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Laboratory Medicine

General Information / Storage of Samples Before Analysis

All samples should be dispatched to the laboratory as soon as possible after collection to ensure best turnaround times and most accurate results. It is highly recommended blood samples should arrive in the laboratory within 24 hours of collection – the laboratory may not be able to process samples received after this time. Overnight storage of blood samples before dispatch to the laboratory is not recommended and actively discouraged.  

Blood Sciences Samples: Minimising Deterioration

All samples will deteriorate from the time they are collected but, with a few simple measures, this deterioration can be minimised.

Samples collected in the hospital should be transported to the laboratory as soon as possible. For some tests special collection procedures should be followed. Please check the tables of sample requirements located in the department specific information to see if special collection procedures apply.

It is best to avoid collecting samples for urea and electrolytes, magnesium, phosphate, ESR, coagulation studies, malarial parasites, cold agglutinins and viral PCR if they cannot be transported to the hospital that day.  Please arrange for the patient to attend at another time when the samples can be sent to the hospital on the transport later that day. Alternatively the patient can attend the walk in phlebotomy service at York or Scarborough Hospital or Asda at Monks Cross. Opening times for these services are detailed in the Phlebotomy Service section of this handbook.

Samples collected outside the hospital should be stored at room temperature until picked up for transport to the hospital. If samples are collected after the transport has left then they should be placed in a refrigerator  except those samples for genetic tests (EDTA), HLA B27 (EDTA), joint aspirates or other “sterile fluids”, urethral swabs and HVS.

Some surgeries have centrifuges to spin down brown top blood samples. Once spun down, these samples are relatively stable but may be stored in a refrigerator until collected by transport. Please clearly mark the request card that the sample has been centrifuged.  Please follow the guidance in the Information sheet for centrifugation when preparing the sample for storage.

Microbiology Samples: Minimising Deterioration

All fluids, e.g. CSF, pleural fluid, joint fluids and pus require culturing without delay.  Specimens should preferably be taken during laboratory opening hours and sent immediately to the Department.  The Microbiology Department (NOT general pathology reception) should be warned of the arrival of urgent and important, unrepeatable specimens. If taken outside laboratory hours the Microbiology “BMS on-call” should be contacted via Switchboard.

In general all specimens should reach the laboratory as soon as possible after being taken.  Micro-organisms may be susceptible to drying, heat or cold (particularly freezing).  In specimens such as sputum and urine they can multiply to inappropriate levels.

Genital pathogens and anaerobic organisms are particularly sensitive to delays before culturing

All bacterial swabs should be placed in transport medium (the clear jelly seen in many swab tubes) which prevents drying, maintains pH and excludes oxygen; Swabs should be kept at room temperature until delivery to the laboratory.

Urine for culture should always be taken in the borate containing red-topped 30ml bottles to prevent bacterial overgrowth.  Refrigerate until delivery.

Specimens of clotted blood (brown top “serum” tubes) are suitable for all serological tests.  Refrigerate until delivery: do NOT freeze.

Blood cultures - Keep at room temperature and send the broths to the laboratory. Do not place on radiators etc as they get too hot (many pathogens cannot tolerate temperatures over 37°C).

Please contact the laboratory for further information if required.

Cytology Samples: Minimising Deterioration

The department opening times are Monday to Friday 8.30 – 17.00. In general all specimens should reach the laboratory as soon as possible after being taken. For information on cytology specimens:  Click Here

Unfixed samples: serous fluids, peritoneal washings, cerebrospinal fluids, cyst aspirates, synovial fluids and urine samples should be transported to the laboratory as soon as possible. However, if there will be a delay i.e. if they are taken at the weekend, or out of hours, they must be refrigerated.

Samples from endoscopy clinic (e.g. gastric, biliary, oesophageal and bronchial brushings, bronchial washings/ lavages and endobronchial ultrasound bronchoscopy (EBUS)) should be sent in green cytospin collection fluid. This is a fixative which preserves cells and therefore should be kept at room temperature. Fixed samples do not need to go in the fridge, but refrigeration will not cause any deterioration.

Fine needle aspirate samples should have direct smears prepared onto labelled glass slides and these should be air-dried before placing in the plastic slide box to be sent to the lab. The needle is washed in green cytospin collection fluid. Both the slides and needle washings can be kept at room temperature, but refrigeration will not cause any deterioration.

Cervical cytology samples that are collected in the Surepath liquid based cytology vials also contain a fixative. They can be kept at room temperature, but refrigeration will not cause any deterioration.

For information on the collection of seminal fluid samples for infertility analysis: Click Here

For information on the collection of seminal fluid for post vasectomy analysis: Click Here

For cytology samples that require testing at HMDS please contact the laboratory in order to determine transportation times. Samples that only require testing at HMDS please send these direct according to advice from their website.

 


Web Page 22 Last Reviewed: 01/07/2019

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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.