 199 -332 

mmol/L 

mmol/d 


4mL Serum mg/L 

4mL Serum 







Take sample 

before next 

dose. 

Lab Note: SAS - 

20°C 

Standardise sampling 

times if possible as 

levels may vary during 

the day 

Newborn 

Screening & 

Biochem Genetics 

Southmead 

Hospital 

Westbury-on-Trym 

Bristol BS10 5NB 

0117 3235556 

24 HOURS 

4 HOURS 

4 HOURS 

1 Hour for 

urgent 

24 HOURS 

24 HOURS 

24 HOURS 

21 DAYS







TEST 

SPECIMEN 

CONTAINER 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

SPECIAL 

PRECAUTIONS 

KEY FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 

TURN – 

AROUND 

(working 

days) 

Vigabatrin 

VIP 

Vitamin A 

Gold Top 

Vacuette 

see Gut 

Hormones 

Green Top 

Vacuette 

4mL Serum 5-35 mg/L 

4mL 

Li Heparin 

Plasma 

1.07 – 3.55 umol/L 



Medical 

Toxicology Unit 

4 th Floor 

North Wing 

St Thomas’ 

Hospital 


02071 888689 

Chemical 

Pathology Lab 

Level D 

South Block 

Southampton 


Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

28 DAYS 

14 DAYS 

Vitamin B12 

Gold Top 

Vacuette 

4mL Serum 161 - 531 ng/L 3 DAYS 

Vitamin D 

Gold Top 

Vacuette 

4mL 

Serum 

See report for 

interpretive 

comments 

nmoL/L 


Homerton 

University Hospital 

Homerton Row 

London 

E9 6SR 

0208 510 7887 

10 DAYS







TEST 

Vitamin D – 

1,25 di(OH) 

DHVD 

Vitamin E 

SPECIMEN 

CONTAINER 

Gold Top 

Vacuette 

Green Top 

Vacuette 

VOLUME 

NEEDED 

SAMPLE 

TYPE 

REFERENCE 

RANGES 

UNITS 

4mL Serum 72 - 125 pmol/L 

4mL Plasma 11.6 – 37.1 umol/L 

SPECIAL 

PRECAUTIONS 

MUST BE 

RECEIVED IN LAB 

WITHIN 30 

MINUTES 



KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 



South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 798717 

Chemical Pathology Lab 

Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

TURN – 

AROUND 

(working 

days) 

10 DAYS 

14 DAYS 

VLCFA 

see Very long 

chain fatty 

. 21 DAYS 

acids 

VMA/Metadrenalins 

Levels may Dept of Chemical 

(adult) 

be affected Pathology 


Adrenaline 0 – 0.1 

by 

Level D 

antihyperte South Block 

Dopamine Acidified 24h 

0.49 – 2.85 


Metadrenaline Urine 

nsive and 

Urine bottle 

< 1.4 umol/d 

Hospital 14 DAYS 

Noradrenaline 0.07 – 0.48 

antiprophyl Tremona Road 

atic drug 

Southampton 


therapy and SO16 6YD 

Normetadrenaline < 3.0 

02380 796427 

stress







TEST 

VMA (child) 

+ HVA 

Voltage-gated Ca 

antibodies 

Voltage-gated K 

antibodies 

White cell 

enzymes 

SPECIMEN 

CONTAINER 

Plain (white 


Gold Top 

Vacuette 

Gold Top 

Vacuette 

see Lysosomal 

enzymes 

VOLUME 

NEEDED 

SAMPL 

E TYPE 

REFERENCE 

RANGES 

UNITS 

10mL Urine Age related umol/mmolCr 

4mL Serum 

4mL Serum 

SPECIAL 

PRECAUTIONS 

Random sample 

MUST BE 

RECEIVED IN 

LAB WITHIN 

1 HOUR 



VGCC 


VKAB 

KEY 

FACTORS 

REFERRAL 

LABORATORY 

(INC ADDRESS) 


Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796427 

Immunology 


Headington 

Oxford 

OX3 7LJ 

01865 225995 

Immunology 


Headington 

Oxford 

OX3 7LJ 

01865 225995 

TURN – 

AROUND 

(working 

days) 

14 DAYS 

28 DAYS 

18 DAYS 

Yo antibodies 

see Purkinje Lab Note: SAS -20°C 

NEUR 

Xanthochromia Universal 1 mL CSF See Clinical procedure 

Lab Note: Special 4ºC 

Zinc 

Dark Blue 

Vacuette 

6mL Plasma 11.0 – 24.0 umol/L 

Must be bled in 

Phlebotomy 


Li Hep may be used for 

Paeds 



Level D 

South Block 


Hospital 

Tremona Road 

Southampton 

SO16 6YD 

02380 796237 

14 DAYS







HAEMATOLOGY 

TEST 

SAMPLE & COLLECTION 

INSTRUCTIONS 

REFERENCE RANGE UNITS COMMON INDICATIONS Turnaround 

time (working 

days) 

Antenatal screen 

Pink top 6ml Transfusion tube 1 

(Group and antibody screen) 

Antibodies (specific identification) Pink top 6ml Transfusion tube 2 

Blood Group and save serum Pink top 6ml Transfusion tube 1 

Bone marrow film 

Please contact Clinical Haematologist for 

Haematological malignant disorders 2 

patient review for potential bone marrow 

(with Trephine biopsy) 

7 

Cold Agglutinins 

Pink top 6ml Transfusion tube (keep sample < 1/32 Cold agglutinin disease; Raynaud’s 2 

at 37 o C) 

Direct Antiglobulin Test Lavender 3ml EDTA tube Haemolysis - antibody mediated 4 hours 

(Coombes Test) 

Donath Landsteiner (PCH) Pink top 6ml Transfusion tube - Contact 

2 

Consultant 

Genotypes and Phenotypes Pink top 6ml Transfusion tube 1 

HLA B27 

1 x large 6ml Lavender top EDTA tube or 2 

Ankylosing spondylitis 21 

x 3ml Lavender topped EDTA tubes 

(HLA B27 samples received 

Monday to Thursday only; to 

reach BNHFT Haematology Dept. 

by 12 noon the same day the 

sample is collected, as it is sent to 

the Regional Centre in 

Southampton). 

Kleihauer test 

Pink top 6ml Transfusion tube 

Trans-placental bleed 

4 hours 

and lavender top EDTA tube 

Anti Xa assay Light Blue citrate tube iu/mL Sub cutaeous Heparin monitoring On request 

or 4 

Beta 2 Microglobulin Yellow SST gel tube 0.0 – 1.7 ug/mL 10 

Bleeding time 

Appointment required - please ring Principal 3.5 – 9.5 min 

BMS Jane Needham







TEST 


INSTRUCTIONS 

Chromosomes 

Refer - please speak to laboratory 

(samples received Monday to Thursday only; to reach the Department by 4.00 pm the same day the sample is 

collected, as it is sent to the Regional Centre in Salisbury) 

CSF Cerebal Spinal fluid 

Coagulation screen 

Prothrombin Time 

INR Therapeutic 

APTT 

APTT Therapeutic 

Thrombin time 

Fibrinogen 

Fibrinogen Antigen 

Light Blue top citrate tube 


time 

(working 

days) 

10.9 – 13.9 

2 - 4 

25.4 – 34.6 

75.0 – 125.0 

11.2 – 13.6 

1.5 – 4.0 

1.43 – 3.55 

secs 

secs 

secs 

secs 

g/L 

Bleeding; bruising 

Pre operation 

Warfarin control 

Heparin monitoring 

D-Dimer Light Blue citrate tube 2 

10.0 – 17.3 

iu/dL 

iu/dL 

mg/L 

Investigation of abnormal 

coagulation 14 

Factor Inhibitor 

Factors VIII, IX, porcine inhibitors, 

screens 

FBC (Full Blood Count) 

[includes blood film 

if required] 

2 x Light Blue top citrate tubes Bethesda Investigation of abnormal 

coagulation 

Not response to factor therapy 

Lavender top 3ml EDTA tube 

Male 

Hb 130 - 180 

Female 

Hb 110 - 165 

WBC 4.0 - 11.0 

g/L 

g/L 

10*9/L 

14 

3 hours 

On request or 

14 

4 hours 

[With blood 

film 3 -5 

days] 

Platelets 150 - 500 

10*9/L







TEST 


INSTRUCTIONS 


time 

G6PD Lavender top 3ml EDTA tube - 4.6 – 13.5 u/g Hb Jaundice; Haemolysis post infection 2 

Glandular Fever screen Lavender top 3ml EDTA tube Infectious mononucleosis; EBV 4 hours 

May be positive in lymphoma & 

others 

Hb HPLC 

Hb electrophoresis 

HbA2 

HbF 

HbS, HbC, HbD, HbE 

Lavender top 3ml EDTA tube 

1.6 – 3.1 

0.1 – 1.0 

% 

% 

% 

Haemoglobinopathy 

Thalassaemia 

Antenatel and newborn screening 

programme 

3 

Abnormal Haemoglobins 

Sample for reference Centre 

Haptoglobin assay 

Heparin Induced 

Thrombocytopenia HITS 

INR (International 

normalised ratio) 

and warfarin dosing 

NAP test 

Lupus inhibitor 

Silca clot time 

Dilute Russel Viper Venom time 

IgM Cardiolipin 

IgG Cardiolipin 

Red cell Parasities 

Malaria film 

Malaria antigens 

Microfilariae 

Trypanosomes 

Leishmaniasis 

2x Lavender top 3ml EDTA tube 

Sent to Haemoglobin reference centre 

Oxford 

Yellow top SST gel tube 

To arrive at BHNFT Haematology by 12 

noon on day sample is taken as sample 

sent to Southampton 

0.7 - 3.8 g/L Haemolysis marker 4 

Yellow top SST gel tube Platelet count dropping by 50% in 24 

hours when heparin infusion started 

Light Blue citrate Tube 

Therapeutic 

Warfarin control 

2.0 - 4.0 

Lavender top EDTA tube 

- Discuss with laboratory 

4 x Light Blue citrate tubes 

Lavender top EDTA tube to Haematology 

for Film. 

Positive results sent to Hospital for Tropical 

Diseases 

30 - 100 2 

0.8 – 1.2 

0.8 – 1.2 

0 – 12 

0 – 13 

MPL 

GPL 

Dependant on 

abnormality.Up 

to 3 months 

On request or 

7 

4 hours 

14 

4 hours







TEST 

PK (Pyruvate kinase - red cell 

enzyme) 

Paroxysmal Noctural 

Haemoglobinuria 

Platelet Function Analysis 

Collagen / EPI 

Collagen / ADP 


INSTRUCTIONS 


time 

(Working 

days) 

Pyruvate kinase deficiency 4 

Lavender top EDTA tube - Contact 

haematology 

Lavender top EDTA tube. 100 % Haemolysis – anaemia 

Haemoglobinuria 


Test need to be done ASAP after 

collection. Please liaiase with Coagulation 87 – 167 

Secs 

ext 3294 

59 – 111 

Secs 

2 

3 hours 

Platelet Aggregation Special tubes and by appointment only; please contact the Principal BMS Jane Needham 

Red cell survival studies 

Red cell membrane studies 

Special tubes and by appointment only; 

please contact the Consultant 

Haematologist 

Sent to Bristol 

Reticulocyte count Lavender top EDTA tube 0.5 - 2.5% 109/l Red cell production; Aplasia; 

Bleeding haemolysis 

Up to two 

months 

Rheumatoid factor Yellow top gel tube RA 2 

Sickle test Lavender top EDTA tube 3 hours 

Thromboelastography 


Test need to be done ASAP after collection. 

Please liaiase with Coagulation ext 3294 

4 hours 

Thrombophilia screen: 

Antithrombin III 

Protein C 

Protein S Free 

APCR 

FVIIIc 

FV Leiden 

ProtrombinGene Mutation 

MTHFR 

4 x Light blue citrate and 2 x Lavender 

EDTA tubes 

Sent to Hammersmith 

Sent to Hammersmith 

Sent to Cambridge 

81.4 – 126.6 

88.3 – 163.5 

3.5 – 10.4 

2.5 – 4.9 

50 – 150 

iu/dl 

iu/dl 

iu/dl 

l/l 

% 

Thrombophilia 

4 hours 

On request or 

14







TEST SAMPLE & COLLECTION INSTRUCTIONS REFERENCE 

RANGE 

Additional Thrombophilia tests 

Anti Thrombin III antigen 

Protein C Antigen 

Total Protein S 

Plasminogen 

Homocysteine 

von Willebrand’s screen VWF 

VIIIc 

VWFAntigen 

VWF Ristocetin co-factor 

VWF Normandy 

VWF Collagen binding 

VIII Multimers 

White cell markers 

CD3 

CD4 

CD8 

CD16+56 

CD19 

LEUK 

4 x Light blue citrate 

Other rare Thrombophilia tests are available 

on request please discuss with Principal BMS 

Jane Needham 


224.0 – 367.0 

2.40 – 4.64 

19.1 – 34.3 

93.8 – 147.8 

Male 5.64 – 14.88 

Female3.0 –12.52 

50 – 150 

50 – 150.0 

50 – 150 

50 – 150 

1 Lavender EDTA 

samples received Monday to Thursday 0.72 – 2.74 

0.40 – 1.61 

0.22 – 1.12 

0.08 – 0.72 

0.08 – 0.61 

mg/L 

mg/L 

ug/mL 

iu/dl 

umol/L 

umol/L 

iu/dL 

iu/dL 

iu/dL 

iu/dL 

10*9/L 

10*9/L 

10*9/L 

10*9/L 

10*9/L 

UNITS COMMON INDICATIONS Turnaround 

time 

Working days) 

von Willebrand’s disease 14 

On request or 

14 

On request or 

2







SEROLOGY 

TEST 


INFORMATION 

REFERENCE 

RANGE 

UNITS COMMON 

INDICATORS 

TURNAROUND 

TIMES (WORKING 

DAYS) 

Alpha virus Gold top gel tube Referred - 21 Days 

Adenovirus antibody Refer to viral antibody screen 

Amoebic IFAT 

Gold top gel tube and a faeces 

Referred - 21 Days 

sample required also 

Antenatal screen (Rubella 

IgG, HIV, Hepatitis B 

surface antigen, Syphilis) 

Gold top gel tube 

(request form MUST be 

signed) 

8 (max) 

Tests performed on 

WEDNESDAY only. 

Antistaphylolysin Gold top gel tube Staphylococcal Referred - 21 Days 

disease 

Antistreptolysin O (ASO) Gold top gel tube Streptococcal Referred - 21 Days 

disease 

Aspergillus precipitins Gold top gel tube Farmers lung Referred - 21 Days 

Avian precipitins Gold top gel tube Referred - 21 Days 

Bartonella antibodies Gold top gel tube Cat scratch 

disease 

Bilharzia antibodies Gold top gel tube 


Bordetella pertussis Gold top gel tube Referred - 21 Days 

antibodies 

Borrelia burgdorferi Gold top gel tube 

Lyme disease 1 

antibodies 

Collection 8 weeks after bite. 

Brucella antibodies Brown top 4.7ml gel tube Brucellosis Referred - 21 Days 

Cat scratch disease Refer to Bartonella antibodies 21 Days







TEST 


INFORMATION 

Chlamydia psittaci Refer to viral antibody screen 

REFERENCE 

RANGE 

UNITS 

COMMON 

INDICATORS 

TURNAROUND 


DAYS) 

Chlamydia Trachomatis Gold top gel tube 


antibodies 

(By arrangement ONLY) 

Cytomegalovirus antigen Urine in a 25ml sterile universal container or 


respiratory secretions 

Cytomegalovirus IgM Gold top gel tube 1 

Cytomegalovirus IgG Gold top gel tube 1 

Dengue antibody Gold top gel tube Referred - 21 Days 

Enterovirus IgM (includes Gold top gel tube Referred - 21 Days 

antibodies to Coxsackie A 

and B and Echovirus 

infections) 

Epstein Barr virus Gold top gel tube Referred - 21 Days 

antibodies 

Filarial antibodies Gold top gel tube Referred - 21 Days 

Galactomanan Gold top gel tube Referred - 21 Days 

Haemophilus B antibody Gold top gel tube Referred - 21 Days 

Helicobacter pylori antigen Stool sample in 60ml universal 8 Testing performed 

Friday ONLY







TEST 


INFORMATION 

REFERENCE 

RANGE 

UNITS 

COMMON 

INDICATORS 

Hepatitis A IgG and IgM Gold top gel tube 1 

TURNAROUND 


DAYS) 

Hepatitis B surface antigen Gold top gel tube 7 

(NOT Antenatal) 

Hepatitis B antibodies Gold top gel tube. 

10 weeks post vaccination 

Immunity 8 Performed 

Tuesday ONLY 

Hepatitis B markers Gold top gel tube 1 after +ve screen 

Hepatitis B viral load Gold top gel tube 14 

Hepatitis C antibody Gold top gel tube 5 Mon – Thurs ONLY 

Hepatitis C viral load Gold top gel tube Referred -21 Days 

HIV 1 and 2 antibodies 

(NOT Antenatal) 


(request form MUST be 

signed and state Patient has 

consented to test) 

HIV viral load Lavender top EDTA tube Referred -21 Days 

Influenza A antibodies Refer to viral antibody screen 

Influenza B antibodies Refer to viral antibody screen 

Legionella antibodies Gold top gel tube Atypical Referred -21 Days 

pneumonia 

Legionella urinary antigen 25ml sterile universal 1 

Leishmania antibodies Gold top gel tube Referred -21 Days 

Leptospira antibodies Gold top gel tube Referred -21 Days 

Malaria 

Lavender top EDTA to haematology for Film 

and call Microbiologist for advice. Antibodies 

rarely required. 

1







TEST 

Measles antibodies IgG 

IgM 

Meningococcal PCR 


INFORMATION 



Lavender top EDTA tube. By 

prior arrangement with the 

laboratory. 

REFERENCE 

RANGE 

UNITS 

COMMON 

INDICATORS 

Ring CCDC if 

suspected 

Meningococcal 

disease 

Ring CCDC. 

Mumps antibodies Gold top gel tube Ring CCDC if 

suspected. 

TURNAROUND 


DAYS) 

1 

Referred -21 Days 



Mycoplasma antibodies Refer to viral antibody screen Referred -21 Days 

Parvovirus B19 IgM Gold top gel tube Suspected 

infection in 

pregnancy 

Q fever (Coxiella burnetii) 

antibodies 

RSV antibodies Refer to viral antibody screen 

Refer to viral antibody screen Puo flu like 

illness, returning 

traveller, animal 

exposure, culture 

negative 

Endocarditis 

Rubella IgG Gold top gel tube Immunity 7 

Rubella IgM 

Gold top gel tube. 

Date of onset essential. 

Infection. If 

suspected ring 

CCDC 




Schistosome antibodies Gold top gel tube Bilharzia Referred -21 Days 

Strongyloides serology Gold top gel tube Referred -21 Days 

Syphilis serology Gold top gel tube Infection 10







TEST 

ToRCH screen 

(Toxoplasma, Rubella IgM 

and IgG, CMV IgM, Herpes) 


INFORMATION 

REFERENCE 

RANGE 

UNITS 

COMMON 

INDICATORS 

TURNAROUND 


DAYS) 

Gold top gel tube Referred -21 Days 

Toxoplasma antibodies Gold top gel tube Infection 2 

Tropical screen 

Gold top gel tube – Discuss 

with Microbiologist 

Varicella zoster antibodies Gold top gel tube Immunity 1 

Viral respiratory antibody 

screen 

Gold top gel tube, collected 

between day 1-3 (acute) and 

day 10-21 (convalescent). 

The acute specimen will be 

stored until the convalescent 

is received. (Adenovirus, 

Chlamydia psittaci, CMV, 

C.burnetii, Influenza A and 

B, RSV, Mycoplasma). The 

range of investigations 

performed will depend on 

clinical details; accurate 

and full information will 

ensure the relevant tests 

are performed. 


Yersinia antibodies Gold top gel tube Referred -21 Days

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