Procedure for review of results
| Name | Unique ID | Edition/Date of Edition |
|---|---|---|
| Procedure for review of results | nchsls:c:biochemistry:document:14 | (1) 03-01-2014 |
| Preparing authority | Approving authority | Review period |
|---|---|---|
| All teaching staff of biochemistry department | HOD Biochemistry | 1 year |
| Printed copy of this document is considered uncontrolled. It should be compared with controlled electronic copy before use |
Generally review of results are done by resident doctors and technicians
Before verification
During verification
| Criteria | Remarks |
|---|---|
| High or low abnormal results | verify properly all abnormal results very well |
| High direct bilirubin in samples from neonatal ward | Call the ward doctors and discuss the laboratory findings |
| Absurd potassium and low calcium | Repeat sample from primary tube —> if still absurd then call doctor and look for transfer of sample from flouride or EDTA to plain vacutte —> If yes then add 'Examination rejection' and ask for repeat sample. |
| If Alb < = 0.1 or creatinine < = 0.1 | Look for Sample cup in Erba XL-640 —> If sample is inadequete, repeat sample after refilling —> If same result comes —> Give sample probe wash and repeat the sample |
| If Alb < = 0.1 | 1.Check the sample type,If Fluid, it is possible. 2. If sample is serum,see the serum part & Cell Part(Hematocrit) of Vacuttee.If cell part is less ,sample may be diluted.So confirm the Hb value of Patient. |
| If ALT < = 0 or Negative | Then result is given as below detection limit. |
| If Calcium < = 0 or Negative | Then ,result is given as Absurd value.[Note : 1.First check the color of vacuttee,It must be plain otherwise calcium is chelated. It has been noticed that during collection of sample, blood is transfered in plain vacuttee from EDTA or Fluride. Check the K+ level, If it is transfered from EDTA, it is abnormally high. 2.It Should not be given as below detection limit.] |
| If potassium is absurd | It may be due to EDTA contamination. How to check EDTA contamination (1)Check Calcium level, if it is absurd, EDTA contamination is confirm. (2) Check plain sample for adequecy of clotting. sample will not be clotted properly if EDTA contamination is there. |
| If Creatinine < = 0 or Negative | First check the result of Billirubin.If It is < 15 mg/dl,give result as below detection.If it is > 15 mg/dl ,give result as Not Done & add remark as Hyperbillirubinemia Interfere with creatinine estimation. |
| If Total & Direct billirubin have same value. | It is possible & give Indirect billirubin = 0 Or Below detection.Both values are correct . |
| If Direct bilirubin value<0.1. | consider it as 0.0 and give Total bilirubin=Indirect bilirubin.For example, DBIL=-0.3, TBIL=0.6 so IBIL=0.6. |
| If Urea is high & Creatinine value is within normal range. | Repeat the test,if it is same , Report should be released. Consult the clinician regarding their impression for patient's condition.[Note : It is possible in early stage of renal Disease.] |
| If sample is highly lipemic and interfere in test result | 1.Find out the cause of turbidity weather it is due to lipid or any other cause. |
| First do the test of TG. if it is high, ask for fasting sample or if it is fasting sample only, do the ultracentrifugation, perform test of albumin, TP, HDL and other parameters which was asked. | |
| If ultracentrifugation is not possible at that time, do the test and release report with remarks that lipemia interfere with test result. If test results are negative e.g creatinine, release report as Not Done and add remarks that lipemia interfere with test result | |
| If TG is normal, dilute the sample 1 time & perform the test. Consult the clinician and look for the other causes of lipemia e.g radioconcentration dye | |
| If Calcium < 8.6 or > 10.2 | Give calculated corrected calcium by using equation 0.8(4-alb)+ obtained calcium. Instrument will add albumin and corrected calcium reflexly Note: We are measuring total calcium = bound calcium + ionised calcium. When albumin is decrease, bound calcium is also decrease and free form of calcium remain same |
| Creatinine < 0.1 or negative | Creatinine result is <0.1.pdf |
| If potassium result is absured | First check the sample, wether it is hemolysed or not. If it is hemolysed, release the report as sample is hemolysed, and send repeat sample. Repeat the potassium ,if Result is same then do calcium.If calcium is <6.5 mg/dl,EDTA contamination may be present.If calcium is normal ,Pottasium result may or may be not absurd.corelate clinically & repeate the sample. |
| If sample is hemolysed | Result of potassium will be high, Billirubin is negatively interfered(high Hb concentration breaks the azobilirubin complex), Protein is positively interfered(RBC has five times higher protein level than serum) |
| If Sodium >160mmol/l or <120mmol/l, Potassium is >8.0 mmol/l or <1.5mmol/l | Repeat the sample again. Make sure that all other tests are done before repeating the electrolyte as the sample volume is 70 microliter. |
| If serum Iron is <20 ug/dl | Manually write result as “<20”. Because LoD of Iron in our laboratory is 20 ug/dl. |
| CSF protein result reporting | csf_protein_test_reporting_edit-2.odp |
| if tp result's = or less than albumin | than repeat both albumin and tp, verify properly for any abnormal or low range results |
| If betaHCG result>15000 | In this condition instrument will do autodilution with dilution factor 100.So we have to wait for second result during verification of result.Second result have to be syncronised before release |
| If UIBC LESS THEN <0 OR NEGATIVE | If UIBC is negative then add remark as UIBC below detection so TIBC can not be calculated and correlate clinically for any recent oral and parentral iron therapy |
*Note: Review of QC results is generally not required after complation of examination because they are reviewed before examination batch is started; in the event QC results are unexceptable, examination is not done in the first place. See individual examination procedures for further details . Maintenance sheet for Auto verification print