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Laboratory Medicine

General Information / High Risk/Danger of Infection Samples

There is an absolute requirement that high risk samples are labelled as such before transport to the laboratory.  The HSE advise the provision of sufficient information on specimen request forms to staff in clinical diagnostic laboratories to enable them to apply the correct safety measures to control the risk. The lack of sufficient relevant clinical details provided on specimen request forms can result in samples being handled at the wrong biological containment level with resulting increased risk of infection to laboratory staff.

Samples must be considered High Risk if the patient has, or is suspected of having:

 CJDv  Hep B Hep C  HIV   TB

 Any other disease classed as category 3 or above

 

Samples from patients with jaundice of unknown origin and patients known to engage in high risk activities, such as IV drug abuse, and or those with recent history of relevant foreign travel that may increase likelihood of exotic agents being present must also be considered high risk.

 

Blood from these patients should normally be taken by medical staff. If Phlebotomists are asked to take blood they must be informed of the situation. This is the personal responsibility of the doctor making the request.  If Phlebotomists are asked to take blood from patients being barrier nursed they must be informed of the situation.

Requests made by order comms electronic requesting

The High Risk box must be ticked when making the request on Ordercomms. This ensures a subtle format change to the request form which, along with the use of double bagging, provides all the labelling required.

Requests made to Microbiology

For all high risk samples the high risk box on the Microbiology request form must be ticked.  Remember to complete the Microbiology request form with all patient details as usual. The sample should be double bagged by placing it inside a second Microbiology request form bag.

Other requests

Requests for departments other than Microbiology, (and where no Order Comms requesting is available), must clearly indicate the infection risk of the patient on the request card.  New request forms are in process for other disciplines which will follow the Microbiology approach in due course. The sample should be double bagged by placing it inside a second request form bag.

Radioactive Samples

Biological samples (blood, urine, tissues or organs) obtained from patients who have recently received radioactive materials for the purposes of therapy or diagnosis are likely to be radioactive. In general, such samples will contain very low levels of radioactivity and consequently do not pose a significant risk to staff provided Standard Precautions are applied.

The procedure (LM-SOP-RADIOACTIVE - Click Here) has been written to comply with the Ionising Radiation Regulations 1999 and then Ionising Radiation (Medical Exposure) Regulations 2000. The Environmental Permitting Regulations 2010 for Medicine (Administration of Radioactive Substances) Regulations 1978 and the Carriage of Good and Use of Transportable Pressure Equipment Regulations.

 In all cases, the handling of radioactive biological samples should be performed with the aim of minimising risk.  The period over which samples are required to be treated as radioactive will depend on the type of radioactive material administered, and guidelines on how long precautions need to be adopted after the radioactive administration will be advised by the department responsible for their administration.

Packaging and transport of high risk samples

All high risk samples must be double bagged and  must NOT be transported using the vacuum tube system.

Enquiries

Any queries regarding high risk samples can be addressed to:

 

Dr D Hamilton

Consultant Microbiologist



Mr Paul Sudworth 

Directorate Manager

 Angela Too

Laboratory Medicine H & S Lead

 


Web Page Last Updated: 24th January 2020

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Visiting cancelled

Due to the increasing number of cases of coronavirus across the UK, York Teaching Hospital NHS Foundation Trust has made the decision to cancel all visiting to all its hospital sites in order to ensure the safety of patients and staff.

There are three exemptions to the ruling which are for one parent of a sick child under 18, for the partner of a woman giving birth and end of life patients at the discretion of the ward sister.

We would ask people to respect this decision and to treat our staff, who will be enforcing the visiting restrictions, with courtesy and respect.  For more information visit our website.


Outpatient appointments

We know that NHS services will come under intense pressure as the coronavirus spreads, and as a Trust we need to redirect staff, free up staff for refresher training and carry out any works as necessary, so we are able to maximise capacity for patients for when the number of infections peak.  We also need to reduce the number of people coming into our hospitals to protect our patients, as well as keeping our staff safe, well and able to come into work.

To do this, with effect from Tuesday 24 March 2020, along with other trusts in the Humber Coast and Vale partnerships, we have made the collective decision to suspend all non-urgent routine outpatient appointments for at least three months.  Urgent and emergency cases and cancer appointments will be carrying on as normal.

These are unprecedented times and we thank you for your understanding.  We know many people waiting for treatment will be disappointed or worried but please not contact the hospital as we will be contacting everyone directly affected in the coming days and weeks.

If you do not receive a letter or a phone call from the hospital, please turn up for your scheduled appointment as normal unless you have symptoms of coronavirus, a cold, flu or norovirus in which case you should contact us to cancel your appointment by clicking here.


Coronavirus (COVID-19)

If you have symptoms associated with coronavirus including a new continuous cough and a high temperature, you are advised to stay at home for 7 days.

Please do not book a GP appointment or attend your GP practice.

If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.  After 14 days, anyone you live with who does not have symptoms can return to their normal routine.

But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days. The most up-to-date public guidance is always online at www.nhs.uk/coronavirus

If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do.  Only call 111 direct if you are advised to do so by the online service or you cannot go online.