1 - CHEMISTRY

Patient identification

30 minutes to 1 hour

1 to 2 hours

Pre-Analytics

• Important: _ _

• Prioritize Brain Attack (BAT), RRT, Code Blue, Heart Team, ER and In Patient samples

• Turnaround time:

  • BAT: ?

  • ER and In Patient: ?

red, yellow

299

216-217-218, 219-220-221

209

207

299

299

Blood

1. Serum samples (_ and _ tubes)

SERUM SAMPLES
Routine Chemistry Test	_
OGTT Samples	_-_-_ or _-_-_
2-hr Post Prandial Blood Sugar	_
Random Blood Sugar	_
Therapeutic Drug Monitoring	_
Blood Alcohol, Homocysteine	_

Therapeutic Drug Monitoring

Blood

• _ _ _ – red top, strictly no yellow top should be received; last dose and time of extraction should be noted

  • Cortisol, Vancomycin, Gentamycin, Carbamazepine, Phenobarbital, Phenytoin, Valproic Acid, Digoxin, Methotrexate

Lactate Assay, 404

Plasma Ammonia, NT-PRO BNP, High Sensitive Troponin I, 403

Blood

1. Plasma samples (centrifuge samples to obtain plasma)

PLASMA SAMPLES
_ _ (gray top)	_
Green Top (Lithium Heparin) (3)	_

Glycohemoglobin (HBA1C), 104

Tacrolimus, Cyclosporine, Sirolimus, 101

Troponin T, 403

Blood

1. Whole blood samples (do not centrifuge)

WHOLE BLOOD SAMPLES
_: Lavender top	_
(3): Lavender top *Note the last does and time of extraction	_
_ _: Green top	_

500

patient name and birthday

Urine Samples

1. Random urine; Random urine alcohol

   • Starting barcode: _

   • Label with complete (2) and aliquot into 2 test tubes.

600

Urine Samples

1. Routine 24 hr urine: 

   • Starting barcode: _

   • 24 hr urine Oxalate, Amylase, Calcium, Chloride, Creatinine, Endogenous Creatinine Clearance, Glucose, Magnesium, Osmolality, Phosphorous, Potassium, Protein, Protein Creatinine Ratio, Sodium, Urea Nitrogen, and Uric Acid 

1. Measure total volume of urine sample and indicate it on the request form

2. Log Patient details (Name, PIN number birthday), total volume of urine and test requested on 24 hr urine logbook

3. Aliquot into (2) test tubes label with complete patient name and birthday

Metanephrine, VMA, 5-HIAA, Catecholamine

50

2-3, HCI, 2-3

2-3

Urine Samples

1. 24 hr Metabolic urine: SEND OUT TO SLMC GLOBAL CITY

   • (4)

1. Measure total volume of urine sample and indicate it on the request form

2. Photocopy the request, this will serve as the request form for send out

3. PSR the barcode number and duplicate (6) copies of barcodes

4. Log Patient details by attaching the barcode labels in the 24 hr urine and Send out logbook and indicate Total volume of urine and the test requested

5. Aliquot into (2) conical tubes approximately _ mL each, attach the barcode label on it. Cover with Carbon paper and attach another barcode label on top of it as well

6. Acidify urine sample with _-_ drops of _ and gently invert sample _-_ times

7. Measure the pH of the sample with a pH strip. Should be pH _-_

8. (1) Sample should be sent to Global City, placed in a zip lock together with the photocopied request. The other sample should be kept for storage

110

RIGHT or LEFT

Body Fluids

1. Ascitic, Pleural, Pericardial, Peritoneal fluid

   • Starting barcode: _

1. Countercheck patient details indicated on primary container. Make sure that the specimen bottle number requested is indicated on the specimen bottle. For pleural fluid, double check if _ or _ pleural fluid sample is noted on the container and test request

2. Label with complete patient name, birthday, indicate if RIGHT OR LEFT (for pleural fluids), and the bottle number of primary container and aliquot into (2) test tubes

700

500, SSC+test tube

Body Fluids

1. CSF

   • Starting barcode: _

1. Countercheck patient details indicated on primary container. Make sure that the specimen bottle number requested is indicated on the specimen bottle

2. Label with complete patient name, birthday and the bottle number of primary container. Aliquot at least _ uL into (1) _+_

1,5 Anhydroglucitol, Amikacin

Send Out Samples to SLMC Global City

1. Blood samples: 

   • _ _ (GLYCOMARK) (either R or Y top) and _ (strictly red top only) 

   • Last dose and time of extraction must be noted. Centrifuge samples.

1. Photocopy (2) copies of the request form if encoded together with other tests, 1 copy will serve as test request to be sent to global, 2nd copy should be filed on send out folder. Cross out other tests except 2 tests mentioned above

2. Log patient details on the send out logbook including test requested

3. Place 1st photocopied request and the sample in a conical tube inside a ziplock and place in SANYO REF 1

Arkray

High Performance Liquid Chromatography

Processing of Samples

1. HBA1c

   • Machine: _

   • Principle: _ _ _ _

   • Control: 1x a day (night duty)

5, 450

5, 450

Processing of Samples

1. HBA1c

   1. Place the ff. on the sample rack: 

      • Tube position 2: Level 1: Prediluted sample: _ uL of patient or control sample + _ uL of diluent 80 in a microvial tube and place it in RACK H CONTROL RACK labeled as level 1

      • Tube position 4: Level 2: Prediluted sample: _ ul of patient or control sample + 450 ul of diluent 80 in a microvial tube and place it in the H CONTROL RACK labeled as level 2

   2. Place rack at the right side and press START 

   3. After every batch running, attach request on print out result and have it counter checked by staff

Model 3320 Osmometer

Freezing Point Osmolality

Protinol, Renol

Processing of Samples

1. Serum and Random Urine Osmolality 

   • Machine: _ _ _

   • Principle: _ _ _

   • Control: 1x a day (whenever there's a request) 

     • SERUM/PLASMA samples – _ (RED) L M H 

     • RANDOM URINE samples – _ (blue) L H

240 mOsm/kg

280

320

300 mOsm/kg

800

Processing of Samples

1. Serum and Random Urine Osmolality 

   • SERUM/PLASMA samples – PROTINOL (RED) L M H 

     • (3)

   • RANDOM URINE samples – RENOL (blue) L H

     • (2)

20

Processing of Samples

1. Serum and Random Urine Osmolality 

   1. Clean chamber

   2. Place pipette _ uL tip on pipettor, aspirate control or sample 

   3. Wipe tip gently with chamber cleaner

   4. Place pipettor in chamber and push it in

   • For controls, log in quality control logbook and plot U chart

   • For patient samples, have it counter checked by staff and write test result on request

Nova-Prime

Ion Selective Electrode (ISE)

1

Processing of Samples

1. Ionized Calcium

• Machine: _-_

• Principle: _ _ _

• Control: Nova Prime Control

  • 1x a day (night duty)

• Should be processed within _ hour because exposure to air could degrade the electrolyte

Spectrophotometry

routine samples

Processing of Samples

1. Atellica SCI

   • Principle: Chemiluminescence Immunoassay

     • _ for Chem

   • For _ _

Chemiluminescence Microparticle Immunoassay

TDM, Tacrolimus, Cyclosporine, Sirolimus

Processing of Samples

1. Architect

   • Principle: _ _ _

   • Usually for serology

Chem: (4)

Enzyme Linked Fluorescent Assay

Trop I

Processing of Samples

1. Vidas 3

   • Principle: _ _ _ _

   • For _ _

Chemiluminescence

methamphetamine, marijuana

Red

Processing of Samples

1. Dimension EXL

   • Principle: _(?)

   • For (2)

   • _ top

Spectrophotometry

Processing of Samples

1. Diazyme

   1. Principle: _