CLINICAL LAB SCIENEC

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ESSENTIALS OF CLINICAL LABORATORY SCIENCE
The blood bank is not highly automated, although new technologies such
as gel technology in which antigens or antibodies may be imbedded in a gel
reagent are in wide use. Highly skilled technologists and sometimes technicians
are involved with measuring and pipetting test reagents and blood in minute
volumes. The work is meticulous and records must be extremely accurate. All
transfusion reactions observed in the patient must be followed up, even though
many of those reactions are of an allergic nature and routine testing will not
show any problem areas. Many technologists in the blood bank possess a master’s
degree in their chosen specialty and perform a great deal of highly specialized
testing for unusual antibodies and antigens, which may have a genetic basis.
With advances in genetic studies, it is entirely possible that the blood bank will
be divided into more than one section, and routine testing for compatibilities of
tissues and genetic tests for procedures not currently performed routinely may
be offered in this major department.
Clinical Chemistry
Hundreds of chemistry examinations for the blood are performed daily in most
chemistry laboratories. It is not cost-effective to perform all of the chemistry
procedures that may be ordered, as some are required at such low volumes that
it is economically wise to send these to a reference laboratory. Fifty or more
tests comprise the majority of procedures performed on a daily basis. Many
of these tests are grouped together in panels or groups of tests that help to differentiate
between various disease states. The large automated instruments used
are extremely accurate and specific for many acute and chronic diseases. This
department provides more definitive result used in rapid diagnosis than almost
any other laboratory section, as the routine tests are available quickly and at any
time.
The presence of many different types of organic and biochemical constituents
in the blood and other body fluids aids in diagnosing various diseases. For
instance, if the kidneys are not properly functioning, there will be an inordinate
level of toxic wastes in the liquid portion of the blood, either serum or plasma,
indicating that the kidneys are not ridding the body of waste products. And in
some cases, malfunction of the kidneys may cause the loss of materials such
as minerals and proteins that the body should be reabsorbing and using in its
metabolism. When certain tissues are damaged, enzymes peculiar to a particular
tissue or organ will cause a rise in certain enzymes as the cells die, giving a clue
as to the tissues being damaged. Tests for therapeutic drug levels and drugs of
abuse are commonly performed in the clinical chemistry department.
The chemistry department is usually the most automated of all the divisions
of the laboratory. In most laboratories, there are one or more large, complex
instruments that perform thousands of tests per hour. These instruments are
highly accurate, sensitive, and specific, and require that the results be evaluated
by the laboratory worker when the values are reported and before they are sent
to the physician who will treat the patient. Some large hospital laboratories may
have several sections within the chemistry department that perform only certain
specific and specialized procedures.
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