Haematology 01226 432810
Consultant Haematologists
Dr Jean-Pierre Ng
Tel : 01226 43(2765) bleep 338 email : jng@nhs.net
Dr Dominique Chan-Lam
Tel : 01226 43(2942) email : dchanlam@nhsnet
Test Selection
Specific test information including sample requirements, reference ranges, special requirements and contact details are available via this link
Sample Volumes and Collection Bottle Types
For details regarding sample volumes and specific collection bottle types click here.
Adding Tests to Existing Samples
Blood Sciences do not recommend or encourage the use of ‘add-on tests’.
However under specific circumstances additional tests may be added to existing requests provided the sample is remains viable. Click here for further information.
Referral Laboratory Contact Details
Click here for addresses and telephone numbers of test referral laboratories listed in the test
‘High Risk’ Samples
Samples from patients with blood borne virus diseases constitute a particular hazard to laboratory staff. All infectious specimens and their accompanying request forms should be clearly marked with ‘Danger of Infection’ stickers.
The range of investigations available on such specimens may be limited. Please contact the laboratory for further information.
Appropriateness of the Request
Biochemical requests are only of clinical significance when ordered in the correct context and within an appropriate time frame. Where possible, Sunquest ICE will prompt the user that existing requests or results already exist on certain analytes to prevent over-ordering of the same tests, therefore, reducing analysis costs and ensuring the best care for the patient.
Doctors requesting investigations should bear in mind Asher’s catechism (British Medical Journal 1954; ii: 460).
- Why do I request this test?
- What will I look for in the result?
- If I find what I’m looking for will it affect my diagnosis?
- How will this investigation affect my management of this patient?
- Will this investigation ultimately benefit this patient?
Critical Results- Haematology
All Haematology results meeting the criteria in the table below will be phoned to the requesting clinician either during working hours or to the out-of-hours service except where the results are persistently abnormal. In these cases, only a change to results that may affect patient management will be phoned.
Results phoned to the out-of-hours service will also be phoned to the GP surgery the following morning to verify that action has been taken.
|
Analyte
|
Critical Limit(s)
|
| Hb |
<80g/l |
| Platelet count |
<50 x 109/l |
| Suspected leukaemia |
Blasts,high WBC,etc. |
| Neutrophils |
<1.0 x 109/l |
| Glandular fever screen |
Positive (In Patient’s) |
| Malaria screen |
Positive |
| Emergency Sickle Screen |
All |
| INR |
>5.0 |
| APTT Ratio |
>4.5 |
| Fibrinogen |
< 1.5g/l |
| DDimer |
>20.0ug/ml |
| All Coagulation Factors |
Below Reference Range |
In addition, the following cases will be promptly referred to a Consultant Haematologist for direct clinical liaison and advice after telephoning to the requesting clinician:
- Newly presented leukaemias
- Newly presented malaria infection
- Positive sickle haemoglobin screen in patients about to undergo anaesthesia
Tumour Markers
The ideal tumour marker has not yet been identified. Increased concentrations can be caused by certain non-malignant conditions thus care must be taken with interpretation. Tumour markers should not be used for unselected population screening. Their major role is in the assessment and follow-up of patients with cancer. The requesting clinician should, therefore, always specify exactly which tumour markers are required and not simply ask for ”Tumour Markers”. The following table lists some of the better established applications of the tumour markers which are available in-house.
The following tumour markers are available in-house:
-
| Tumour Marker |
Malignancy |
| AFP |
Hepatoblastoma
Hepatocellular carcinoma
Gonadal and extra-gonadal germ cell tumours (with b-HCG) |
| b-HCG |
Choriocarcinoma*
Hydatidiform mole*
Gonadal and extra-gonadal germ cell tumours (with AFP) |
| CA 125 |
Ovarian malignancy |
| CA 199 |
Pancreatic cancer |
| CEA |
Colorectal cancer |
| PSA |
Prostate cancer |
* patients should be registered with a Trophoblastic Tumour Treatment Centre – Sheffield.
Tumour markers not offered as in-house investigations can be provided by other centres. Please contact the laboratory for further information.
β-HCG In Pregnancy
b-Human chorionic gonadotrophin (b-HCG) becomes detectable in the maternal circulation about seven days after fertilisation ie. about the time of implantation and is measurable about a week before the first missed menstrual period. Thereafter the concentration rises rapidly, doubling every two to three days until it peaks at about ten weeks of gestation. Serum b-HCG should not be used as a routine pregnancy test. It has, however, an important role in the diagnosis and management of suspected ectopic pregnancies, threatened abortions and early pregnancies in which the viability is in doubt.
GP ICE User Guides
Please see the ICE user guides below for on-line electronic Pathology requesting for GP service users.
ICE training for GP service users is provided by the GP Liaison officer.
Outpatient Phlebotomy Manager/GP Liaison Officer
Carol Heritage
Tel : 01226 43(2582) email : cheritage@nhs.net
GP EMIS Web Practice Systems
ICE Training Manual EMIS
GP TPP System One Practice Systems
ICE Training Manual TPP
Accessing the service
- Tel: Haematology 01226 432862
