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Content
Title Page
Message from the Hospital Director 1
Message from the Head of Department 2
Editorial Committee 3
Organization chart, Department of Pathology, Hospital Taiping 4
Ministry of Health’s Vision and Mission 5
Department of Pathology’s Vision and Mission, Client Charter 6
Terminology 7
General Information
1.0 Introduction 8
2.0 Services and Functions
3.0 Services Quality
4.0 Service Hours
5.0 Contact Numbers for Department of Pathology, Hospital Taiping 9
6.0 Pre analytical requirements 10
6.1 Request form
6.2 Samples/Specimens
6.3 Type of Containers
6.4 Transportation of Specimen
7.0 Rejection 11
8.0 Results/Reports
9.0 Critical Value Information 12
Table 1 Critical Limit in Chemical Pathology
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
Table 2 Critical Limit Hematology 13
Table 3 Critical Findings in Anatomical Pathology
Table 4 Critical Findings in Microbiology 14
10.0 Types of Container and Order of Draw 15
11.0 General Workflow for Handling of Specimen in the Department of Pathology, Hospital 16
Taiping
Chemical Pathology 17
1 Introduction 18
2 List of Services
3 Specimen Collection and Handling
3.1 Arterial Blood Gas (ABG) Analysis
3.2 Plasma Ammonia
3.3 Plasma Lactate 19
3.4 Hormone and Tumor Markers
3.5 Random Urine Specimen
3.6 24 Hours Urine Specimen
3.7 Urine for Drugs of Abuse (DOA) for Medico-Legal Cases
3.8 Cerebrospinal Fluid (CSF) Biochemistry Test 21
3.9 Other Body Fluids Biochemistry Test
4 Test Offered in Chemical Pathology Laboratory, Hospital Taiping & LTAT 22
5 Reporting and Dispatching of Results 28
6 Retention Period of Specimens and Results/Reports
Hematology 29
1 Introduction 30
2 List of Services
3 Specimen Collection and Handling
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
4 Test Offered in Hematology Laboratory, Hospital Taiping & LTAT 31
4.1 Routine Tests
4.2 Specialized Tests
5 Reporting and Dispatching Of Result(S) 32
6 Retention Period of Specimens and Results/Reports 33
Microbiology & Serology 35
1 Introduction 36
2 List of Services
3 Specimen Collection and Handling
3.1 General Guidelines
3.2 Specific Guidelines (Bacteriology)
3.3 Sample for Mycology 43
3.4 Blood Film for Malaria (BFMP) or Filaria 45
4 Test Offered in Microbiology Laboratory, Hospital Taiping and LTAT 46
5 Test Offered in Serology Laboratory, Hospital Taiping and LTAT
6 Reporting and Dispatching of Results 53
7 Retention Period of Specimen and Results/Reports
Histopathology 54
1 Introduction 55
2 List of Services
3 Request for Histopathology Service
3.1 General (Routine) Histopathology
3.2 Frozen Section
3.3 Transplant 56
4 Specimen Collection and Handling
5 Transportation of Specimen 58
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
6 Histopathology (HPE) Turn Around Time
7 Reporting and Dispatching of Results 59
8 Retention Period of Specimen and Results/Reports 60
Cytopathology 61
1 Introduction 62
2 List of Services
3 Specimen Collection and Handling 63
3.1 Type of Specimen, Container, Volume and Transportation
3.2 Request Form 64
4 Cytology Lab Turn Around Time 65
5 Reporting and Dispatching of Results
6 Retention Period of Specimen and Results/Reports 66
Outsource Services 67
1 Introduction 68
2 List of Services
2.1 Outsource Operating Hour
2.2 Transportation Schedule to Referral Centers 69
3 Specimen Collecting and Handling
4 Test Offered in Outsource Services, Hospital Taiping & LTAT 71
5 Reporting and Dispatching of Results 196
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
NO. Title Page
APPENDIX 1 PER-PAT 301 FORM 198
APPENDIX 2 PREPARATION OF THICK BLOOD SMEAR 199
APPENDIX 3 HISTOPATHOLOGY FORM HOSP TAIPING (HTPG/JP/03/04) 200
APPENDIX 4 CRITICAL FINDINGS FOR ANATOMICAL PATHOLOGY 201
APPENDIX 5 BORANG PERMOHONAN PAP SMEAR (PS 1/98 (PINDAAN 2007) 202
APPENDIX 6 HEMATOLOGY/SEROLOGY REQUEST FORM PDN (PDN/HA/QP-01/01) 203
APPENDIX 7 HEMATOLOGY/SEROLOGY PDN GUIDELINES 204
APPENDIX 8 BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI JABATAN 205 KIMIA (KIMIA 15-Pin. 1/2004) PAGE 1 APPENDIX 9 BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI JABATAN 206 KIMIA(KIMIA 15-Pin. 1/2004) PAGE 2 APPENDIX 10 DENGUE SEROTYPE SURVEILLANCE MKAK SG. BULOH (MKAK – BPU – D02) 207
APPENDIX 11 MEASLES-BORANG PERMOHONAN DAN KEPUTUSAN UJIAN MKAK SG. BULOH 208 (MKAK – MSLF 01/2004) APPENDIX 12 MKAK REQUEST FORM (MKAK-BPU-U01) 209
APPENDIX 13 LAB REQUEST FORM FOR SUSPECTED CASE OF SWINE INFLUENZA 210 (KKM/BKP/H1NI/2009/3) APPENDIX 14 NATIONAL ENTEROVIRUS SURVEILLANCE FORM (MKAK – BPU U01) 211
APPENDIX 15 CYTOGENETICS REQUEST FORM HKL (HKL/HA/TPM/N-1-(1)) PAGE 1 212
APPENDIX 16 CYTOGENETICS REQUEST FORM HKL (HKL/HA/TPM/N-1-(1)) PAGE 2 213
APPENDIX 17 REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR 214 (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 1 APPENDIX 18 REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR 215 (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 2
APPENDIX 19 REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR 216 (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 3 APPENDIX 20 REQUEST FORM AIRC IMR (IMR/AIRC/PID/RF) 217
APPENDIX 21 AIRC GUIDELINES 218
APPENDIX 22 BONE MARROW CYTOGENETICS FORM IMR 219
APPENDXI 23 DNA ANALYSIS FOR THALASSEMIA SYNDROMES 220 IMR(IMR/CaRC/HAEM/22/2203/03(1)/REQForm) PAGE 1
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
APPENDIX 24 DNA ANALYSIS FOR THALASSEMIA SYNDROMES IMR (IMR/ CaRC/ HAEM/2 221 2/2203/03(1)/REQForm) PAGE 2 APPENDIX 25 CONGENITAL HYPOTHYROIDISM CORD BLOOD SCREENING TEST 222
APPENDIX 26 TDM REQUEST FORM 223
APPENDIX 27 BORANG PERMOHONAN UJIAN TIBI MKA (TBIS 20C) 224
APPENDIX 28 THERAPEUTIC DRUG MONITORING REQUEST FROM HKL (HKL/JPDR/AK-07-01) 225
APPENDIX 29 HLA TYPING TEST REQUEST FORM IMR (IMR/QIRC/TI/RF-2) 226
APPENDIX 30 HOSPITAL AMPANG SPECIAL HEMATOLOGY REQUSITION PAGE 1 227
APPENDIX 31 HOSPITAL AMPANG SPECIAL HEMATOLOGY REQUSITION PAGE 2 228
APPENDIX 32 TORCHES PROGRAMME 229
APPENDIX 33 IEM REQUEST FORM IMR (IMR/SDC/BC/FORM-RQ) PAGE 1 230
APPENDIX 34 IEM REQUEST FORM IMR (IMR/SDC/BC/FORM-RQ) PAGE 2 231
APPENDIX 35 ACUTE FLACCID PARALYSIS FORM 232
APPENDIX 36 BRUCELLOSIS LAB0RATORY REQUEST FORM IMR (IMR/IDRC/BACT/BRUCE/01) 233
APPENDIX 37 PERKHIDMATAN GENETIK & METABOLIK HKL (HKL/JG/MG/IEM/PK-01-01) 234
APPENDIX 38 HIGH RISK SCREENING FOR POMPE IMR 235
APPENDIX 39 MERCOV REQUEST FORM IMR & MKAK 236
APPENDIX 40 BORANG PERMOHONAN UJIAN MAKMAL HFMD MKAK 237
APPENDIX 41 LEPTOSPIROSIS LABORATORY REQUEST FORM (IMR/IDRC/BACT/LEPTO/01) 238
APPENDIX 42 REQUEST FORM FOR MULTIPLE MYELOMA AND SPECIFIC PROTEINS IMR 239 (IMR/SDC/UMDP/PROTEIN/REQUEST FORM) APPENDIX 43 UJIAN SEROLOGI BAGI PENYAKIT HIV IMR (IMR/VIRO/HIV/1) 240
APPENDIX 44 UJIAN POLYMERASE CHAIN REACTION (PCR) UNTUK HIV DI KALANGAN BAYI 241 (IMR/VIRO/HIV/2) APPENDIX 45 BORANG PERMINTAAN UJIAN PENGESAHAN DADAH (UPD-1 (PINDAAN 2)) PAGE 1 242
APPENDIX 46 BORANG PERMINTAAN UJIAN PENGESAHAN DADAH (UPD-1 (PINDAAN 2)) PAGE 2 243
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018 Message from the Hospital Director 1
MESSAGE FROM THE HOSPITAL DIRECTOR
The laboratory service is an essential part of the healthcare system and plays a crucial role in the management of patients, hence making a need for high quality laboratory services imperative.
In line with the Ministry of Health’s Vision, the Department of Pathology has made great efforts in ensuring good laboratory services are provided to not only the patients seeking medical treatment at Hospital Taiping but also at hospitals and health clinics in the northern zone of Perak state.
The Department of Pathology ongoing efforts of reviewing, updating and improving the contents of the laboratory handbook are to ensure not only accurate and clear information are communicated properly but also to ensure this laboratory handbook serves as a user friendly guideline for all healthcare providers.
I hope that this updated edition will be fully utilized by all healthcare facilities which either uses the Department of Pathology, Hospital Taiping as a primary or secondary center for lab testing.
I would also like to congratulate all editorial board members for their invaluable contributions towards the improvement and revision of this Laboratory Handbook and hope that the Department of Pathology will continue to provide accurate, efficient, cost-effective and high quality services.
Dr. Hajah Narimah Binti Yusof Director Hospital Taiping Perak, Malaysia.
SEPTEMBER 2018
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
Message from the Head of Department 2
MESSAGE FROM THE HEAD OF DEPARTMENT
The Department of Pathology is striving to deliver a comprehensive and high quality lab result that would aid clinicians in making a clinical diagnosis and institute treatment. In recent years, the Department has not only expanded its laboratory units and test menu, but also acquired its very own resident pathologist(s) in specific disciplines of testing.
We have 96 staffs comprising of Consultants, Medical Specialists, Medical Officers, and Laboratory Technologists and offer our clients with diagnostic testing and clinical consultation.
The quality of our laboratory results/reports is assured by Internal Quality Control Programmes and participation in various External Quality Assurance (EQA) Schemes/programmes offered by RCPA Australia and other recognized bodies.
In the current third edition of the Laboratory Handbook, we have categorized the test menu according to disciplines and provided guidelines and relevant information as patient preparation, sample collection and handling and, laboratory technique.
It is our hope that this Handbook will meet your needs by providing useful laboratory information. We welcome your feedback and suggestions so that together we can provide the best patient care.
Last, but not least, I wish to extend my sincere thanks to all staff who have worked so hard to put this issue together.
Dr. Kalyani Saraswathy a/p Supramaniam Consultant Histopathologist and Head of Department Department of Pathology Hospital Taiping Perak, Malaysia.
SEPTEMBER 2018
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
3 EDITORIAL COMMITTEE MEMBERS
EDITORIAL COMMITTEE MEMBERS
Advisor : Dr. Kalyani Saraswathy A/P Supramaniam
Coordinator : Dr. Sanada Binti Abu Bakar
Contributors : Dr. Zarifah Binti Zam Dr. Ainul Hana Binti Ahmad Tajuddin Dr. Anusha A/P Kalyanasundaram Dr. Abdul Kadir Bin Mat Dr. Wong Tin Lit Pn. Yogeswary A/P Sivaraja Pn. Nur Amalia Binti Azemi Cik Louise Santana Malar Pn. Nor Ruzanna Binti Zainuddin En. Jaslin Bin Jasmin
Secretary : Dr. Wee Shea Roew Cik Nur Aishah Binti Abu Shahmah Cik Nurul Natasha Binti Jais Cik Mumtaz Begum Binti Kamal Siva Cik Lavanyalaxmi A/P Karmagan
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
44 Organization Chart, Department of Pathology, Hospital Taiping
ORGANIZATION CHART, DEPARTMENT OF PATHOLOGY, HOSPITAL TAIPING
HOSPITAL DIRECTOR
DR HAJAH NARIMAH BINTI YUSOF
HEAD OF DEPARTMENT
DR KALYANI SARASWATHY A/P SUPRAMANIAM HISTOPATHOLOGIST
JUSA C
HISTOPAHO
CHEMICAL HEMATOLOGY MICROBIOLOGY PATHOLOGY COUNTER SERVICE HISTOPATHOLOGY OUTSOURCE LAB & SEROLOGY LAB LAB & CYTOLOGY LAB SERVICE OUTSOURCE SERVICE
HEAD OF UNIT HEAD OF UNIT HEAD OF UNIT HEAD OF UNIT DR SANADA BINTI DR AINUL HANA BINTI DR ANUSHA A/P DR ZARIFAH BINTI ZAM ABU BAKAR AHMAD TAJJUDIN KALYANASUNDARAM MEDICAL MICROBIOLOGIST HEMATOPATHOLOGIST CHEMICAL PATHOLOGIST HISTOPATHOLOGIST UD54 UD56 UD54 UD54
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
5 MOH Vision & Mission
MINISTRY OF HEALTH (MOH)
VISION A nation working together for better health.
MISSION
The mission of the Ministry of Health is to lead and work in partnership:
i. to facilitate and support the people to:
attain fully their potential in health. appreciate health as a valuable asset. take individual responsibility and positive action for their health.
ii. to ensure a high quality health system that is:
customer centered. equitable. affordable. efficient. technologically appropriate. environmentally adaptable. innovative.
iii. with emphasis on:
professionalism, caring and teamwork value. respect for human dignity. community participation.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
Department Of Pathology’s Vision & Mission 6
DEPARTMENT OF PATHOLOGY, HOSPITAL TAIPING
VISION
To be a medical laboratory that can provide pathology and transfusion service that are dynamic, efficient and effective consistent with environmental change, current technology and customer demand.
MISSION
To provide high quality pathology services to improve and achieve customer satisfaction in medical treatment and patient care through:
Trained, knowledgeable and professional staffs. Teamwork. A safe, harmonious and conducive working environment. Appropriate equipment that meets its function.
CLIENT CHARTER
Every patient will be given appropriate treatment of quality in this hospital. Every client will be treated well in a friendly, considerate, respectful, polite, honest and sincere manner. Every patient will be given clear explanation pertaining to the suggested procedure and treatment, including risks and other options. Every patient who requires specialized treatment that is not available at this hospital will be referred to another appropriate center. Every patient is guaranteed that their honor and dignity will be protected while receiving treatment. All information pertaining to disease and treatment will be kept confidential and only will be revealed to certain party with his/her consent and subject to law.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
7 Terminology
TERMINOLOGY
Definition of terminologies used in this manual:
Critical value (CV) – Test results or value that falls outside the critical limits or the presence of any unexpected abnormal findings, cells or organisms which may cause imminent danger to the patient, and/or require immediate medical attention.
Critical limits – Boundaries of low and high lab test values beyond which may cause imminent danger to the patient and/or require immediate medical attention.
TAT - A total turnaround time is defined as the cumulative time taken for a sample to be processed. It includes the start time at which the sample is taken from a patient, time spent in transportation, its arrival at reception, pre-analysis and post analytical phases until validation by laboratory staff, the result being issued and its subsequent receipt by the requesting physician.
LTAT - A laboratory turnaround time is defined as the total time taken for a sample to be processed within the laboratory, from its arrival at the reception until a validated result has been released.
1 working day LTAT - 1 working day LTAT is defined as 24 hours LTAT excluding Saturday, Sunday and public holiday.
STAT/ Urgent – A short turnaround time is defined as a minimum time period for known routine LTAT for a test.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
8 General Information
GENERAL INFORMATION
1.0 INTRODUCTION
The Department of Pathology, Hospital Taiping aims to provide quality services to ensure accurate and timely lab results. This handbook is intended to provide all users of our pathology lab with (i) concise guide to the range of services provided as well as (ii) on the steps to be taken for proper collection and submission for testing.
2.0 SERVICES AND FUNCTIONS
The Department of Pathology is located at Level 3, Clinical Service Bock (CSB), Hospital Taiping. The department provides diagnostic and consultative services in the following disciplines: Chemical Pathology Hematology Histopathology (including clinical autopsies and frozen sections) Cytopathology Microbiology & Serology
These services are carried out by respective units/laboratories, each of which is headed by one or more pathologists specialized in that particular field of testing. The department also provides outsource services to various referral labs.
Apart from these services, the department also acts as a training center for medical students, medical laboratory technologists and biomedical science students.
3.0 SERVICES QUALITY Quality of lab results/reports is assured by: Internal quality control program. Participate in various External Quality Assurance (EQA) scheme or program.
4.0 SERVICE HOURS 1. 24 hour services: Chemical Pathology Hematology Microbiology * For list of the 24 hour tests, refer to related pages under each unit. 2. Office hour services: Histopathology and Cytology: Monday to Friday: 08.00 am – 01.00 pm 02.00 pm – 05.00 pm (Saturdays, Sundays & Public Holidays: Closed) 3. On-call services are provided and the call roster is made available to the hospital operators.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
General Information 9
5.0 CONTACT NUMBERS FOR DEPARTMENT OF PATHOLOGY, HOSPITAL TAIPING
Any queries or problems can be directed to the following personnel at the following extensions:
UNIT DESTINATION EXT PATHOLOGY OFFICE 5316 HEAD OF UNIT CHEMICAL PATHOLOGIST 5312 CHEMICAL PATHOLOGY CHEMICAL PATHOLOGY LAB & 5336 DRUG LAB 5333 HEAD OF UNIT HEMATOLOGIST 5314 HEMATOLOGY MEDICAL OFFICER 5328 SCIENTIFIC OFFICER 5374 HEMATOLOGY LAB 5331 HEAD OF UNIT MICROBIOLOGIST 5312/5372 MICROBIOLOGY SCIENTIFIC OFFICER 5372 MIKROBIOLOGY LAB 5303 SEROLOGY 5301 HEAD OF DEPARTMENT 5317 HISTOPATHOLOGIST 5313 HISTOPATHOLOGY MEDICAL OFFICER 5325/5327 HISTOPATHOLOGY LAB 5308 CYTOPATHOLOGY CYTOPATHOLOGY LAB 5366 OUTSOURCE SERVICES OUTSOURCE LAB 5367
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
10 General Information
6 PRE ANALYTICAL REQUIREMENTS
6.1 Request form
A standard laboratory request form is used for all categories of test except Histopathology request and referral lab/ specialized test. All request forms must be filled in legibly. The completed forms shall be signed and stamped by a doctor and accompanied by properly collected specimen(s). The following information must be provided for every request: I. Patient’s detail : Full name, full identity card (IC) number, sex and age. II. Source : Ward, clinic and name of hospital (if relevant) III. Patient’s clinical summary : Relevant clinical summary including provisional diagnosis and treatment. IV. Test detail(s) : Request must specify the test required. V. Specimen(s) : Date and time of specimen collection. Type of specimen and anatomic site (if relevant). VI. Request detail(s) : Doctor’s name, signature and official stamp.
6.2 Samples/specimens
The samples/ specimens should be collected by the ward or clinic staff using appropriate technique to ensure quality and correct containers. The specimen containers must be labeled with at least two identifiers (i.e. name of patient and patient’s I.C number) and test requested. The specimen containers should be placed in biohazard plastic bags with the respective request forms stapled outside the bag. The patient identification on the specimen must match exactly the identifier on the test request form. Unlabeled or mislabeled specimens will not be testified.
6.3 Type of containers
The specimen should be sent to laboratory in appropriate containers (please see list of test under each unit for specification).
6.4 Transportation of specimen
The specimens should be transported to the laboratory as specified for the type of test requested within appropriate time frame and according to transport requirements for that test. All specimens should be sent to the laboratory together with a request form and receive acknowledgement from the laboratory staff.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
General Information 11
7 REJECTION
7.1 Request which do not fulfill the laboratory requirements will be rejected. Below are the common/primary rejection criteria: Leaking specimen. Wrong container. Test request is not stated. Insufficient sample. Request with incomplete patient’s particulars: Incomplete identity card (IC) number. Name of the patient is not provided. No ward/clinic written on the request form. No specimen received for the test requested. The specimen is not suitable for analysis e.g. hemolysis blood sample. Patient’s information on the request form does not tally with that on the specimen bottle.
7.2 The laboratory procedure for rejection is as follows: I. A rejection form will be filled by the lab staff. II. The rejection form with reasons for the rejection will be given to the porter; a phone call will not be made. III. If the specimen is blood or urine, a new specimen will be requested. If it is a precious specimen e.g. CSF, tissue etc.: the ward staff will be informed to come to the lab to rectify the problem, if it is appropriate.
7.3 Please refer to the respective sections for specific rejection criteria.
8. RESULTS/REPORTS
3.1 Routine test result from Chemical Pathology, Hematology, Microbiology and Serology will be placed in the designated pigeon hole. 3.2 For histopathology, cytopathology and serology (infectious disease), reports will be dispatched to ward/clinic by lab staff. 3.3 All critical result (CV) will be notified to the requestor immediately. (Please refer to tables 1-4; pages 11-13)
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
12 General Information
9. CRITICAL VALUE NOTIFICATION Table 1: Critical Limit in Chemical Pathology
NEONATES PEDIATRIC ADULT (Less than 28 days) (1 mth-12 year) (13 year and above) TEST UNIT LOWER UPPER LOWER UPPER LOWER UPPER LIMIT LIMIT LIMIT LIMIT LIMIT LIMIT Sodium(Na) mmol/L - - 125 155 125 155 Potassium(K) mmol/L - - 2.8 6.0 2.8 6.0 Calcium(Ca) mmol/L - - 1.7 3.1 1.5 3.1 Ammonia umol/L - - - 100 - - T. Bilirubin umol/L - 300 - - - - Magnesium mmol/L - - 0.5 1.8 0.41 2.0 Phosphate mmol/L - - 0.4 2.8 0.32 2.87 Glucose mmol/L - - - - 2.8 20 Lactate mmol/L - - - 3.0 - 5.0 pH - - - - 7.60 7.2 7.55 pO2 kPa 7.8 - pCO2 kPa - - 2.6 9.1 - 9.3 Serum Osmolality mmol/kg - - 250 310 250 350 Creatine Kinase U/L - - - - - 5000 Lithium mmol/L - - - - - 1.5 CSF-Glucose mmol/L - - 1.6 - - - CSF-Protein g/L - - - 1.87 - - Urea mmol/L - - - 19.0 - - Uric Acid umol/L - - - 500 - -
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
General Information 13
Table 2: Critical Limit Hematology
NEONATES PEDIATRIC ADULT (Less than 28 days) (1 mth-12 year) (13 year and above) TEST UNIT LOWER UPPER LOWER UPPER LOWER UPPER LIMIT LIMIT LIMIT LIMIT LIMIT LIMIT Hemoglobin g/L 8.0 22.0 7.0 20.0 6.0 19.0 (Hb) Hematocrit( % 25 70 20 60 20 60 HCT) Platelet /L - - 50 x 109/L 1000 x 109/L 20 x 109/L 1000 x 109/L TWBC /L - - 2.0 x 109/L 50.0 x 109/L - - INR Ratio - - - >5 - >5 PT Sec - - - - - >2.5 upper limit 80 sec or > 2x APTT Sec - - - - - upper reference range Fibrinogen mg/dL - - 70 - 100 -
Table 3: Critical Findings in Anatomical Pathology
TEST CRITICAL FINDING Unexpected or discrepant Unexpected malignancy, wrong organ removed. findings Reports of infection Bacteria in heart valves or bone marrow. Organism in an immune-compromised patient such as AFB, fungi, viral, protozoa. Organisms in Cerebrospinal fluid(CSF) Unusual organism or organism in unusual sites e.g. amoeba in the eye. Report in critically ill patients Crescents is greater than 50% of glomeruli in renal biopsy specimen requiring immediate therapy Transplant rejection. Cases than have immediate Fat in endometrial curettage clinical consequences Mesothelial cells in a heart biopsy Fat in a snare colon biopsy specimen
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
14 General Information
Table 4: Critical Findings in Microbiology
TEST CRITICAL FINDING Cerebrospinal fluid Culture & Microscopy result(normal or abnormal) Sensitivity Cerebrospinal fluid Antigen detection Positive rapid antigen detection Blood culture Positive result from gram stain or/and culture Sterile body fluids Positive result from gram stain or culture Acid Fast Bacilli Positive smear result or/and culture Malaria Parasite on blood film Presence of malaria parasite. Stool culture Salmonella Typhi, Vibrio cholerae, Shigella Any type culture ESBLs producer organism, MRSA, Multi-Resistant Organism(MRO), VRE, VRSA Antigen detection Legionella spp Pernasal swab Bordetella Pertussis, Corynebacterium diphtheria
Reference: A quick guide for improving notification of critical lab results in MOH hospitals – A project for improving patient safety.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
General Information 15
10. TYPES OF CONTAINER AND ORDER OF DRAW
Order of draw in phlebotomy is a system of collecting more than one tube of blood at the same time from a patient while reducing instances of cross-contamination. Contamination may occur when the syringe contacts microorganisms, additives or blood mixed with additives in previous test tubes. [CLSI (formerly NCCLS) Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard – Sixth Edition is as followed: ORDER OF BOTTLE LABORATORY USE MIX BY DRAW INVERTING 1 For blood culture collection, remove flip- 8-10 times off caps from BACTEC culture vial(s). Wipe
tops of vials with single alcohol swab and allow drying. Avoid contamination as entering the needle into the bottle. Mix Blood Culture Bottle specimen by inversion several times. 2 PT/INR, APTT, Fibrinogen, D-Dimer, 3-5 times Platelet Function Test, Lupus Anticoagulant
Citrate Tube 3 Biochemistry Test 5 times LFT, RP,FLP,Calcium, Cardiac enzymes, Phosphate, Magnesium, Amylase, Serum Bilirubin, TSH, FT4, βHCG,AFP, Prolactin,
Salicylates, Serum Separator Microbiology Test Tube ASOT ,Rheumatoid Factor (RF), CRP, Infectious Mononucleosis, Leptospiral Rapid Test, Hep C, HIV, HBsAg, Anti HBS, VDRL,TPHA, Widal, Dengue Serology, ANA, anti dsDNA, Mycoplasma serology, Dengue Rapid Test 4 Blood grouping , Cross Match, FBC, FBP, 8 times Retic count, LAP score, Hb electrophoresis, CD4/CD8,HbA1c
EDTA Tube 5 FBS,2HPP,RBS, Serum Lactate 8 times
Fluoride Tube
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
16 General Information
11. GENERAL WORKFLOW FOR HANDLING OF SPECIMEN IN THE DEPARTMENT OF PATHOLOGY, HOSPITAL TAIPING
WORKFLOW EXPLANATION
Receive 1. Receive specimen
Unsuitable 2. Reject if the specimen is unsuitable. Check RejectReject Suitable
3. Acknowledge receipt of specimen(s) in Acknowledge in the Inform ward/clinic dispatch book. dispatch book
4. Assign lab number to each specimen Accept and assign and send to respective units.
Process and 5. Process and analyze specimen. analyze
Dubious 6. Check and verify result. Validate Repeat the test if necessary.
7. Generate report. Generate report
8. Dispatch report Dispatch
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
Chemical Pathology 18
1. INTRODUCTION
The Chemical Pathology laboratory provides biochemical testing for patient management. Our services cover analysis and interpretation of biochemical changes in body fluids for purpose of screening, diagnosis and monitoring of diseases.
2. LIST OF SERVICES
2.1 Routine biochemistry tests 2.2 Specialized biochemistry tests for hormones, tumor markers, HbA1c and drugs of abuse.
3. SPECIMEN COLLECTION AND HANDLING
3.1 Arterial blood gas (ABG) analysis
3.1.1 Confirm the need for the ABG and identify any contraindications (inadequate collateral circulation at the puncture site, should not be performed through a lesion or a surgical shunt evidence of peripheral vascular disease distant to the puncture site, a coagulopathy or medium- to high-dose anticoagulation therapy). 3.1.2 Unless results are required urgently, allow at least 20 minutes after any change in oxygen therapy before sampling (to achieve a steady state). 3.1.3 Explain to the patient as to why you are doing the test, what it involves and the possible complications; then obtain consent to proceed. 3.1.4 Prepare the necessary tools/equipments (heparinized syringe with cap, 20-22G needle, sharps disposal container, gauze) and don universal precautions. 3.1.5 Identify a suitable site for sampling by palpating the radial, brachial or femoral artery. Routine sampling should initially, be attempted from the radial artery of the non-dominant arm. 3.1.6 Once adequate blood has been obtained (minimum 0.5ml), remove the needle and apply firm, direct pressure to the venipuncture site for at least 5 minutes (until bleeding has ceased). 3.1.7 Ensure that no air bubbles are present in the sample, as they may compromise results. CAP the syringe IMMEDIATELY to prevent air from entering the syringe. 3.1.8 Please label the sample and fill up 2 copies of request form. 3.1.9 The sample should be transported on ice to the laboratory (please avoid direct contact between sample and ice). 3.1.10 Send the sample IMMEDIATELY to the laboratory by hand, as the stability is only 1 HOUR from the time (i.e. collection date followed by a 24 hour collection period) the sample is collected until it is analyzed in the analyzer. Do not use pneumatic tube system to send the sample.
3.2 Plasma Ammonia
3.2.1 A free‐flowing venous (or arterial) blood sample should be collected into a specimen tube (preferably pre‐chilled) containing either lithium heparin or EDTA as an anticoagulant and which has been determined to be free of ammonia contamination. 3.2.2 Ideally, the patient should be no stressed, as difficult venipuncture can cause a spurious increase in ammonia concentration. 3.2.3 The sample should be transported on ice to the laboratory immediately so that it can be centrifuged within 15 minutes of collection and the plasma obtained is analyzed immediately.
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3.2.4 These precautions are necessary as the ammonia concentration of standing blood increases spontaneously, due to generation and release of ammonia from red blood cells and, to a lesser extent, the deamination of amino acids by enzymes in the circulation, such as γ‐glutamyltransferase. 3.2.5 Unless in an emergency, the sample should be collected in a fasted state (or at least 4–6 hours after a meal), not following physical exercise, and smoking should be avoided for at least 9 hours before the sample is collected. 3.2.6 Clotted samples, samples collected via indwelling catheters and capillary samples should not be used, as any significant hemolysis of the sample will cause spuriously elevated ammonia levels.
Note: Once separated, plasma ammonia is stable for 4 hours at 4 °C and 24 hours at ‐20 °C.
3.3 Plasma Lactate
3.3.1 The patient should be fasting and at complete rest for at least 2 hours to allow the blood lactate concentration to stabilize. Patients should avoid exercise of the hand or arm before and during the collection of blood. 3.3.2 Ideally, venous specimens should be obtained without the use of a tourniquet because venous stasis will increase lactate levels. If a tourniquet must be used, the blood should be drawn immediately after the tourniquet is applied. 3.3.3 Blood cells continue to metabolize glucose following collection, resulting in the production of lactic acid. For this reason, a gray-top tube containing sodium fluoride, which inhibits glycolysis, is usually recommended for plasma lactate sample collection. 3.3.4 Send sample chilled in ice slurry to the laboratory immediately to further inhibit glycolysis and lactic acid formation. 3.3.5 Plasma lactate concentration can be falsely increased if the plasma is not separated from the cells shortly after sample collection (Centrifugation and separation of plasma from cells is recommended within 15 minutes of collection). 3.3.6 Sample stability after separation from cells: 2 - 8°C for up to 14 days.
3.4 Hormone and Tumor Markers
3.4.1 Blood should be collected in the morning. 3.4.2 Send sample to laboratory immediately. 3.4.3 Please refer to subsequent list of tests for the type of specimen, required container to be used, and laboratory turnaround time (LTAT) and other specific remarks.
3.5 Random Urine Specimen
3.5.1 An early-morning, first voided specimen is usually preferred for testing. 3.5.2 Clean groin area prior to collecting urine. 3.5.3 Catch mid-stream urine using 60 mL sterile container during emptying of the bladder. 3.5.4 Send specimen immediately to laboratory; never send urine sample through pneumatic tube system. 3.5.5 Never keep urine sample in the ward/ clinic/ home as urine sample collected more than 2 hours will affect result reliability.
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3.6 24 hours urine specimen
3.6.1 Determine the type of qualitative assays planned to be performed on the collected specimens This is important to determine whether preservative is required, the special container is available at laboratory upon request. For urine collection without preservative, the normal 24-hours urine container may be used. When specimens are to be collected over a specified period of time, the patient’s close adherence to instructions is important. 3.6.2 On the day of the collection, discard the first morning urine void, and begin the collection After this void. Collect all urine for the next 24 hours so that the morning urine void on the second day is the final collection. 3.6.3 Urine should be passed into a separate container at each voiding and then emptied into a larger container for the complete specimen. This two-step procedure prevents the danger of patient splashing himself/herself with the preservative (e.g. acid) in the container. 3.6.4 Store the bottle at room temperature or in the refrigerator. 3.6.5 If patient needs to have a bowel movement, any urine passed with the bowel movement should be collected. Try not to include feces with the urine collection. If feces does get mixed in, do not try to remove the feces from the urine collection bottle. 3.6.6 After the collection period has been completed, label the container appropriately and, state the collection date and time. Send the collected urine to laboratory immediately for processing.
3.7 Urine for Drugs of Abuse (DOA) for medico-legal cases
Sample collection must follow the guidelines as in the ‘Garis Panduan Bagi Ujian Pengesanan Penyalahgunaan Dadah Dalam Air Kencing (Guidelines for Testing Drugs of Abuse in Urine), Bahagian Perkembangan Perubatan Kementerian Kesihatan Malaysia’, 2002 as below:-
3.7.1 Sample collection must be properly supervised. Laboratory personnel shall not be involved in the sample collection. Collection site must have suitable toilet facilities and are free from soap, dispenser or cleaning agent. 3.7.2 The urine volume should be at least 30 mL. 3.7.3 The person supervising the collecting should stand close enough to the patient/suspect to see that the urine specimen is genuinely passed out by the person and there is no attempt to falsify or adulterate the specimen. 3.7.4 The urine bottle must be securely capped and sealed with sealing wax. 3.7.5 Bottle must be labeled in front of the patient/suspect with the following information: 3.7.5.1 Patient’s full name 3.7.5.2 Full identity card number 3.7.5.3 Date and time of specimen collection 3.7.5.4 Signature of Supervising Officer 3.7.5.5 Drug(s) suspected 3.7.6 Proper Chain of Custody procedures for urine collection shall be maintained. 3.7.7 Donor shall not be permitted to transport samples to the laboratory.
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3.8 Cerebrospinal Fluid (CSF) biochemistry test
Tests include Total Protein, Globulin, Glucose and Chloride
3.8.1 Specimen should be collected in a sterile manner and placed in a Bijou bottle. 3.8.2 Collect minimum of 3-5 mL of specimen. 3.8.3 If glucose and protein tests are requested, serum levels should be requested at the same time. The normal CSF glucose is about 60% compared to serum level. 3.8.4 Do not refrigerate specimens. 3.8.5 Send specimen immediately to laboratory. Never keep CSF specimen as specimen collected more than 1 hour will affect result integrity. Specimens more than 1 hour old will be processed but the results may be erroneous due to a delay in transit/processing. 3.8.6 A delay in examining CSF falsely low glucose value due to glycolysis. 3.8.7 Other body fluids that require certain biochemical test should be informed and discussed with the Scientific Officers / Chemical Pathologist prior to sending.
3.9 Other body fluids biochemistry test
3.9.1 Other body fluids that require certain biochemical test should be informed and discussed with the Scientific Officers/ Chemical Pathologist prior to sending.
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4. TEST OFFERED IN CHEMICAL PATHOLOGY LABORATORY, HOSPITAL TAIPING & LTAT
TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Arterial/ venous Whole Heparinized 1 ml 0.5 ml 15 minutes Send to lab immediately on ice Blood Gas Analysis blood syringe Alanine Amino Serum/ Plain tube (adult) / Adult: 4 hours Transferase (ALT) Plasma Lithium heparin 3.5ml (Routine) Albumin with gel tube Alkaline (microtainer/paed) Paed: 45 mins Phosphatase (ALP) 0.4-0.6ml (Urgent) Alpha Fetoprotein 3 working (AFP)* days Ammonia Plasma EDTA tube 2.0ml 45 mins Send to lab immediately (Urgent) on ice Amylase Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Amylase Random Sterile urine 2.0-5.0ml 4 hours urine container (Routine)
45 mins (Urgent) Aspartate Serum/ Plain tube (adult) / Adult: 4 hours Transaminase (AST) Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Bilirubin - Total & Measured value Direct Bilirubin-Indirect Calculated value Body Fluids Body Sterile container 3.0 ml 1 working Biochemistry* fluids day CA 125* Serum/ Plain tube (adult) / Adult: 5 working Plasma Lithium heparin 3.5ml days CA 19-9* with gel tube (microtainer/paed) Paed: 0.4-0.6ml Cannabis* Urine Sterile urine Minimum 3-5 working Container must be sealed container 30.0ml days with wax Carcinoembryonic Serum/ Plain tube (adult) / Adult: 3 working Plasma specimens collected in Antigen (CEA)* Plasma Lithium heparin 3.5ml days lithium or sodium heparin with gel tube have been shown to exhibit an (microtainer/paed) Paed: average of 7% to 8% higher 0.4-0.6ml results compared to corresponding serum results
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Calcium Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Calcium* 24 hours 24 hour urine Minimum 1 working If <500ml, will be rejected urine bottle 500ml day except in paediatric and ESRD collection patient C-Reactive Protein Plain tube (adult) / Adult: 2 working (CRP) Serum/ Lithium heparin 3.5ml days Chloride Plasma with gel tube 4 hours (microtainer/paed) Paed: (Routine) 0.4-0.6ml 45 mins (Urgent) Chloride* 24 hours 24 hour urine Minimum 1 working If <500ml, will be rejected urine bottle 500ml day except in paediatric and ESRD collection patient Cholesterol Total Plain tube (adult) / Adult: 4 hours Cortisol* Serum/ Lithium heparin 3.5ml 3 working Indicate time of specimen Plasma with gel tube days collected (microtainer/paed) Paed: 0.4-0.6ml Cortisol* 24 hours 24 hour urine Minimum If <500ml, will be rejected urine bottle 500ml except in paediatric and ESRD collection patient Creatine Kinase Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Creatinine* Urine 24 24 hour urine Minimum 1 working If <500ml, will be rejected hours bottle 500ml day except in paediatric and ESRD patient Creatinine 24 hours 24 hour urine Minimum 1 day Both urine and blood samples Clearance* urine bottle 500ml are required. Serum/ Plain tube (adult) / Adult: Plasma Lithium heparin 3.5ml Calculated value with gel tube (microtainer/paed) Paed: 0.4-0.6ml
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TEST TYPE OF CONTAINER VOLUME LTAT REMARKS SPECIMEN CSF Biochemistry CSF 3.0-5.0ml 45 mins i)Glucose ii)Total Protein iii)Globulin iv)Chloride
v)Appearance Sterile bijou bottle Ferritin* Serum/ Plain tube (adult) / Adult: 3-5 working Morning samples are Folate* Plasma Lithium heparin 3.5ml days preferred. with gel tube Fasting at least 12 hours. Free T4* (microtainer/paed) Paed: 3 working 0.4-0.6ml days Glucose Plasma Sodium fluoride Adult: 4 hours tube (adult) / 2.0ml (Routine) Sodium Fluoride tube-microtainer Paed: 45 mins (paed) 0.5ml (Urgent) Glucose Tolerance 4 hours Tests (OGTT) (Routine) i) Fasting Blood Glucose ii)Two (2) Hours Post Prandial HDL Cholesterol Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 0.4-0.6ml Hemoglobin A1C* Whole EDTA tube 2.0ml 7 working blood days Human Chorionic Serum/ Plain tube (adult) / Adult: 3 Working Gonadotrophin* Plasma Lithium heparin 3.5ml days with gel tube (microtainer/paed) Paed: 0.4-0.6ml Iron Total* Serum Plain tube 3.5ml 3-5 working Morning samples are Unbound Iron days preferred. Binding Capacity Fasting at least 12 hours. (UIBC)* TIBC=Iron † UIBC (TIBC is calculated) Lactate Plasma Sodium fluoride 2.0ml 45 mins Send to lab immediately tube (STAT) on ice
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Lactate Serum/ Plain tube (adult) / Adult: 4 hours Dehydrogenase Plasma Lithium heparin 3.5ml (Routine) (LDH) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) LDL-Cholesterol 4 hours Calculated value (Routine) Magnesium 4 hours (Routine)
45 mins (Urgent) Magnesium* Urine 24 24 hours urine Minimum 1 working If <500ml, will be rejected hours bottle 500ml day except in pediatric and ESRD collection patient Microalbumin* Fresh Sterile 2.0ml 1 working morning urine container day urine Morphine* Urine Sterile Minimum 3-5 working Container must be sealed urine container 30ml days with wax
Osmolality Serum Plain tube 3.5ml 4 hours Osmolality Random Sterile 2.0ml 4 hours Urine urine container Parathyroid Plasma EDTA tube 2.0ml 3-5 working Human serum (use of serum Hormone (intact) days separator tube/plain tube) IPTH* may result in a decrease in concentration Paraquat Random Sterile 2.0ml 45 minutes urine urine container Phosphate Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Phosphate* Urine 24 24 hours urine Minimum 1 working If <500ml, will be rejected hours bottle 500ml day except in pediatric and ESRD collection patient Potassium Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent)
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Potassium* Urine 24 24 hours urine Minimum 1 working If <500ml, will be rejected hours bottle 500ml day except in pediatric and ESRD collection patient Protein Creatinine Spot urine Sterile 30ml 4 hours Index (PCI) urine container Protein, Total Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Protein* Urine 24 24 hours urine Minimum 1 Working If <500ml, will be rejected hours bottle 500ml day except in pediatric and ESRD collection patient PSA, Total* Serum Plain tube 3.5ml 3 working days Salicylate Serum Plain tube 3.5ml 45 minutes Sodium Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml (Routine) with gel tube (microtainer/paed) Paed: 45 mins 0.4-0.6ml (Urgent) Sodium* Urine 24 24 hours urine Minimum 1 working If <500ml, will be rejected hours bottle 500ml day except in pediatric and ESRD collection patient Thyroid Stimulating Serum/ Plain tube (adult) / Adult: 3 working Hormone (TSH)* Plasma Lithium heparin 3.5ml days with gel tube (microtainer/paed) Paed: 0.4-0.6ml Thyroid Stimulating Cord 3.0ml 1 working National newborn screening Hormone (TSH)* Blood day for congenital hypothyroidism
Test tube 16/100 mm cylindrical (TSH tube) Triglycerides Serum/ Plain tube (adult) / Adult: 4 hours Plasma Lithium heparin 3.5ml with gel tube (microtainer/paed) Paed: 0.4-0.6ml
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Troponin I (High Serum/ Plain tube (adult) / Adult: 4 hours Sensitive) Plasma Lithium heparin 3.5ml (Routine) Urea with gel tube Uric Acid Paed: 45 mins 0.4-0.6ml (Urgent) Urine Biochemistry Random Sterile 3.0-5.0ml 2 hours (Qualitative) Urine urine container i)Blood ii)Bile iii)Urobilinogen iv)Ketone v)Protein vi)Nitrite vii)Glucose viii)pH ix)Specific Gravity x)Leukocytes Urine Pregnancy Random Sterile 2.0-5.0ml 4 hours Early morning urine is Test (UPT) urine urine container (Routine) preferable
45 mins (Urgent) Vitamin B12* Serum/ Plain tube (adult) / Adult: 5 working Morning samples are Plasma Lithium heparin 3.5ml days preferred. with gel Fasting at least 12 hours. tube Paed: (microtainer/paed) 0.4-0.6ml Therapeutic Drug Serum/ Plain tube (adult)/ Adult: Toxicity Please use the dedicated TDM Monitoring (TDM) Plasma Lithium heparin 3.5ml case: 1 Hour form and fill up accordingly. Acetaminophen with gel tube Please consult the pharmacist Amikacin (microtainer/ paed) Paed: Non toxicity on call before send any TDM Carbapenem 0.4-0.6 ml case: sample to the laboratory. Digoxin 2 Hours Gentamicin Phenobarbital Phenytoin Theophylline Valproic acid Vancomycin
*Test is not offered during weekend/public holiday. If there is strong clinical indications please consult the chemical pathologist or scientific officers on call. **Type of specimen and container required is based on recommendation by current manufacturer.
This may subject to change and depend on the analyzer used.
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5. REPORTING AND DESPATCHING OF RESULT(S)
5.1 Routine biochemistry result will be validated by the Medical Laboratory Technologist (MLT) and Scientific Officer. Special biochemistry result will be validated by Scientific Officer and Chemical Pathologist. 5.2 All results will be made available according to the respective test’s LTAT. 5.3 Printed test result for in-patient are dispatched via designated pigeon holes located at the main counter of Pathology Department. 5.4 Drugs of abuse result will be validated by Scientific Officer. Results will be sealed and collected by hand by representative of related agencies or strictly dispatched to requester only. Patients are not allowed to collect their own results.
6. RETENTION PERIOD OF SPECIMENS AND RESULTS/REPORTS
RECORD/ MATERIAL RETENTION DURATION
6.1 Request form accompanying specimen 6.1.1 Routine test 1 month after issue of report/result 6.1.2 Special test 12 months after issue of report/result
6.2 Report duplicates 6.2.1 Neonatal screening and inborn error of 25 years metabolism 6.2.2 Drug of abuse testing (confirmatory or 7 years screening) 6.2.3 Therapeutic drug monitoring 7 years 6.2.4 All other reports 7 years
6.3 Results 3 years
6.4 Samples 6.4.1 Serum, plasma, blood, frozen urine and other 1 days after issue of report/result frozen body fluids
6.4.2 Other body fluids e.g. urine, cerebrospinal fluid, 24 hours after test done
pleural fluid
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Hematology 30
1. INTRODUCTION The Hematology laboratory is part of the Laboratory Medicine Directorate, Department of Pathology Taiping Hospital. Its work involves screening, diagnosis and monitoring of therapy of hematological conditions such as anemia, thalassemia and leukemia. The Laboratory participates in External Quality Assessment Schemes including Automated Hematology, Hemostasis, D-dimer, Morphology as well as Manual Differential Count.
2. LIST OF SERVICES
This laboratory provide service to Taiping Hospital and district hospitals (Parit Buntar, Selama, Gerik and Kuala Kangsar Hospital) and health centers in the northern zone of Perak.
Most of the routine hematological test such as full blood count, full blood picture, hemostasis profile, hemoglobin analysis are done locally. Some of the specialized test such as bone marrow aspiration and trephine biopsy are done locally. The rest of the specialized test such as CD4 & CD8, Immunophenotyping and Coagulation factors assay are outsourced to the various referral centers.
3. SPECIMEN COLLECTION AND HANDLING
The phlebotomist should first check the patient's identity, making sure that it corresponds to the details on the request form. It is essential that every specimen is labeled with adequate patient identification immediately after the samples have been obtained.
FBC test should be performed within 6 hours of collecting the blood sample, but a delay of up to 24 hours is acceptable if the blood is kept at 4°C.
Ideally, sample for coagulation tests, the PT and the APTT should be sent to the laboratory immediately and testing should be accomplished within 4 hours of collection. Blood to anticoagulant ratio is very important in coagulation testing; 9 volumes of blood must be added to 1 volume of anticoagulant. Under filled primary citrate anticoagulant tube will typically prolong PT and APTT.
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4. TEST OFFERED IN HEMATOLOGY LABORATORY, HOSPITAL TAIPING & LTAT
4.1 ROUTINE TESTS
TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Full Blood Count (FBC) Whole EDTA tube Adult: 2ml 4 hours Refer to Attachment 1 Blood (Routine) for guidelines for FBP Differential Count Neonate: request. 0.5ml 45 Reticulocyte Count minutes (Urgent) Erythrocyte Whole Westergen 4 hours Sedimentation Blood Tube Rate(ESR)
Glucose-6-Phosphate Whole Newborn: 2ml 24 hours Allow the blood stained Dehydrogenase blood Filter Paper, a (Routine) filter paper to air dry (G6PD) single blot of before sending to the blood 1 hour lab. Adult: EDTA (Urgent) tube Coagulation Plasma Trisodium Adult: 1.8ml 4 hours Should be sent to the i)Prothrombin Time / Citrate tube (Routine) laboratory Activated Partial (3.2%, Neonate: immediately. Thromboplastin 0.109M) 0.5ml 60 Time(PT/APTT) minutes ii)International (Urgent) Normalized Ratio (INR) iii)Fibrinogen level iv)D-dimer
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4.2 SPECIALIZED TESTS
TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Full Blood Picture Whole EDTA tube Adult: 2ml 5 working i) For urgent cases, please (FBP) Blood days consult the medical officer Neonate: (Routine) in hematology unit 0.5ml ext.5328 (during working 24 hours hours) and the pathologist (Urgent) on call (after working hours). ii)Please refer to indications of FBP test. (Attachment 1)
Mixing test Plasma Trisodium Adult: 2 working 1) All case need to be Citrate tube 1.8ml days discussed with (3.2%, 0.109M) - at least 3 hematopathologist before- bottles hand 2) Make an appointment with Hematology lab staff 3) Samples should be sent immediately to the laboratory.
Bone Marrow Bone Direct smear on glass slide 7 working i) All cases need to be Aspirate Marrow days discussed with (Routine) hematopathologist beforehand 3 working ii) Make an appointment days with hematology (Urgent) laboratory staff Hemoglobin Whole EDTA tube Adult: 21 For District Hospitals & analysis Blood 3ml working Health Clinics; the Hb days analysis sample should be Neonate: sent together with: 0.5ml i) FBC result ii) One stained peripheral blood smear iii) One unstained peripheral blood smear
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5. REPORTING AND DISPATCHING OF RESULT(S)
5.1 All routine hematology tests result will be validated by Medical Laboratory Technologist or Scientific Officer. All specialized hematology tests will be reported and validated by Medical Officer and Hematopathologist. 5.2 Printed test results are dispatched via designated pigeon holes located at the main counter, Department of Pathology.
6. RETENTION PERIOD OF SPECIMENS AND RESULTS/REPORTS.
RECORD/ MATERIAL RETENTION DURATION Request form accompanying specimen 1.1 1.1.1 Routine test 1 month after issue of result 1.1.2 Test with interpretive report 3 years after issue of report
1.2 Reported blood film (i.e., slide) 3 years after issue of report
1.3 Blood samples 2 days after the test is done
1.4 Bone marrow slides 7 years after issue of report
1.5 Reports 1.5.1 Bone marrow 20 years 1.5.2 Hemoglobin analysis 20 years 1.5.3 Special coagulation test (e.g., Mixing test) 20 years 1.5.4 Full blood picture 7 years
1.6 Results 1.6.1 Full blood count 3 years 1.6.2 Routine coagulation test (e.g., PT, INR, APTT, 3 years disseminated intravascular coagulation)
1.6.3 G6PD Screening 7 years
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Attachment 1
GUIDELINES FOR FBP REQUEST
Indication for FBP: Request for FBP must be based on certain criteria. Below are guidelines that can be used before ordering FBP.
1.Flagging of blood cells indices as shown by FBC. Examples: a) White Blood Count: i.Abnormally high white cell > 30 x 109/L, to look for evidence of acute leukemia or myeloproliferative disorder. ii. Low white cell count < 3 x 109/L. b) Abnormality of the differential WBC: i. Neutrophils: <0.5 x 109/L, >30 x 109/L ii. Lymphocytes: >5 x 109/L (adults), >7 x 109/L (<12 years old) iii. Monocytes: >1.5 x 109/L (adults), >3 x 109/L (<12 years old) c) Platelets: i. Low platelet count < 50 x 109/L (to ensure not due to false Thrombocytopenia such as EDTA induced platelet clumps or platelet satelitism). ii. Very high platelet count > 1000 x 109/L. d) Hemoglobin: i. Severe anemia: <5g/dl, to look for evidence of hemolysis.
*However if the patient is hospitalised and FBC is flagged almost every day, a daily FBP is not indicated.
2.Based on patient history or clinical findings. Examples: a) Acute leukemia b) Hemolytic anemia c) Microangiopathic hemolytic anemia (MAHA)/ Fragmentation syndrome d) For clinical follow up of known haematological disorder cases eg: ALL, CML, MDS etc.
3.For assessment/screening. Examples: a) Vacuolated lymphocytes in suspected metabolic disorder patient/baby. b) When performing bone marrow aspirate procedure.
FBP is not indicated in the following situation: 1. Healthy patient with normal blood cell indices planned for elective procedures/operations e.g. cataract for operation. 2. Medical checkup – if blood cell indices normal. 3. Daily FBP for hospitalized patient.
*However if FBP is required clinically, one has to state reason(s) and one may need to directly liaise with the medical officer / hematopathologist on call at ext 5328/ 5314 respectively.
REFERENCE: 1. University Kebangsaan Malaysia: Summary of ABX Hospital Evaluation Report Pentra Dx 120 SPS, July 2009: 36 – 37
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Microbiology & Serology 36
1. INTRODUCTION
Microbiology laboratory is particularly involved in isolating and establishing the causative agents as well as monitoring and screening of infectious diseases.
2. LIST OF SERVICES
2.1 Diagnostic microbiological service which comprise of Bacteriology, Parasitology, Serology and Mycology. 2.2 Participation in hospital wide infection control activities related to surveillance, control and prevention of nosocomial infection. 2.3 Provision of Microbiology studies of the Hospital environment and sterility testing. 2.4 Microbiological investigations for medicolegal cases.
3. SPECIMEN COLLECTION AND HANDLING
3.1 GENERAL GUIDELINES
3.1.1 The quality of laboratory results depends greatly on the proper collection and handling of the specimens as well as obtaining satisfactory materials for examination. 3.1.2 The clinical specimen must be material from the actual infection site and must be collected with minimum contamination from adjacent tissues, organs or secretions. 3.1.3 A sufficient quantity of specimen must be obtained in order to perform the examination required. 3.1.4 Appropriate collection devise, specimen containers and culture media must be used to ensure optimal recovery of microorganisms. 3.1.5 Ideally the specimen must be collected before the commencement of antibiotic therapy. 3.1.6 The specimen container must be properly labeled, placed in a biohazard plastic bag and accomplished by a completed laboratory request form. 3.1.7 Specimens are best transported immediately to the laboratory.
3.2 SPECIFIC GUIDELINES (BACTERIOLOGY)
3.2.1 Blood culture
i. Determine the type of culture bottles to utilize, aerobic and anaerobic. ii. Check name, IC, RN to avoid clerical error. iii. Wash or sanitize hands before and after removing gloves. Follow Standard Precautions for all patients. iv. Apply tourniquet to the extremity and identify the phlebotomy site.
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v. Preparation of the phlebotomy site: a. Using the povidone-iodine or chlorhexidine cleanse a 5 cm area using circular motion starting at the site and working outward. b. If using iodine product, clean patient’s skin with alcohol to remove excess iodine. c. If unable to use iodine (e.g., allergic): Use Chlorhexidine. Use alcohol pad to cleanse the patient’s skin, using a circular motion starting at the site and moving outward. Do not touch the venipuncture site after skin preparation. If palpation is absolutely necessary, sterile gloves must be applied immediately prior to palpation. vi. Appropriate amount of blood for culture draw (BACTEC bottles): a. 8-10 ml blood per Adult aerobic and anaerobic culture bottle. Do not overfill. b. 5ml blood per Myco-F-Lytic bottle. c. 1-3 ml blood per Pediatric bottle. vii. Label culture bottles with patient’s name and hospital number. Do not place label over bar-coded area of the bottle. Fill out Pathology request form: a. State clinical history b. Indicate site from which blood was collected in the comment(s) section. If using a catheter to draw culture, indicate type and site of catheter in the comments section (i.e., left subclavian triple lumen) c. Indicate suspected diagnosis, if necessary (required for endocarditis). d. Include date and time of collection. viii. Send specimens to the laboratory as soon as possible. Never refrigerate blood culture specimens. ix. Send second set of blood cultures using the same procedure as above. x. Send 2 or 3 set of blood culture if indicated. xi. In order to suspected catheter related stream infection (CRBSI) and subacute endocarditis, more specific blood culture procedures may be necessary. See below for recommendations:
A. Suspected catheter related blood stream infection (CRBSI):
i. One set is obtained from a suspected site/s. (Central catheter) ii. Second set must be from a separate peripheral site iii. If catheter is removed, send tip using sterile procedure for cultures. Do not send catheter tip without sending concomitant blood cultures.
B. Subacute endocarditis:
i. Draw 2-3 blood culture sets on day 1. ii. With 1 hour apart per set. iii. Establishing a specific microbial diagnosis is more important than starting immediate antibiotics.
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3.2.2 Bone marrow
i. Prepare skin using aseptic technique. ii. Drape the surrounding skin with sterile linen. iii. Aspirate the marrow percutaneously using a sterile needle and syringe. iv. Transfer 3-5ml for each: For suspected bacterial infection, uses aerobic/ anaerobic a blood culture bottle. Whereas for suspected AFB and fungal infection uses mycobacteria/fungal blood culture bottle (Myco/F Lytic bottle which is available in microbiology lab).
3.2.3 Cerebrospinal fluid (CSF)
i. Wear proper Personal Protective Equipment (PPE). ii. An open tube is held to collect the fluid; other personnel should stand away or wear masks in order to avoid respiratory contamination. iii. Decontaminate the skin with povidone iodine, followed by 70% alcohol using an increasingly outward circular movement. iv. Drape sterile linen over the skin surrounding the puncture site. v. Insert the needle. Collect 3-4 mls of CSF into sterile Bijoux bottles for the examination of: a. microscopy and culture for bacterial (Cryptococcus and mycobacterium if indicated ) b. biochemistry vi. Send the specimen immediately to the laboratory vii. Do not store in the refrigerator for suspected bacterial meningitis viii. If viral pathogen is suspected, please refrigerate(keep to 2-8C)
3.2.4 Sterile body fluids (except urine and cerebrospinal fluid)
i. Prepare the skin using aseptic technique. ii. Collect the fluid using a sterile needle and syringe. iii. Transport immediately. iv. Do not send sterile body fluids on swabs.
3.2.5 Peritoneal dialysis fluid
A sample from the bag is obtained as follows: i. Disinfect the port of the bag with alcohol. ii. Collect at least 20 mls of fluid through the disinfected area using a needle and syringe. iii. Place the sample into the sterile container and send to the laboratory immediately.
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3.2.6 Genital samples
3.2.6.1 High vaginal swabs
i. Using a sterile speculum lubricated with sterile normal saline and not antiseptic cream, swab either from the posterior fornix or the lateral wall of the vagina. ii. Inoculate the swab into Amies Transport Medium.
3.2.6.2 Endocervical swab
i. Under direct vision, gently compress cervix with blades of speculum and use the rotating motion with swab, obtain exudates from the endocervical canal. ii. Inoculate the swab into Amies Transport Medium.
3.2.6.3 Urethral discharge (male)
i. Wipe the urethra with sterile gauze or swab. ii. Collect the exudates with a sterile swab and inoculate into Amies Transport Medium. iii. If discharge cannot be obtained by milking the urethra, use a sterile swab to collect material from about 2 cm inside the urethra. iv. Place the swab into Amies Transport Medium.
3.2.7 Urine culture
3.2.7.1 Midstream urine
Male patients
i. Withdraw the prepuce and cleanse the glans penis with soapy water and thoroughly rinse with water. ii. Pass the first few milliliters of urine to flush out the bacteria from the urethra, then collect the mid- stream portion in a sterile universal container and close it tightly.
Female patient
i. Clean the periurethral area and perineum with soapy water and thoroughly rinse with water. ii. Hold the labia apart during voiding and pass the first few milliliters of urine. iii. Collect the midstream portion in a sterile container and close it tightly.
Note: When culture for tubercle bacilli is required, collect at least 50 ml of early morning midstream urine of 3 consecutive mornings into sterile container.
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3.2.7.2 Catheterized urine
i. Catheter urine specimen should be taken by aseptic puncture of the catheter conduit and syringe out into a sterile container. ii Urine from catheter bags is generally unsuitable for culture.
Note: Culturing urinary catheter tips is a waste of time because the catheter tips are invariably contaminated with urethral organisms.
3.2.7.3 Bladder urine samples
i. This is obtained via suprapubic aspiration or cystoscopically. ii. Urine is collected in a sterile container.
3.2.8 Respiratory specimens
3.2.8.1 Nasal swab
This is commonly done for screening of MRSA carriage. i. Moisten a swab with sterile saline. ii. Swab both the anterior nares and insert the swab into the nose and gently rotate against the nasal mucosa.
3.2.8.2 Nasopharyngeal swab
This is especially useful for the diagnosis of whooping cough (Bordetella pertussis) Bordetella pertussis Culture and PCR. i. Use nasopharyngeal swab on a flexible wire handle to collect the specimen. ii. Swab is used to inoculate the Charcoal Transport Medium. iii. Only Rayon and Dacron swabs are used for PCR. Calcium anginate and cotton swabs are not suitable for PCR test. iv. Techniques: a. Seat the patient comfortably. Tilt the head back. b. If available, insert a nasal speculum. Press the swab through the nares until resistance is met due to contact with the nasopharynx. c. Rotate the swab gently and allow the swab to maintain contact with the nasopharynx for 20-30 seconds or until coughing is induced. d. Place the swab into the transport medium. Label the tube with the patient’s name and identification number. Leave the swab embedded in the tube during transport. e. Transport immediately.
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3.2.8.3 Throat swab
i. Ask the patient to open his/her mouth widely, gently depress the tongue with a tongue depressor and rub the sterile swab over the tonsillar areas and the mucosa on the posterior pharyngeal wall behind the uvula. ii. Gently turn the swab so that its whole surface comes in contact with the inflamed mucosa or tongue with the swab. iii. Avoid touching the oral mucosa or tongue with the swab. iv. Place the swab in Amies Transport Medium immediately.
Notes: In suspected Diphtheria case, in which patient may presented with pseudo membrane, pieces of pseudo-membrane may also be submitted for culture. Pseudo-membrane should be placed in sterile container with small amount of sterile saline (not formalin) and transported to the lab immediately.
3.2.8.4 Sputum
i. Collect the sputum early in the morning, after a deep cough or after a session of physiotherapy. If tuberculosis is suspected, send 3 consecutive specimen. ii. Ask the patient to cough deeply and spit directly into a sterile universal container. iii. If delay is anticipated, store the sample in a refrigerator.
3.2.8.5 Bronchial alveolar lavage (BAL/ brushing/ biopsies)
i. Place the specimen which is obtained via bronchoscopy into a sterile container. ii. Send the specimen to the laboratory immediately.
3.2.9 Pus, swab, tissue
3.2.9.1 Pus C&S
Specimen collection: i. Should be done under aseptic technique. ii. Aspirate purulent material from the depth of the wound with a sterile needle and syringe. iii. Transfer at least 2-3 ml into sterile screw capped container. iv. Send immediately to the laboratory. v. Wherever possible collect pus by aspiration rather than swab.
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3.2.9.2 Swab
Special note: dry swab is not suitable for culture.
i. Ear Swab/Eye swab. a. Clean the external meatus / skin around the eye with sterile water. b. Collect exudates with a sterile swab. c. Place swab in Amies Transport Medium and send to the laboratory as soon as possible.
ii. Wound swab. a. Collect pus prior to any antiseptic dressing. b. Clean wound & surrounding area with sterile water or sterile saline to remove all superficial environmental bacteria colonizing the wound. c. Soak a sterile swab thoroughly in the exudates and place in Amies Transport Medium. Transport to the laboratory at room temperature as soon as possible.
iii.Mouth /Gum swab a. Instruct patient to rinse mouth before sampling. b. Rub a sterile swab over the inflamed area. c. Place in Amies Transport Medium and send to the laboratory as soon as possible.
3.2.9.3 Tissue C & S
i. Aseptically cut a sample of the suspected infected site. ii. Put in a sterile screw cap container. DO NOT ADD FORMALIN. iii. Dispatch to the laboratory as soon as possible.
3.2.10 Stool C & S
i. Stool C&S requires feces (stool) specimen or rectal swab for testing. ii. Volume required: ¼ of stool container. iii. If it is not possible to obtain feces, collect a specimen by inserting a cotton swab into the rectum for rectal swab and use Cary-Blair Transport Medium. iv. Send immediately to the laboratory.
Note: For Clostridium difficile toxin detection: a. Collect fresh stool in a sterile container. Only loose or diarrheal stools are recommended for Clostridium difficile test. Specimens collected in formalin or swabs are not acceptable. b. Transport to the laboratory immediately.
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3.2.11 TIP Catheter/UVC Tip C & S
i. Clean skin around the catheter. Remove the tip in an aseptic manner. ii. Cut-off the catheter/UVC tips using an alcohol-wiped scissors and then, places the tip into a sterile container. iii. Send specimen to the laboratory as soon as possible.
Note: Catheter tips are not advisable to be sent for C & S.
3.2.12 Sterility Testing for Milk and Total Parenteral Nutrition (TPN)
i. Sterile test for Milk / TPN. ii. Send 5 mL of material prepared in sterile container to the laboratory.
3.3 SAMPLE FOR MYCOLOGY
3.3.1 Skin, nails and hair
Clean cutaneous and scalp lesions with 70% alcohol prior to sampling as this will improve the chances of detecting fungus on microscopic examination, as well as reducing the likelihood of bacterial contamination of cultures. Prior cleaning is essential if ointments, creams or powders have been applied to the lesion. Skin, nails, and hair specimen should be collected into folded squares of paper or directly onto an agar plate.
i. Skin Material should be collected from cutaneous lesions by scraping outwards from the margin of the lesion with the edge of a glass microscopic slide or a blunt scalpel.
ii. Hair a. Specimen from the scalp should include hair roots, the content of plugged follicles and skin scales. b. Hairs should be plucked from the scalp with forceps or the scalp is brushed with a plastic hairbrush and collected onto an agar plate.
iii. Nails Nail specimen should be taken from any discolored, dystrophic or brittle parts of the nail.
3.3.2 Mouth
Swabs from the buccal mucosa should be moistened with sterile water prior to taking the samples and send in Amies Transport Medium
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3.3.3 Ears
Scrapings of material from the canal are to be preferred, although swabs can also be used.
3.3.4 Ocular specimens
i. Material from patients with suspected fungal infection of the cornea (keratomycosis) should be collected by scraping the ulcer. The entire base of ulcer, as well as the edges, should be scrapped.(swabs are not suitable for sampling corneal lesions) ii. The material is collected directly onto agar plates for culture and to a glass slide for microscopic examination.
3.3.5 Blood i. Blood culture for fungal is collected in the same manner as for blood culture for bacteria using manufacturer fungal bottle. ii. The request for fungal culture should be indicated clearly on the request form and a total of two weeks incubation will be carried out.
3.3.6 Cerebrospinal fluid
CSF specimens (3-5 mls) should be collected in a sterile container for microscopy and culture.
3.3.7 Bone marrow
This specimen is helpful for making the diagnosis in a number of deep fungal infections. 3-5 mls of aspirated material should be collected and transferred into a manufacturer blood culture bottle.
3.3.8 Pus
i. Pus from undrained subcutaneous abscesses or sinus tracts should be collected with a sterile needle and syringe. ii. If grains are visible in the pus (as in mycetoma), these must be collected. In mycetoma , if the crusts at the opening of the sinus tracts are lifted, grains can often be found in the pus underneath.
3.3.9 Tissue
i. If possible, material should be obtained from both the middle and edge of the lesions. ii. Small cutaneous, subcutaneous or mucosal lesions can often be excised completely. iii. Tissue specimen should be placed in a sterile container without formalin.
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3.3.10 Specimen for serological tests
These comprise of test in bacteriology, virology, parasitology and immunology. Methods of blood collection: i. Draw 3-5 mls of blood into a plain tube without anticoagulant. ii. Clot at ambient temperature and dispatch to the lab as soon as possible
Note: Hemolysis, icteric or lipaemic specimens invalidate certain tests. If such specimens are received, the samples will be rejected to ensure quality.
3.4 BLOOD FILM FOR MALARIA (BFMP) or FILARIA
Thick film: Always handle slides by the edges or by a corner to make the thick film. Using the corner of the spreader, quickly join the drops of the blood and spread them to make an even, thick film. The blood should not be excessively stirred but can be spread in circular form with 3 to 6 movements. The circular thick film should be about 1 cm in diameter.
Thin film: Using a second clean slide as “spreader” and, with the slide with the blood drops resting on a flat, firm surface, touch the small drop with the spreader and allow the blood to run along the edge. Firmly push the spreader along the side, keeping the spreader at an angle of 45°C. Make sure that the spreader is in even contact with the surface of the slide all the time the blood is being spread.
Notes: For filarial, sample should be taken between 10.00 pm-4.00 am
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4. TESTS OFFERED IN MICROBIOLOGY LABORATORY, HOSPITAL TAIPING AND LTAT
TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN 10mls- 3-5 days * The cap of the bottle Aspirate C&S Pus / exudates 30mls must be close tightly Other than to avoid sample from Body fluid C&S CSF, blood and leaking. urine Mid-stream * Send to the lab urine (MSU) IMMEDIATELY. Urine C&S Suprapubic urine (SPU) Gram stain Fluid 1 Hour
Sputum C&S 3-5 days Sterile Bottle Tracheal Aspirate C&S
Nasopharyngeal Aspirate C&S Respiratory Specimen Broncho alveolar Lavage C&S Bronchial Washing C&S
Tissue C&S Biopsy Specimen Bone C&S - * Cut the catheter tip Catheter Tip C&S Catheter (5cm) using sterile scissor. *Send to the lab IUCD C&S IUCD immediately. Intravascular Fluid Vitreous 3-5 days *Please get the agar (Vitreous Taping) C&S Fluid from lab.
Corneal Scrapping Corneal C&S scraping
-
Sabouraud, Chocolate and Blood/ MacConkey Agar
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Blood C&S Blood 8-10ml 5-10 days (Adult) For Fungal, 1-3ml may up to (Paeds) 14 days
Bactec FA Plus For TB aerobic (orange) culture, may up to 42 days
Bactec FN Plus Anaerobic (blue)
Bactec PF Plus Paediatric
Bactec Myco/F Lytic
Pus Pus/ Exudate swab - 3-5 days * No dry swab C&S allowed. Eye/Ear Eye / Ear swab C&S Nasal Nasal swab C&S Throat swab C&S Throat
Amies Transport Medium without charcoal
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN Cerebrospinal 3-4 mls. 3-5 days CSF C&S *The cap of the bottle Fluid MUST BE close tightly CSF FEME 1 Hour to avoid leaking.
Room temperature.
DO NOT store in the refrigerator except for request of virology, Sterile Bijou Bottle where specimens should be kept at 4-8°C. - 3-5 days If sending fresh stool, Stool C&S Stool place in container and Rectal Swab C&S Swab from send to the lab Rectal Immediately. (Within 2 Hours)
Swab with Carry Blair Medium Genital - 3-5 days Genital swab C&S High Vaginal High Vaginal Swab C&S Endocervical Endocervical Swab C&S Penis Penis Swab C&S
Urethral Swab C&S Urethral Amies Transport Medium (With Charcoal)
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN
Direct smear for AFB Sputum 24 Hours *Early morning sputum preferred. (Routine) *Room
Temperature. Sputum AFB *Store at 4°C if ‘direct smear’ for Delay urgent Sputum Container case/waiting patient : 2 Hours (Urgent)
Blood Film Malaria Blood *20 µl (about 1 Hour * Leave to air dry Parasite. 10 cent coin (DO NOT use hair (To get size). dryer) positive or Blood Film Filarial *Thick smear negative Parasite. result) 60 µl. *Prepare a thick smear on slides in Glass slide *Room oval shape (after Temperature. 10 pm till 4 am).
Stool for Occult Fresh stool One fourth of 3 Hour blood a container.
Stool FEME
Stool for Clostridium difficile toxin.
Stool Container
Environmental Environmental 3 Days *Procedure done Sampling. at operation theatre room by infectious control - Nurse.
*Usually after Tryptic Soy Agar Plate change the HEPA filters.
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TEST TYPE OF CONTAINER VOLUME LTAT REMARKS SPECIMEN Mycological Hair 14 Days *Please get the Examination agar and slides Nail (For No (Microscopy) from lab. Growth) Skin Scraping Fungal stain
Fungal C&S For growth colonies Sabouraud, Chocolate, will be sent Blood/MacConkey - to HRPB Agar Ipoh for further test
Slide Spore Test Spore - 3 days *Attest / Spore strip *Send attest indicator vials that gone through the autoclaving cycle together with control attest. Attest indicator vials *Both test and control attest must be from the same batch. MersCov PCR Nasopharyngeal - - *Sample will be and Throat Swab send to Hospital Ipoh *Keep at 4-80C *Please send in ‘Triple Packaging’ *ETT secretion, Swab with Viral BAL and sputum Transport Medium sample for (VTM) MersCov, please use sterile container
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TYPE OF TEST CONTAINER VOLUME LTAT REMARKS SPECIMEN
Corynebacterium Throat swab - 3-5 days *Positive isolates diphteriae C&S will be send to IMR for toxin testing *Slides were also prepared if preliminary Gram Staining result needed
Swab with Amies *Please get the Transport Medium swab and slides from lab *Transport in Room Temperature
Bordetella pertussis Nasopharyngeal - *For culture keep in swab Room Temperature culture and PCR *For PCR, keep at 4- 8 degree *Culture will be done in Hospital
Taiping, sample for For Culture, Amies PCR will be Transpor Medium with outsourced. charcoal For PCR, Amies Transport Medium without Charcoal
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5.TESTS OFFERED IN SEROLOGY LABORATORY TAIPING HOSPITAL AND LTAT
TEST TYPE OF CONTAINER VOLUME LTAT REMARKS SPECIMEN Blood/ 3-3.5ml 1 working Anti Streptolysin 0 titre day (ASOT). Plasma/ serum Rheumatoid factor (RF)
Monotest for infectious
Mononucleosis.
3-6 * For Anti HIV, working Anti HIV, HbsAg, Anti HbsAg, Anti Hbs, Anti days Hbs, Anti HCV. HCV– If needle prick 1ml-2ml test @ Transplant – Please call SO/ CM On call *LTAT 24 Hours for needle prick and 4 hours for transplant Plain Tube with Gel
VDRL and TPPA
3 working Dengue IgM days Dengue NS1 1 working For NS1/IgM/IgG Antigen/Combo day (Combo Test) – For urgent test please contact S.O/CM On call LTAT 1 hour.
Leptospiral IgM
5 working Anti-Nuclear Plain tube with gel for days Antibody(ANA) baby DsDNA (double
stranded DNA)
Mycoplasma Antibody
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6. REPORTING AND DESPATCHING OF RESULT(S)
6.1 Test results will be validated by Clinical Microbiologist and Science Officer. Medical Lab Technologist will only validate gram stain, cell count and result culture that shows no growth of any organism. 6.2 All results will be made available according to the respective test’s Lab turnaround time (LTAT). 6.3 Printed test result for in-patient are dispatched via designated pigeon holes located at the main counter of the Department of Pathology. 6.4 The results for HIV, HCV, HBs Ag and VDRL will NOT be informed by phone, and will be directly dispatched to the respective departments by laboratory attendants.
7. RETENTION PERIOD OF SPECIMENS AND RESULTS/REPORTS
RECORD/ MATERIAL RETENTION DURATION
7.1 Request form accompanying specimen for 1 month after issue of report/result Bacteriology, Parasitology, Virology and Mycology
7.2 Specimens for culture & sensitivity 2 days after issue of report/result 7.2.1 All specimens except urine & blood Discard after issues of report/ result 7.2.2 Urine Negative - Discard after issue of report/result 7.2.3 Blood (including fungal culture) Positive - 7 days after issue of report/result
7.3 Serum/plasma for serology Negative - Discard after issue of report/result Positive - 7 days after issue of report/result
7.4 Slides Discard after issue of report/result 7.4.1 Wet preparation Negative- Discard after issue of report/result 7.4.2 Stained/ Immunofluorescence slides Positive- 2 days after issue of report/result
Note: Negative culture and sensitivity, serology and slides are discarded after issue of reports/result
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1. INTRODUCTION
Histopathology lab deals with the macroscopic and microscopic examination of surgical specimens as well as biopsies.
2. LIST OF SERVICES
2.1 General (routine) histopathological examination of tissue (light microscopy). 2.2 Frozen section 2.3 Histochemistry 2.4 Immunohistochemistry (*) 2.5 Clinical autopsy
NOTE: Immunohistochemistry testing is done in panels and not in one go based on the H&E stained slides.
3. REQUEST FOR HISTOPATHOLOGY SERVICE
3.1 General (routine) histopathology.
3.1.1 Use HTPG/JP/03/04 form filled in with relevant clinical information for all histopathological examination requests. 3.1.2 If the report is needed urgently, please mark the request form with the word ‘URGENT’ clearly at the top right hand corner preferably in red ink.
3.2 Frozen Section.
3.2.1 All requests for frozen section examination must be preceded by appointment and discussion with the Histopathologist on call at least 24 hours before operation. This is followed by filling up of the request form (HTPG/JP/03/04) for the frozen section. Please fill in the request form completely (including location of operating theater, operating theater extension number, name of the surgeon to be informed of the result and the previous HPE number or other relevant investigation for correlation purpose) and submitting it to the Histopathology Laboratory for notification 1 day before the operation. If previous HPE is done elsewhere, slide and report should be submitted prior to posting of the case for frozen section. 3.2.2 Please inform the laboratory at extension 5308: i. When the patient is wheeled into the operating room or ii. If the frozen section examination is cancelled. All cases scheduled for frozen section examination are best placed first in the operating list. 3.2.3 Transport the specimen immediately to the histopathology laboratory fresh with no formalin added.
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3.3 Transplant.
Histopathologist on call should be notified as soon as possible.
4. SPECIMEN COLLECTION AND HANDLING
4.1 All specimens for routine histological examination are to be fixed in 10% formalin in suitable clean leak-proof container. The container should have wide opening and if possible with screw cap to prevent leakage.
Leak proof, wide opening and Non-leak proof and fragile containers non-fragile container are not appropriate for usage
4.2 The volume of formalin used must be at least 10 times the volume of specimen to be fixed.
Fully immersed specimen Partial immersed specimen
4.3 Do not put large specimen in small containers as this would prevent proper fixation of the tissue, distort the specimen. Also if a small mouthed container is used, there will be difficulty in taking out the specimen from the bottle/container a possibility of damaging/crushing the specimen..
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Appropriate size container Shallow and small mouthed containers are in appropriate for usage 4.4 All specimen containers should have the same identification details as that written on the request forms.
Correct method of labeling specimen(s)
4.5 Specimens from different anatomical sites should be sent in separate containers, properly labeled and must be clearly itemized in the request form.
4.6 For cases that require confirmation of the adequacy of surgical excision, the margins of the specimens must be marked or tagged accordingly with suture and/or diagrammatic representation of the excised specimens.
4.7 NOTE: Histopathology assessment of muscle biopsy and renal biopsy skin biopsy are not provided in our service. Hence, the respective discipline ordering these tests should make the proper arrangement with the designated referral specialist at other centers.
4.8 Skin biopsy specimens for immunofluorescence study must be sent to HRPB Ipoh during office hours via hospital transport by the requesters themselves. The case will be read and reported by our histopathologist once staining are ready.
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5. TRANSPORTATION OF SPECIMEN
5.1 Specimens for routine histopathological examination should be sent directly to Histopathology Laboratory (not to the main reception counter).
5.2 For frozen section examination, the specimen should be sent immediately upon removal to the laboratory by a doctor.
6. HISTOPATHOLOGY (HPE) TURN AROUND TIME
URGENT NON URGENT CATEGORY SPECIMEN (without intervention ⃰ ) (without intervention ⃰⃰ )
A: Small Biopsy Tissue Biopsy: 3 working days 7 working days (<1.0 cm) Eg: liver, lung, trucut, bladder and prostate biopsies.
Except: Skin, endometrial sampling/ curettage, bone/trephine biopsies (requiring decalcification). B: Simple Specimen - Appendix 7 working days 7 working days - Fallopian tube - Product of conception C: Big Specimen - Other than category A & B. 7 working days 14 working days (>1.0 cm) - Clinical Autopsy specimens. 14 working days 14 working days
*Intervention includes further regrossing of the specimen or deeper/ recut of the tissue blocks, further histochemical or immunochemical testing or referral for second opinion to other hospitals for subspecialty (expert) opinion.
NOTE: Results of frozen section will be immediately communicated to the surgeon via telephone or to the doctor who brought the specimen to the laboratory.
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7. REPORTINGS AND DESPATCHING OF RESULTS
7.1 All tests will be seen and validated by a histopathologist within LTAT
7.2 All histopathology reports will be sent to the respective clinics accordingly as stated below:
CASE DEPARTMENT/CLINIC SURGICAL SURGICAL OUTPATIENT DEPARTMENT ENT ORL CLINIC EYE EYE CLINIC SKIN SKIN CLINIC ORTHO ORTHO CLINIC GYNAE O&G CLINIC MEDICAL RESPECTIVE WARDS RESPIRATORY CHEST CLINIC PAEDIATRIC PAEDIATRIC CLINIC CLINICAL AUTOPSY RESPECTIVE DEPARTMENT
7.3 Note: Reports are not put into the LIS system.
7.4 Report enquiry:
Enquiry of reports over the phone by clinical staff is discouraged. However in case of urgent reports, the DOCTOR in-charge can call the lab (ext. 5308) or speak to the medical officer (ext.5327) or pathologist (ext. 5313) in charge.
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8. RETENTION PERIOD OF SPECIMEN AND RESULT/ REPORTS
RECORD/ MATERIAL RETENTION DURATION
As long as the corresponding 8.1 Request form accompanying specimen report is kept.
Report duplicates/ records/ block keys/ diagrams and 20 years 8.2 copies of any representative images prepared
8.3.1 Immunofluorescence slides 2 days after issue of report 8.38.3.2 8.3.2 All other slides including special stains and frozen 7 years sections
8.4 Blocks, including paraffin blocks from frozen section tissue 20 years
8.5 Frozen tissue blocks for immunofluorescence studies 3 months
8.6.1 Unblocked tissue removed at surgery 1 month after issue of report 8.6 8.6.2 Unblock tissue retained at autopsy 3 months issue of autopsy report
8.7 Autopsy 8.7.1 Registers and report duplicates Indefinite 8.7.2 Tissue blocks 20 years 8.7.3 Slides 7 years 8.7.4 Records of tissue and organ disposal Indefinite
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1. INTRODUCTION
Cytopathology is a discipline in Pathology that involves the morphologic study of cells. It is broadly divided into exfoliative cytology and aspiration cytology. Exfoliative cytology involves examination of specimens that contain cells exfoliated from body cavities and surfaces. It is further subdivided into gynecological cytology and non-gynecological cytology. Aspiration cytology involves examination of cells that are actively obtained by fine needle aspiration.
2. LIST OF SERVICES
2.1 Exfoliative cytopathology
2.1.1 Gynecologic-conventional pap smear 2.1.2 Non-gynecologic-body fluids, sputum, brushing (bronchial brushing, bronchial washing), Tzanck smear. 2.1.3 Spermatozoa examination 2.1.4 Seminal fluid analysis This test is carried out by appointment only: i. Instruct patient to abstain from sex for 4 days prior to collection of semen. ii. Do not use condoms that are treated with spermicide. iii. It is preferable to ask patient to masturbate as most condoms come treated chemically. iv. Collect the full ejaculation in wide mouth sterile specimen container. v. Take note the time of collection
2.2 Aspiration cytopathology (FNAC)
2.2.1 The FNAC clinic is conducted once a week (on Wednesdays, except Public Holiday) 2.00 – 4.00 pm at the Surgical Outpatient Department (SOPD), Hospital Taiping wherein medical officer from the Department of Pathology will be placed on site for the assessment of cellularity i.e adequacy. 2.2.2 A medical officer from The Department of Pathology will access the cellularity of the aspirates done for admitted ill patients in the ward on appointment basis. 2.2.3 Please note that: i. Lumps and bumps that are palpable and superficial in location only are applicable for FNAC.
Note: FNAC for deep seated lesions are performed by radiologists under radiological guidance on appointment basis a medical officer from Department of Pathology will be available to access the cellularity on site.
ii. Vascular lesions or those of vascular origin are not suitable for FNAC.
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3. SPECIMEN COLLECTION AND HANDLING
3.1 TYPE OF SPECIMEN, CONTAINER, VOLUME AND TRANSPORTATION VOLUME/ SITE/TYPE CONTAINER REMARKS QUANTITY
Body fluid As collected Dispatch immediately. If delay anticipated refrigerate at 2°C-8°C. (pericardial Fluid, Pleural Fluid, Peritoneal NAME Fluid) FULL IC NO TYPE OF SPECIMEN
Sterile specimen container (Universal leak-proof container)
Bronchial a) Air dried-smear 1-3 smears Dispatch immediately. brushing b) Wet fix smear with 95% Alcohol/ Cytospray
Bronchial Sterile specimen container As collected Dispatch immediately. If delay washing anticipated, refrigerate at 2°C-8°C.
Bron Sterile specimen container As collected Dispatch immediately. chial alveolar lavage (BAL)
Cerebrospinal As collected Dispatch immediately. fluid
NAME FULL IC NO TYPE OF SPECIMEN
Sterile bijou bottle
Cyst fluid Sterile specimen container As collected Dispatch immediately for processing. If delay anticipated refrigerate at 2°C-8°C.
Eye fluids/Eye Sterile specimen container As collected Dispatch immediately for processing. If washing delay anticipated refrigerate at 2°C-8°C.
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SITE/TYPE CONTAINER VOLUME/ REMARKS QUANTITY
Sputum Sterile specimen container As collected Early morning deep cough specimen (not saliva). Transport immediately.
Tzanck smear Air- dried smear 1 smear
Cervical vaginal Wey fix smear with 95% 1 smear a) Slide should be placed in a slide (PAP) smear Alcohol for 15-20 minutes or mailer before dispatch to laboratory. Cytospray immediately b) Write patient’s name and full IC number using a pencil.
Fine Needle a) Wet fix smear with 95% As collected Dispatch immediately. Aspiration Ethanol/Cyto spray. (FNAC) of all organ b) Air dried smears. As collected c) Specimens for cell blocks As collected in “cell block” solution.
Seminal fluid Sterile specimen container As collected Dispatch immediately. analysis
3.2 REQUEST FORM
3.2.1 PER-PAT 301 form for routine cytological examination. If urgent result is required, indicate with word “URGENT” written clearly at the top right hand corner of the request form. 3.2.2 PS 1/98 (Pindaan 2007) form for gynecologic examination. 3.2.3 All request form should be filled legibly, complete with relevant clinical history and findings by medical officer/ specialist, name of medical officer and specialist in-charge. 3.2.4 All fluids and washings must be sent immediately to the lab. 3.2.5 Specimen for cytological examination should be sent directly to the cytology laboratory. 3.2.6 Where delay to lab is anticipated, refrigerate at 2°C-8°C to prevent degenerative changes.
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4. CYTOLOGY LAB TURN AROUND TIME
URGENT NON URGENT TYPE OF SPECIMEN (without intervention ⃰⃰ ) (without intervention ⃰ )
Non-gynae 3 working days 7 working days
FNAC 5 working days 7 working days
Pap Smear 5 working days 14 working days
Seminal Fluid Analysis 1 working day (By appointment)
*Intervention includes further recuts of the blocks, special staining, immunochemical testing or referral for second opinion to other hospitals.
5. REPORTING AND DISPATCHING OF RESULTS
5.1 All cytology cases will be reported by a histopathologist. 5.2 All cytology reports will be sent to the respective clinic according to the department as stated below:
CASE DEPARTMENT/ CLINIC SURGICAL SOPD ENT ORL CLINIC EYE EYE CLINIC SKIN SKIN CLINIC ORTHO ORTHO CLINIC GYNAE O&G CLINIC MEDICAL RESPECTIVE WARDS RESPIRATORY CHEST CLINIC PAEDIATRIC PAEDIATRIC CLINIC CLINICAL AUTOPSY RESPECTIVE DEPARTMENT
5.3 Enquiry of reports over the phone is discouraged. However in case of urgent reports, the DOCTOR in-charge can call the lab (ext. 5366) or speak to the medical officer (ext. 5327) or pathologist (ext. 5313).
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6. RETENTION PERIOD OF SPECIMEN AND RESULT/ REPORTS
RECORD/ MATERIAL RETENTION DURATION
As long as corresponding report 6.1 Request form accompanying specimen is kept
6.2 Report duplicates/ records/ block keys/ diagrams and 20 years copies of any representative images prepared
6.3 Exfoliative and Fine Needle Aspiration Cytology (FNAC) 6.3.1 Slides 7 years 6.3.2 Cell blocks 20 years
6.4 Sputum, urine, cerebrospinal fluid and other body fluids 2 days after issue of report
6.5 Specimens received in liquid based fixative 1 month after issue of report
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1. INTRODUCTION
Outsource service is one of the important service in Pathology Department. Tests that are not offered by Pathology Department, Taiping Hospital will be send out to other laboratory for testing. Outsource unit involved in consultation, preparing, storage, package, sending outsource samples to another laboratory. Result from other laboratory will be manage according by outsource before dispatching to requesting ward or clinics.
2. LIST OF SERVICES
Provides service to Taiping Hospital and District Hospital (Parit Buntar, Selama, Gerik and Kuala Kangsar) and health center in the northern zone of Perak. Specialized tests involve Chemical Pathology, Hematology and Microbiology Unit.
For any inquiry of the service provided by Outsource unit, kindly contact the following extension number: 5367 (Person in Charge - Pn Haslina Binti Yaacob).
For further clarification on the procedures and tests, you may also contact the respective officers as below:
NO CONSULTANTS AREA OF EXPERTISE CONTACT NO. (ext) Dr Zarifah Bt Zam 5312 1 Microbiology Pn Fatimah Bt Sonkerim 5311 Dr Ainul Hana Bt Taruddin 5312 2 Chemical Pathology Pn Yogeswary a/p Sivaraja 5311 Dr Sanada Bt Abu Bakar 5314 3 Hematology Pn Nor Baiti Ahmad Kamarudin 5374
2.1 Outsource Operating Hour:
NO TIME AND COLLECTION SAMPLE HOSPITAL/ DISTRICT/ HEALTH Monday- Friday 1 All Ward/Clinic in Taiping Hospital 8.00am-5.00pm Monday-Thursday 8.00am-12.30pm 2.00pm-4.30pm District Hospital (Parit Buntar, Selama, Gerik, 2 Kuala Kangsar) and health centers in Northern Friday Zone of Perak 8.00am-11.45pm 2.45pm-4.30pm
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2.2 Transportation Schedule to Referral Centers:
NO TRANSPORTATION DAY LOCATION Hospital Raja Permaisuri Bainun, Ipoh; Hospital Bahagia Ulu 1 Monday-Friday Kinta; MKA Jelapang, Ipoh; Jabatan Kimia, Ipoh Hospital Kuala Lumpur, Institut Penyelidikan Malaysia, Hospital Sungai Buloh, MKA Sungai Buloh, Hospital Ampang, 2 Tuesday & Thursday Pusat Darah Negara, Hospital Putrajaya, Institut Kanser Negara
3. SPECIMEN COLLECTING AND HANDLING
3.1 Request for pathology tests should be written on the appropriate pathology request forms.
3.2 In all cases, the request forms must provide the following information: i. Full name of patient ii. I/C number or hospital registration number iii. Patient’s sex iv. Patient’s location (ward or clinic) v. Destination to report vi. Requesting medical officer’s name and signature vii. Test requested viii. Relevant clinical history and diagnosis including medications, fasting or non-fasting etc. ix. Time and date of sample collection x. Specialist signature (for certain tests)
3.3 Identify the sample type, tubes to be used and other test requirement thoroughly before collecting sample to avoid rejection. Please contact Outsource Unit for clarification on specialized tests before sample collection.
3.4 All specimen should be collected in correct tubes or containers and labeled immediately after collection at the patient’s bedside with: i. Date of collection ii. Test requested iii. Patient’s name and Identification No.
3.5 The laboratory reserves the right to reject a specimen under any of the following condition: i. Requisition form is not completely filled (refer to ordering of test above) ii. Patient particulars on specimen and form does not match iii. Specimen arrives without a requisition form or vice versa
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Hak Cipta Terpelihara © Jabatan Patologi, Hospital Taiping
Outsource Service 70
iv. Insufficient quantity v. Specimen unsuitable for testing eg clotting, hemolysis etc.
All rejections will be informed to the respective ward/ clinic/ district hospital/ health clinic and documented in pathology rejection forms and a copy of the rejection form will be sent to the respective ward/ clinic/ district hospital/ health clinic.
3.6 Specimens from district hospitals and health clinics should be sent together with 2 copies of the Consignment Form (HTPG/JP/13/10) and the consignment should be separated according to tests and units in the Department of Pathology Hospital Taiping.
3.7 Upon reception at Outsource Unit, specimens and forms will be sorted accordingly and sent to respective referral hospitals such as Hospital Raja Permaisuri Bainun (HRPB), Malaysian Chemistry Department Ipoh Branch, Makmal Kesihatan Awam Jelapang (MKAI), Hospital Bahagia Ulu Kinta (HBUK), Hospital Kuala Lumpur (HKL), Pediatric Department HKL, Institute of Medical Research (IMR), Mkaml Kesihatan Awam Sungai Buloh (MKAK), Hospital Sungai Buloh, Hospital Ampang, Pusat Darah Negara (PDN) and Hospital Pulau Pinang.
3.8 Type of containers
Sodium Sodium Lithium Heparin for Lithium Heparin Swab with transport K EDTA Tube Plain Tube 2 Citrate Tube Fluoride Tube Chromosome Study for OFT Test medium(Carry blair)
24HR Urine Stool Urine Viral Transport 4cc of chilled 8% Amies Transport Bijou Bottle container Container Container Media (VTM) perchloric acid in medium (With For OFT For Citrate Tube insulated container Charcoal) Test Media Chromoso (VTM) 8% me Study ort Media perchloric (VTM) 8% acid in perchloric insulated acid in container insulated er Citrate container Tube er Citrate Tube Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
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4. TEST OFFERED IN OUTSOURCE LABORATORY HOSPITAL TAIPING & LTAT
(Disclaimer: All LTAT stated in the table below are the LTAT of the Referral Laboratory, hence please be noted that the Total Turn Around Time for Pathology Hospital Taiping from time of specimen received till dispatched of results will be longer).
TEST STATUS (Active/ TAT UNIT/ Pathology Dept,Pathology CONTAINER VOLUME REFERENCE DESCRIPTION/ DETAIL TEST NAME Suspended/ SPECIMEN TYPE (Working CENTRE TYPE REQUIRED CENTRE (PREPS/Depth Instructions) Discontinued/ day) (Location) New)
Acid Sphingo Screening Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
Hospital Handbook Taiping Laboratory 2018 myelinase, ASM Suspended. chemistry Specialist need to contact (NP A/B) Confirmatory IMR. Sample can only send need to call after consultation from IMR. Pakar Genetik Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
ADAMTS13 Active Plasma Trisodium 2 tubes for 2-4 weeks Hemato- Hospital 1) Specialist who request the a) ADAM TS-13 citrate 3.2% each test, logy Ampang test need to make an activity to collect appointment with a b) ADAM TS-13 until consultant in Hemostasis inhibitor indicated Unit.
mark 2) Form: Hospital Ampang Special Hematology Lab Requisition Ha: Hema2017 12/17/16 with relevant clinical history and diagnosis & specialist sign.
OutsourceService
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Adrenocortico- Active Blood EDTA tube in 3mL 5 days Chemical HKL Form: PER.PAT 301
trophic ice Pathology Fresh EDTA in ice. Centrifuge
Hormone and separate plasma (ACTH) immediately. Store at -20⁰C if not outsourced on the same day. Transport with ice
Pathology Dept, packs.
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Adenovirus Active i) i) NPA: Sterile NPA: 1 - 5 days Virology IMR Keep and transport specimen Antigen, Acute Nasopharyngeal plastic vial Mucous at 2-8°C. Respiratory aspiration (NPA), contain 2-3ml secretion in Syndrome ii) Broncho of Virus VTM alveolar lavage Transport
(BAL) Media (VTM) iii) Sputum ii) BAL: Sterile
Pathology Dept,Pathology plastic tube container iii) Sputum:
Sterile plastic tube
Hospital Handbook Taiping Laboratory 2018 container
OutsourceService
OutsourceService
Adenovirus Active i) Eye swab, i) Eye swab: i) Eye swab: 1 - 5 days Virology IMR Keep and transport specimen
Antigen, ii) Lacrimal tears Sterile plastic Sterile swab at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal
Pathology Dept, capillary tube tears: 10-20 µl tears
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Adenovirus Active i) i) NPS: Sterile i) NPS: A 14 - 35 Virology IMR Keep and transport specimen Isolation, Acute Nasopharyngeal plastic vial flexible, fine days at 2-8°C. Inflammatory swab (NPS), contain 2-3ml shafter Myocardial ii) Throat swab of VTM polyester Diseases (TS) ii) TS: Sterile swab. Use
iii) Rectal swab plastic vial different iv) Stool, contain 2-3ml swab for each
Pathology Dept,Pathology v) Cardiac biopsy of VTM nostrils vi) Pericardial iii) Rectal ii) TS: Sterile aspirate swab: Sterile swab plastic vial iii) Rectal contain 2-3ml swab: Stool
Hospital Handbook Taiping Laboratory 2018 of VTM on sterile iv) Stool: swab Sterile bottle moistened v) Cardiac with distilled biopsy: water Sterile iv) Stool: containers >5gm (thumb containing size) VTM to keep v) Biopsy: tissue moist Remove vi) Pericardial portions, aspirate: about 1.5cm Sterile plastic cube of
vial contain various parts 2-3ml VTM of affected organs
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Adenovirus Active i) i) NPA: Sterile i) NPA: 14 - 35 Virology IMR Keep and transport specimen
Isolation, Acute Nasopharyngeal plastic vial Mucous days at 2-8°C. Respiratory aspiration, contain 2-3ml secretion in Syndrome ii) of VTM VTM Nasopharyngeal ii) NPS: ii) NPS: A swab, Sterile plastic flexible, fine
Pathology Dept, iii) Throat swab, vial contain shafter iv) Throat gargle, 2-3ml of VTM polyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different
Hospital Taiping L vii) Nasal swab, contain 2-3ml swab for each viii) Organ of VTM nostrils biopsies iv) Throat iii) TS: Sterile gargle: Sterile swab plastic iv) Throat
a container gargle
boratory Handbookboratory 2018 v) BAL: Sterile v) BAL plastic tube vi) Sputum container vii) Nasal vi) Sputum: swab: Sterile Sterile plastic swab. Use container different vii) Nasal swabs for swab : Sterile each nostrils plastic vial viii) Biopsy: contain 2-3ml Remove VTM portions, viii) Biopsy: about 1.5cm Sterile cube of containers various parts containing of affected VTM to keep organs tissue moist
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Adenovirus Active i) Eye swab, i) Eye swab: i) Eye swab: 14 - 35 Virology IMR Keep and transport specimen Isolation, ii) Lacrimal tears Sterile plastic Sterile swab days at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water ii)
tears: In Lacrimal capillary tube tears: 10-20
Pathology Dept,Pathology µl tears Adenovirus Active i) After After 1 - 10 Virology IMR After consultation only. Nucleic Acid, Nasopharyngeal consultation consultation days Acute swab (NPS), only only Inflammatory ii) Throat swab
Hospital Handbook Taiping Laboratory 2018 Myocardial (TS) Diseases iii) Rectal swab iv) Stool, v) Cardiac biopsy vi) Pericardial aspirate Adenovirus Active i) After After 1 - 10 Virology IMR After consultation only. Nucleic Acid, Nasopharyngeal consultation consultation days Acute aspiration, only only Respiratory ii) Syndrome Nasopharyngeal swab, iii)Throat swab,
iv) Throat gargle, v) BAL vi) Sputum, vii) Nasal swab, viii) Organ biopsies
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Adenovirus Active Eye swab, i) Eye swab: i) Eye swab: 1 - 10 Virology IMR Keep and transport specimen
Nucleic Acid, lacrimal tears Sterile plastic Sterile swab days at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal
Pathology Dept, capillary tube tears: 10-20 µl tears Adenovirus PCR Active Sputum / Sterile screw 1 ml 7 days Molecular MKAK 1) Specimen should be Nasopharyngeal capped Unit collected < 5 days after onset
Hospital Taiping L aspirate / Swab container / of illness. Sterile 2) A brief concise history of container illness and physical findings with 2.0-2.5 is required especially the ml date of onset of illness and
a of VTM date of specimen collection.
boratory Handbookboratory 2018 3) Keep and transport specimen at 2-8°C. Aldolase Private Laboratory
Aldosterone Active Plasma in EDTA 3 EDTA tubes 6 mL 21 days Endocri- Hospital Form: PER.PAT 301
nology Putrajaya Cop & sign specialist, fulfill the criteria (State in the form: clinical history, drug history, latest potassium level >4.0 mmol/L, requested by specialist/endocrine specialist only, record of patient`s position (supine/upright)).
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Alkaline Private Laboratory Phosphatase Isoenzymes
Alpha 1 Anti- Active Blood Plain tube 3mL 5 days Chemical HKL Form: PER.PAT 301.
trypsin Pathology
Pathology Dept,Pathology Alpha-1-Acid- Active Blood Plain tube 3mL 7 days Bio- Hospital Form: PER.PAT 301. Glycoprotein chemistry Ampang (Orosomucoids)
Hospital Handbook Taiping Laboratory 2018 Alpha- Active Random urine Clean 2mL 25 days Bio- IMR Form: PER.PAT 301. aminoadipic universal chemistry Semialdehyde bottle (AASA) / Piperideine-6- carboxylate (P6C) Aluminum Active Blood Plain tube 3 mL Toxicology Jabatan Form: Pemeriksaan Forensik/ Kimia, Ipoh Toksikologi. Sign & stamp of the requesting DR must be clear.
Amobiasis Active Whole blood in EDTA tube or 2.5 ml 7 days Para- IMR Keep and transport specimen Diagnosis - PCR EDTA, sterile air sitology at 2-8°C. Pus/Aspirate/ tight Biopsy/ container Scrapings Amoebiasis Active Serum, Blood Plain tube 2ml 5 days Para- IMR Keep and transport specimen Diagnosis - sitology at 2-8°C. Serology
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Amphetamine- Active Urine Urine 30mL 14-30 Drug H.Kepala Borang Ujian Pengesanan
Type Stimulants container days Laborator Batas (By Dadah - UPD (Pindaan 1) (ATS) y Post, Non form / PER-PAT 301 form. Medico Specimen to be sealed by legal) ward. Anaerobic Active Pure bacterial Agar or Not 30 days Bacteri- IMR Preliminary tests must be
Pathology Dept, Organism isolate media which applicable ology performed first and results Identification support the sent together with pure growth isolate and clinical history. Androstene- Active Serum Plain tube 5 mL 15 days Endo- Hospital Form: PER.PAT 301
Hospital Taiping L dione crinology Putrajaya Cop & sign specialist, fulfill the criteria (State in the form: clinical history, drug history, latest potassium level >4.0 mmol/L, requested
a by specialist/ endocrine
boratory Handbookboratory 2018 specialist only, record of patient`s position (supine/upright)). Angiotensin Private Laboratory (Serum) Converting
Enzyme (ACE)
Anti-Islet Cells Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen (ICA) Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
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Anti-Neuronal Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen Antibodies or CSF tube/Bijou Adult: immune at 2-8°C. Para neoplastic Bottle 5-10 ml Neurological Serum: Syndrome 1-3 ml
(PNS) Antibodies
Pathology Dept,Pathology Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 21 days Auto- IMR Keep and transport specimen Acetylcholine Adult: immune at 2-8°C. Receptor 5-10 ml Antibody (ACR) Serum: 1-3 ml
Hospital Handbook Taiping Laboratory 2018 Anti-AMA-M2 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Amphiphysin Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti-Aquaporin Active Blood/ Serum/ Plain gel Child: 3 ml 7 days Auto- IMR Keep and transport specimen 4 (Anti-Aq4) CSF tube/ Bijou Adult: immune at 2-8°C.
Bottle 5-10 ml Serum: 1-3 ml
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Anti-Beta 2 Active Blood/ Serum Plain gel tube Child: 3 ml 10 days Auto- IMR Keep and transport specimen
glycoprotein 1 Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Pathology Dept, Antibiotic Active Bacterial culture Culture Pure cultures 7 days Bacteri- IMR Preliminary tests must be resistance media which ology performed first and results verification support the sent together with pure growth isolate and clinical history. Transport in ambient
Hospital Taiping L temperature.
Anti-BP 180 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml a Serum:
boratory Handbookboratory 2018 1-3 ml Anti-BP 230 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Cardiolipin Active Blood/ Serum Plain gel tube Child: 3 ml 10 days Auto- IMR Keep and transport specimen Antibody (ACL), Adult: immune at 2-8°C. IgM & IgG 5-10 ml Serum: 1-3 ml Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen Centromere Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
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Anti-Contactin- Discontinued Blood/ Serum Plain gel tube Child: 3 ml 7 days Auto- IMR Keep and transport specimen associated Adult: immune at 2-8°C. protein 2 (Anti- 5-10 ml CASPR2) Serum: 1-3 ml
Anti-CV2 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: 5-10 immune at 2-8°C.
Pathology Dept,Pathology ml Serum: 1-3 ml
Anti-Cyclic Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Citrullinated Adult: immune at 2-8°C.
Hospital Handbook Taiping Laboratory 2018 Protein 5-10 ml (CCP/ACPA) Serum: 1-3 ml Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Desmoglein 1 Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Desmoglein 3 Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Antidiuretic Private Laboratory (Serum) Hormone (ADH) / Argenine Vasopressin (AVP)
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Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 21 days Auto- IMR Keep and transport specimen
Endomysium Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti-fungal Active Pure fungal Pure isolate Pure isolate 10 days Bacteri- IMR Identify the fungus first and
Pathology Dept, susceptibility isolate. Mixed in media that in media that ology results sent together with testing growth will be support support pure isolate and clinical rejected growth growth history. Transport condition: ambient temperature.
Hospital Taiping L Anti-Gastric Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Parietal Cell Adult: immune at 2-8°C. Antibody (APC) 5-10 ml Serum: 1-3 ml
a Anti-GD1a Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen
boratory Handbookboratory 2018 CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
Anti-GD1b Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml Anti-GD2 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
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Anti-GD3 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
Anti-Gliadin Active Blood/ Serum Plain gel tube Child: 3 ml 21 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C.
Pathology Dept,Pathology 5-10 ml Serum: 1-3 ml Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 10 days Auto- IMR Keep and transport specimen
Hospital Handbook Taiping Laboratory 2018 Glomerular Adult: immune at 2-8°C. Basement 5-10 ml Membrane Serum: (GBM) 1-3 ml
Anti-Glutamic Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Acid Adult: immune at 2-8°C. Decarboxylase 5-10 ml (GAD) Serum: 1-3 ml Anti-Glutamic Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Acid Adult: immune at 2-8°C. Decarboxylase 5-10 ml
(GAD) Serum: 1-3 ml Anti-GM1 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
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Anti-GM2 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen
CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
Pathology Dept, Anti-GM3 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
Hospital Taiping L Anti-GM4 Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
a boratory Handbookboratory 2018 Anti-gp210 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti-GQ1b Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C.
Bottle 5-10 ml Serum: 1-3 ml Anti-GT1a Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
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Anti-GT1b Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/ Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml
Anti-HBc IgM Active Blood Plain tube 3-5 ml 1-2 days Virology HKL Room temp. or in ice. EIA
Pathology Dept,Pathology
Anti-HBc Total Active Blood Plain tube 3-5 ml 1-2 days Virology HKL Room temp. or in ice. EIA
Hospital Handbook Taiping Laboratory 2018
Anti-HBe EIA Active Blood Plain tube 3-5 ml 1-2 days Virology HKL Room temp. or in ice.
Anti-Hu Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Insulin G Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Insulinoma- Adult: immune at 2-8°C. Associated 5-10 ml
Antigen 2 (IA2) Serum: OutsourceService 1-3 ml
OutsourceService
Anti-Jo 1 Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen
Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Pathology Dept, Anti-KLM 1 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: 5-10 immune at 2-8°C. ml Serum: 1-3 ml
Hospital Taiping L
Anti-LCI1, anti- Discontinued Blood/ Serum Plain gel tube Child: 3 ml 7 days Auto- IMR Keep and transport specimen CASPR2 Adult: immune at 2-8°C. 5-10 ml Serum: a 1-3 ml
boratory Handbookboratory 2018 Anti-Leucine- Discontinued Blood/ Serum/ Plain gel Child: 3 ml 7 days Auto- IMR Keep and transport specimen rich glioma- CSF tube/ Bijou Adult: immune at 2-8°C. inactivated Bottle 5-10 ml protein 1 (Anti- Serum: LCI1) 1-3 ml
Anti-Liver- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Kidney Adult: immune at 2-8°C. Microsome 5-10 ml (LKM) Serum: 1-3 ml
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Anti-M2- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen 3E/BPO Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Ma Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C.
Pathology Dept,Pathology 5-10 ml Serum: 1-3 ml
Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Hospital Handbook Taiping Laboratory 2018 Mitochondrial Adult: immune at 2-8°C. Antibody (AMA) 5-10 ml Serum: 1-3 ml
Anti-musk Private Laboratory
Anti-Neutrophil Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Cytoplasmic Adult: immune at 2-8°C. Antibody 5-10 ml (ANCA) Serum: 1-3 ml Anti-N-Methyl- Active Blood/ Serum/ Plain gel Child: 3 ml 7 days Auto- IMR Keep and transport specimen D-Aspartate CSF tube/ Bijou Adult: immune at 2-8°C. Receptor Bottle 5-10 ml (NMDAR) Serum:
1-3 ml OutsourceService
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Anti HIV- Active Blood Plain tube Child: 3ml 7 days Micro- HPP Keep and transport specimen
Immunoblot Adult: 5 ml biology at 2-8°C. (Serology *Reject if patients on HAART. Lab) Anti-platelet Active Fresh peripheral K2EDTA tube 2-3ml Hemato- Pusat a) To get an approval from
Pathology Dept, antibody (adult) blood x 5 logy Darah PDN's Hematopathologist Plain tube Negara beforehand. (without gel) b) Accompanied by Per-PAT x 5 form with relevant clinical history. To include latest
Hospital Taiping L platelet count. Signed by specialist. Anti-PML Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml
a Serum:
boratory Handbookboratory 2018 1-3 ml Anti-Ri Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-RNP 70 Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
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Anti-Ro-52 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Scl -70 Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C.
Pathology Dept,Pathology 5-10 ml Serum: 1-3 ml
Anti-SLA/LP Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Hospital Handbook Taiping Laboratory 2018 Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Smith Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen (Anti-Sm) Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti-Smooth Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Muscle Adult: immune at 2-8°C. Antibody 5-10 ml
(ASMA) Serum: 1-3 ml Anti-Sp100 Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum:
1-3 ml OutsourceService
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Anti-SSA/Ro Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen
Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Anti-SSB/La Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen
Pathology Dept, Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Hospital Taiping L Anti- Active Blood Plain tube 5 ml 7 days Micro- HKL Keep and transport specimen thyroglobulin biology at 2-8°C. antibodies
Anti-Thyroid Active Blood Plain tube 5 ml 7 days Micro- HKL Keep and transport specimen
a boratory Handbookboratory 2018 Microsomal biology at 2-8°C. antibody (anti- thyroid peroxidase antibody) TPO Anti-Thyroid Active Blood Plain tube 5 ml 14 days Micro- HKL Keep and transport specimen receptor biology at 2-8°C. antibody/ Anti TSH antibody
Anti-Tissue Active Blood/ Serum Plain gel tube Child: 3 ml 21 days Auto- IMR Keep and transport specimen Transglutamina Adult: immune at 2-8°C. se (tTG) 5-10 ml Serum: 1-3 ml
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Anti-U1RNP Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml
Anti-Voltage Discontinued Blood/ Serum Plain gel tube Child: 3 ml 7 days Auto- IMR Keep and transport specimen gated (Axisbio Adult: immune at 2-8°C. Pathology Dept,Pathology potassium Diagnostics 5-10 ml channel (VGKC) ada offers) Serum: 1-3 ml
Anti-Yo Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Hospital Handbook Taiping Laboratory 2018 Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Apo A-1 Private Laboratory (Serum)
Apo B-Total Private Laboratory (Serum)
Apo C-III Private Laboratory (Serum) (Phenotyping)
Apo E Private Laboratory (Serum) Genotyping
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Arsenic Active Blood Plain tube 3 ml Toxicology Jabatan Form: Pemeriksaan Forensik/
Kimia, Ipoh Toksikologi. Sign & stamp of requesting DR must be clear.
Aspergillus Active Serum, CSF Sterile plain As much as 7 days Bacteri- IMR Transport at ambient
Pathology Dept, galactomanan tube possible ology temperature; if delayed keep antigen at 2-8°C. detection Atypical Upon request Sputum, Pus, CSF Sterile For CSF 1-2 5 days Bacteri- IMR For CSF send to lab Mycobacterium only & Other body container ml ology immediately; for sputum
Hospital Taiping L infection or fluids ideally collect 3 consecutive Mycobacteria specimens. A single well other than collected specimen is Tuberculosis adequate. (MOTT) PCR
a
boratory Handbookboratory 2018 Avian Influenza Active i) After After 1 - 10 Virology IMR After consultation only. Viruses Nucleic Nasopharyngeal consultation consultation days Acid (H5, H7 & aspiration, only only H9) ii) Nasopharyngeal swab, iii)Throat swab,
iv) Throat gargle, v) BAL vi) Sputum, vii)Nasal swab, viii) Organ biopsies
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Bacterial Active Pure Bacterial Not 30 days Bacteri- IMR Preliminary tests must be Identification isolate applicable ology performed first and results sent together with pure isolate and clinical history.
Bacterial Active CSF, Swabs, For swabs 3-5ml 7 days Bacteri- IMR For CSF do not refrigerate.
isolation and Body fluids, Pus, send in ology Send immediately at room Antibiotic Urine Stuart's temperature. Pathology Dept,Pathology susceptibility transport testing media. For other samples send
in sterile
Hospital Handbook Taiping Laboratory 2018 screw capped container Barbiturate Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/sterile Kimia, Ipoh Toksikologi. Sign & stamp of container requesting DR must be clear.
Bartonella Active Serum Plain tube 2ml 5 days Bacteri- IMR Transport at 2-8°C. henselae ology Antibody detection Benzodiazepine Active Blood Plain tube 3 ml 18 hrs Clinical HKL Form: TDM. (Red cap) Toxicology
Beta Carotene Private Laboratory (Serum)
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Beta-2 Active Blood Plain tube 10mL 7 days Molecular IMR Form: Request Form for
Microglobulin Diag- Multiple Myeloma Serum nostics & must reach the lab not more Protein than 7 days (at 2⁰C-8⁰C) after collection date.
Pathology Dept, Beta-2 Active Blood Sterile 20mL 14 days Bio- Hospital Form: PER.PAT 301. Microglobulin container chemistry Ampang
Beta-2 Active Urine Sterile 20mL 14 days Bio- Hospital Form: PER.PAT 301.
Hospital Taiping L Microglobulin container chemistry Ampang
Beta-2 Active CSF Bijoux Bottle 1-2mL 7 days Bio- Hospital Form: PER.PAT 301. Microglobulin chemistry Ampang
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Biotinidine Active Dried blood spot Whatmann 3 circles of 10 days Bio- IMR Ensure blood completely Enzyme Activity 903 Filter DBS chemistry dried before putting in paper plastic sheet. Wet blood spot will be rejected.
BK virus (BKV) Active Blood, Serum Plain tube 4 ml 7 days Virology HKL Packed with ice.
DNA Quantitation
Blood Active Blood Plain tube 3 mL Toxicology Jabatan Form: Pemeriksaan Forensik/ Toksikologi Kimia, Ipoh Toksikologi. Sign & stamp of requesting DR must be clear.
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Bone Marrow Active Bone marrow Sterile First 2.0-3.0 18 days Hema- IMR Specimen must be: Chromosomal aspirate sodium ml tology a) Collected under sterile Analysis for heparin tube conditions. Acute b) Packed in ice during leukaemia transport.
(Cytogenetics) c) Request Form: Bone Marrow Cyto-Genetics with
Pathology Dept,Pathology specialist sign & stamp. **The sample should reach the lab immediately upon collection on any day in the morning except on the eve of
Hospital Handbook Taiping Laboratory 2018 any public holiday as sample stability is only up to 24 hours. Bone Marrow active Peripheral blood Sterile 2.0-3.0 ml 18 days Hema- IMR Specimen must be: Molecular for / Bone marrow sodium tology a) Collected under sterile Acute aspirate heparin tube conditions. leukaemia b) Packed in ice during transport. c) Request Form: Bone Marrow Cyto-Genetics with specialist sign & stamp. **The sample should reach the lab immediately upon
collection on any day in the morning except on the eve of any public holiday as sample stability is only up to 24 hours.
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Bone-Specific Private Laboratory (Serum)
Alkaline Phosphatase
Bordetella Active Nasopharyngeal Sterile 1-2 ml of 5 days Bacteri- IMR For nasopharyngeal swabs
Pathology Dept, pertussis PCR aspirates, container nasopharyng ology do not use calcium alginate Nasopharyngeal eal isolate or cotton swabs. Transport swabs nasopharyngeal aspirate in ice.
Borellia Active Serum Plain tube 2ml 9 days Bacteri- IMR Transport at 2-8°C.
Hospital Taiping L burgdorferi ology antibody detection Bromide Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of
a boratory Handbookboratory 2018 container requesting DR must be clear.
Brucella PCR Active Blood in EDTA EDTA tube 5 ml 4 days Bacteri- IMR Transport at 2-8°C. Must be tube ology fresh specimen, taken prior to antibiotic treatment. Laboratory must be informed prior to sending sample.
Brucella Active Serum Plain tube 2 ml 5 days Bacteri- IMR Transport at 2-8°C. Serology ology
Bruton Tyrosine Active Blood EDTA 2 ml 5 days PID IMR Transported without ice. By Kinase(BTK) appointment only. protein detection
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C Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Neutrophil Adult: immune at 2-8°C. Cytoplasmic 5-10 ml Antibody (C- Serum: ANCA) 1-3 ml
C1 Esterase Private Laboratory (Serum) Inhibitor
Pathology Dept,Pathology
C3C4 Active Blood Plain tube 3 mL 3 days Bio- HRPB Form: PER.PAT 301 chemistry Cop and sign specialist. Complete with diagnosis &
Hospital Handbook Taiping Laboratory 2018 clinical history. CA-153 Active Blood Plain tube 3mL 2 days Clinical HKL Form: PER.PAT 301. Toxicology
Cadmium Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of container requesting DR must be clear.
Calcitonin Suspended Blood Plain tube 3 mL 4-6 weeks Chemical Institut Form: PER.PAT 301. Pathology Kanser Request by specialist only. Negara Form complete with history.
Specialists ordering the test need to call IKN before order test. Campylobacter Active Stool swab Cary Blair - 7 days Micro- HRPB jejuni (Culture) Transport biology Media
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CA-MRSA PCR Active Bacterial culture Pure isolate Pure isolate 7 days Bacteri- IMR Send pure isolates with
ology clinical history.
Carbapenemas Active Bacterial culture Blood agar or Pure isolate 14 days Bacteri- IMR Send patient history with
Pathology Dept, e genes nutrient slant ology preliminary antibiotic detection susceptibility test results.
Catecholamines Active 24 hr urine 24H urine Adult: > 20 days Chemical HKL Form: PER.PAT 301 - Epinephrine container 500mL Pathology Record 24hrs urine volume
Hospital Taiping L - with 10mL of on the request form. Cop Norepinephrine 25% HCL and sign specialist. Rejection - Dopamine criteria: 1. Inadequate urine collection (Adult < 500 mL; children samples < 750 mL
a will be treated as random
boratory Handbookboratory 2018 urine samples). 2. Urine pH > 5 Ceruloplasmin Active Blood Plain tube 3mL 10 days Chemical HKL Form: PER.PAT 301. Pathology
Chikungunya Active Blood, Serum Plain tube Child: 3 ml 1 - 10 Virology IMR Keep and transport specimen
Virus Antibody, Adult: days at 2-8°C. Acute 5-10 ml Dermatological Serum: Syndrome, 1-3 ml IgM/IgG
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Chikungunya Active Serum Plain tube Serum: 1 - 10 Virology IMR Keep and transport specimen Virus Antibody, 1 - 3 ml days at 2-8°C. Acute Inflammatory Musculoskeleta
l Diseases, IgM/IgG
Pathology Dept,Pathology Chikungunya Active Blood, Serum Plain tube Child: 3 ml 14 - 35 Virology IMR Keep and transport specimen Virus Isolation, Adult: days at 2-8°C. Acute 5-10 ml Dermatological Serum: Syndrome 1-3 ml
Hospital Handbook Taiping Laboratory 2018 Chikungunya Active Serum Plain tube Serum: 14 - 35 Virology IMR Keep and transport specimen Virus Isolation, 1-3ml days at 2-8°C. Acute Inflammatory Musculoskeleta l Diseases Chikungunya Active Blood, Serum Plain tube Child: 3 ml 1 - 10 Virology IMR Keep and transport specimen Virus Nucleic Adult: days at 2-8°C. Acid, Acute 5-10 ml Dermatological Serum: Syndrome 1-3 ml
Chikungunya Active Serum Plain tube Serum: 1 - 10 Virology IMR Keep and transport specimen Virus Nucleic 1-3ml days at 2-8°C. Acid, Acute Inflammatory Musculoskeleta l Diseases
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Chitotriosidase Private Laboratory (Plasma)
Chlamydia Active Blood Plain tube 3 ml 3 days Micro- HKL
Pathology Dept, pneumoniae biology antibody
Chlamydia Active Genital Received in Not 7 days Micro- HKL Fix slides with methanol for 5 trachomatis discharge/ slide with applicable biology minutes.
Hospital Taiping L Immunofluores Eye discharge smear and cence label Cholinesterase Active Blood Plain tube 3mL 3 days Bio- HRPB Form: PER.PAT 301 Level chemistry Cop and sign specialist. Complete with diagnosis &
a boratory Handbookboratory 2018 clinical history. Chromium Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of container requesting DR must be clear.
Chromogenin A Private Laboratory (Serum) (CgA)
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CD4 / CD8 Active Fresh peripheral K2EDTA 2.0 ml 7 days Hema- HRPB a) Mix the blood thoroughly, Enumeration blood tology gently and immediately after collection. Avoid direct contact with ice. b) Test is run on daily basis
during office hours. c) Transport at room
Pathology Dept,Pathology temperature (20°C - 24°C). d) Sample stability is 72 hours. For CD4 alone, the test is done in KK Taiping. Sample is
Hospital Handbook Taiping Laboratory 2018 handled by MOPD staff not through the lab. Chromosome Active Peripheral blood Sterile 10 ml 18 days Hema-- IMR Specimen must be: breakage study lithium tology / a) Collected under sterile for Fanconi's heparinized Genetics conditions. anemia tube b) Packed in ice during transport. c) Form: Bone Marrow Cytogenetics with specialist sign & stamp. **Patient must not on antibiotic in 2 weeks preceding blood collection.
**IMPORTANT: An appointment is necessary for the performance of this analysis. A control sample matched for age and sex is required.
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Chromosome Active Whole blood Lithium 5ml (Fresh Hema-- HKL Form: Cytogenetics HKL
Studies heparin tube sample) tology / Requesting DR should make (Karyotyping) (Tube will be Genetics appointment with HKL (Tue supplied & Thurs & enquire about when there is special requirements ie. appointment analysis for partners also
Pathology Dept, date) COAGULATION Active Plasma Trisodium Known case: Hema- Pusat a) Form: National Blood FACTOR ASSAY citrate 3.2% 1 tube, filled tology Darah Centre Hematology / a) Factor II until Negara Serology Request Form with
Hospital Taiping L b) Factor V indicated relevant clinical history to be c) Factor VII mark signed by attending d) Factor X New case: 3 physician. e) Factor XI tubes, filled f) Factor XII until
a g) Factor XIII indicated
boratory Handbookboratory 2018 mark COAGULATION Active Plasma Trisodium 4 tubes fill Hema- HRPB Form: Per Pat 301 FACTOR ASSAY citrate 3.2% until tology a) Factor VIII & indicated Factor IX level mark assay B) Factor VIII &
Factor IX inhibitor level assay Factor Assay Active Plasma Trisodium 3 tubes fill 2 days Hema- Hospital citrate 3.2% until tology Ampang indicated mark
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CMV - DNA Active Blood / CSF / EDTA tube / 5 ml / 2 ml 2 days Micro- HSB 1) EDTA tube (Adult), 1 EDTA Genome Tissue / BAL Sterile Bijou biology (Baby). Detection/CMV Bottle / (Mole- 2) Spin for plasma by VIRAL PCR Sterile cular centrifuge. Container Diagnostic 3) Packed in ice for
Lab) transportation. *Need 3 copy of request
Pathology Dept,Pathology form CMV - DNA PCR Active Blood (EDTA)/ EDTA 3 ml 7 days Virology HKL 1) Fresh sample or Viral Load Plasma (EDTA) 2) Frozen plasma. (Quantitative)- 3) Packed with ice. for transplant & Test offered for Patient
Hospital Handbook Taiping Laboratory 2018 treatment Kidney Transplant (HDU) monitoring Only. *for other cases please refer officer/specialis t CMV- IgM&IgG Active Blood Plain tube 3-5 ml 7 days Micro- HKL ELISA biology
CMV- IgM ELISA Active Blood Plain tube 3-5 ml 7 days Micro- HRPB biology
Cocaine Active Urine Sterile 5 mL Toxicology Jabatan Form: Pemeriksaan Forensik/ container Kimia, Ipoh Toksikologi. Sign & stamp of requesting DR must be clear.
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Coeliac Active Blood/ Serum Plain gel tube Child: 3 ml 21 days Auto- IMR Keep and transport specimen
Antibodies Adult: immune at 2-8°C. 5-10 ml Serum: 1-3 ml Congenital Active Blood Plain tube 3-5 ml 14 days Micro- HRPB Use special form (For baby
Pathology Dept, Infection - biology only). Use adult plain tube. TORCHES IgM i) Toxoplasma ii) Other
Hospital Taiping L (Syphilis, Varizela- Zoster,Parvovir us B 19) iii)Rubella
a iv) Cytomegalo
boratory Handbookboratory 2018 Virus vi) Herpes Copper Active 24 hr urine Urine 10ml 10 days Toxicology IMR Form: PER.PAT 301. Container & Preservative: Pharmaco HNO3, logy, pH2/plain Herbal
Medicine Research Centre (HMRC)
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Copper Active Blood Plain tube 3mL 10 days Toxicology IMR Form: PER.PAT 301. & Pharma- cology, Herbal
Medicine Research
Pathology Dept,Pathology Centre (HMRC) Coronavirus Active i) After After 14 - 35 Virology IMR After consultation only. Isolation Nasopharyngeal consultation consultation days aspiration, only only
Hospital Handbook Taiping Laboratory 2018 ii) Nasopharyngeal swab, iii)Throat swab, iv) Throat gargle, v) BAL vi) Sputum, vii)Nasal swab, viii) Organ biopsies
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Coronavirus Active i) After After 1 - 5 days Virology IMR After consultation only.
Nucleic Acid Nasopharyngeal consultation consultation aspiration, only only ii) Nasopharyngeal swab,
Pathology Dept, iii)Throat swab, iv) Throat gargle, v) BAL vi) Sputum,
Hospital Taiping L vii) Nasal swab, viii) Organ biopsies Coxiella Active Serum Plain tube 2 ml 5 days Bacteri- IMR Transport at 2-8°C. Serology ology
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Coxsackie virus Active Vesicular Sterile plastic Swabs to be 1 - 5 days Virology IMR Antigen swab/scraping vial put into 2- 3ml of VTM,2-8°C
Coxsackie virus Active Vesicular Sterile plastic Swabs to be 14 - 35 Virology IMR
Isolation swab/scraping vial put into 2- days 3ml of VTM,2-8°C Coxsackie virus Active Vesicular Sterile plastic Swabs to be 1 - 5 days Virology IMR Nucleic Acid swab/scraping vial put into 2- 3ml of VTM,2-8°C
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C-Peptide Active Blood Plain tube 3 mL 10 days Chemical HKL Form: PER.PAT 301. Pathology
Creatine & Active Random urine Clean 2 mL 25 days Bio- IMR Form: PER.PAT 301.
Guanidino universal chemistry acetic Acid bottle
Pathology Dept,Pathology Creatinine Active Blood Plain tube 3 mL 1 day Bio- HRPB Form: PER.PAT 301 Kinase-MB, chemistry Cop and sign specialist. CKMB Complete with diagnosis & clinical history.
Hospital Handbook Taiping Laboratory 2018 Crimean Congo Active Serum, Tissue After After 1 - 5 days Virology IMR After consultation only. Hemorrhagic Biopsy consultation consultation Fever Nucleic only only Acid Cryptococcal Active CSF/ Blood Sterile 1 ml 1 hour Micro- HRPB Transport at ambient Antigen container after biology temperature; if delayed keep bijou bottle, receive of at 2-8°C. plain tube speci-men
Cryoglobulin Active Blood Provided NA 21 days Hema- Hospital Fresh sample & Walk In by lab tology ampang Patient. By appointment (Ext : 6216).
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CSF Glycine Active CSF Sterile Bijou 2ml 20 days Molecular IMR Form: Request Form for
Diag- Multiple Myeloma CSF must nostics & be accompanied by patient's Protein serum. CSF must be frozen immediately after collection. CSF (frozen) and serum (at 2-
Pathology Dept, 8°C) must reach the lab not more than 7 days after collection date. CSF LACTATE Active CSF Fluoride 1ml 24hrs Pediatric HKL Sample should be sent
Hospital Taiping L Oxalate Tube (routine) Labo- immediately in ice packed. pic ratory
CSF Oligoclonal Active CSF & Blood CSF & Plain 3mL blood & 20 days Molecular IMR Form: Request Form for Bands (Serum) tube 2mL CSF (at Diag- Multiple Myeloma CSF must
a least 0.5mL nostics & be accompanied by patient's
boratory Handbookboratory 2018 CSF) Protein serum. CSF must be frozen immediately after collection. CSF (frozen) and serum (at 2- 8°C) must reach the lab not more than 7 days after collection date. CSF Oligoclonal Active CSF & Blood CSF & Plain 3mL blood & 14 days Bio- Hospital Form: Request Form for
Bands (Serum) tube 2mL CSF (at chemistry Ampang Multiple Myeloma CSF must least 0.5mL be accompanied by patient's CSF) serum. CSF must be frozen immediately after collection. CSF (frozen) and serum (at 2- 8°C) must reach the lab not more than 7 days after collection date.
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C-telopeptide / Private Laboratory (Serum) N-telopeptide
Culture for Active i) Sputum Sterile screw i) Sputum: 3- 2 months Tuber- MKAI 1. Specimen Blood is not
Mycobacterium ii) Bronchial capped 5 ml (Nega - tive culosis available. tuberculosis/ washing container ii) Bronchial Culture) 2. ID of Non Tuberculosis
Pathology Dept,Pathology BACTEC / MGIT iii) Pus washing: 2-5 ID : 5 days Mycobacteria is performed iv) Urine ml from by MKAK Sg.Buloh. v) Other body iii) NA culture 3. If suspected MDR or fluids (pleural, iv) Urine: 3-5 posi-tive contact MDR, ask permission synovial, CSF etc) ml DST: 35 from Specialist for Gene
Hospital Handbook Taiping Laboratory 2018 vi) Tissue v) Other body days from Expert test in HRPB, Ipoh. vii) Gastric fluids: 2-5 ml date of lavage. If there is vi) Tissue: positive ID delay, neutralize Add 2-5 ml sample by sterile adding 1.5 ml salaine/ sterile 40% distilled anhydrous water to disodium avoid drying phosphate vii) Gastic (Na2HPO4) for lavage: 2-5 every 35-40 ml ml specimens. Store
neutralized sample at 2-8°C and send to MKA Ipoh in cold box.
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Cytomegaloviru Discontinued Blood, Serum Plain tube Child: 3 ml 1 - 5 days Virology IMR
s (CMV/HHV-5) Adult: Antibody, IgG 5-10 ml Serum: 1-3 ml Cytomegaloviru Discontinued Blood, Serum Plain tube Child: 3 ml 1 - 5 days Virology IMR
Pathology Dept, s (CMV/HHV-5) Adult: Antibody, IgM 5-10 ml Serum: 1-3 ml
Hospital Taiping L
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Cytomegaloviru Active i) i) NPA: Sterile i) NPA: 14 - 35 Virology IMR s (CMV/HHV-5) Nasopharyngeal plastic vial Mucous days Isolation aspiration, contain 2-3ml secretion in Acute ii) of VTM VTM Respiratory Nasopharyngeal ii) NPS: ii) NPS: A
Syndrome swab, Sterile plastic flexible, fine iii)Throat swab, vial contain shafter
Pathology Dept,Pathology iv) Throat gargle, 2 - 3ml of VTM po lyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different vii) Nasal swab, contain 2-3ml swab for each viii) Organ of VTM nostrils
Hospital Handbook Taiping Laboratory 2018 biopsies iv) Throat iii) TS: Sterile gargle: Sterile swab plastic iv) Nasal container swab: Sterile v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum: each nostrils Sterile plastic v) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of
contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing
VTM to keep OutsourceService tissue moist
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Dehydroepiand Active 0.5mL serum in Plain tube / 0.5 mL / 20 days Chemical HKL Form: PER.PAT 301
rosterone plain tube OR EDTA 3.5mL Pathology Keep the specimen frozen or Sulphate 3.5 mL whole within 2-8⁰C during (DHEAS) blood transportation. in EDTA tube Dengue Ab-IgG Active Blood Plain tube 3-5 ml 7 days Micro- HRPB
Pathology Dept, ELISA biology
Dengue RT-PCR Active Serum Plain tube/ 1 - 3 ml 7 days Molecular MKAK 1) Specimen should be
Hospital Taiping L Gel tube Unit collected < 5 days after onset (without of illness. anticoagulant 2) A brief concise history of ) illness and physical findings is required especially the
a date of onset of illness and
boratory Handbookboratory 2018 date of specimen collection. 3) Keep and transport specimen at 2-8°C. Dengue Virus Discontinued Blood, Serum Plain tube i) Blood: 1 - 5 days Virology IMR Antibody, Acute 5-10ml Dermatological ii) Serum: Syndrome, IgM 1-3ml
Dengue Virus Discontinued Blood, Serum Plain tube i) Blood: 1 - 5 days Virology IMR Antibody, Acute 5-10ml ii) Haemorrhagic Serum: 1- Syndrome, IgM 3ml Dengue Virus Discontinued CSF, Serum i) CSF: sterile i) CSF: 1 - 5 days Virology IMR Antibody, Acute container 1-3ml Neurological ii) Serum: ii) Serum: Syndrome, IgM plain tube 1-3ml
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Dengue Virus Active Serum Plain tube/ 1 - 3 ml 35 days Molecular MKAK 1) Specimen should be Isolation Gel tube Unit collected < 5 days after onset & Serotyping (without of illness. anticoagulant 2) A brief concise history of ) illness and physical findings
is required especially the date of onset of illness and
Pathology Dept,Pathology date of specimen collection. 3) Keep and transport specimen at 2-8°C. Dengue Virus Active Tissue Biopsy After LT 14 - 35 Virology IMR After consultation only Isolation, Acute consultation days
Hospital Handbook Taiping Laboratory 2018 Hemorrhagic only Syndrome Dengue Virus Active CSF, Serum, After After 14 - 35 Virology IMR After consultation only Isolation, Acute Organ biopsies consultation consultation days Neurological only only Syndrome
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Dengue Virus Active Blood, Serum, i) i) Blood: 5-10 1 - 5 days Virology IMR Keep and transport specimen
Nucleic Acid, CSF, Organ Blood/serum: ml at 2-8°C. Acute biopsies Serum (Child: 3 ml) Hemorrhagic separator ii) Serum: 1- Syndrome tube 3ml ii) CSF: Sterile iii) CSF: 1-3ml
Pathology Dept, container iv) Orga n iii) Organ biopsy: biopsy: Remove Sterile portions,
Hospital Taiping L containers about 1.5cm containing cube of VTM to keep various parts tissue moist of affected organs
a Dengue Virus Active Serum Plain tube 1-3ml 1 - 5 days Virology IMR Keep and transport specimen
boratory Handbookboratory 2018 Nucleic Acid, at 2-8°C. Acute Inflammatory Musculoskeleta l Diseases
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Dengue Virus Active Serum, CSF, i) Serum: i)Serum: 1- 1 - 5 days Virology IMR Keep and transport specimen Nucleic Acid, Organ biopsies serum 3ml at 2-8°C. Acute separator ii) CSF: 1-3ml Neurological tube ii) iii) Organ Syndrome CSF: Sterile biopsy:
container Remove iii) Organ portions,
Pathology Dept,Pathology biopsy: about 1.5cm Sterile cube of containers various parts containing of affected VTM to keep organs
Hospital Handbook Taiping Laboratory 2018 tissue moist Detection of Active Serum Sterile plain 2-3 ml 5 days Bacteri- IMR Transport at ambient Burkholderia tube ology temperature; if delayed keep pseudomallei at 2-8°C IgM Diabetes Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Mellitus (DM) Adult: immune at 2-8°C. Antibodies 5-10 ml Serum: 1-3 ml Diagnosis Active Corneal scrape, Sterile, air NA 10 days Para- IMR By Appointment only. Acanthamoeba Contact lens, tight or sitology Medium in container: Sterile spp - PCR Contact lens contact lens distilled water or saline.
suspension, storage Spinal fluid Diagnosis Active Corneal scrape, Sterile, air NA 10 days Para- IMR By Appointment only. Acanthamoeba Contact lens, tight or sitology Medium in container: Sterile spp- In vitro Contact lens contact lens distilled water or saline. culture suspension, storage
Spinal fluid OutsourceService
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Diagnosis Active Corneal scrape, Sterile, air NA 3 days Para- IMR By Appointment only.
Acanthamoeba Contact lens, tight or sitology Medium in container: Sterile spp- Contact lens contact lens distilled water or saline. Microscopy suspension, storage Spinal fluid Diagnosis Active Corneal scrape, Sterile, air NA 10 days Para- IMR By Appointment only.
Pathology Dept, Naegleria spp - Contact lens, tight or sitology Medium in container: Sterile PCR Contact lens contact lens distilled water or saline. suspension, storage Spinal fluid
Hospital Taiping L Diagnosis Active Corneal scrape, Sterile, air NA 10 days Para- IMR By Appointment only. Naegleria spp - Contact lens, tight or sitology Medium in container: Sterile In vitro culture Contact lens contact lens distilled water or saline. suspension, storage Spinal fluid
a boratory Handbookboratory 2018 Diagnosis Active Corneal scrape, Sterile, air NA 3 days Para- IMR By Appointment only. Naegleria spp - Contact lens, tight or sitology Medium in container: Sterile Microscopy Contact lens contact lens distilled water or saline. suspension, storage Spinal fluid Dihydrorho Active Blood Lithium 2 ml 5 days PID IMR Transported without ice. By damine assay heparin appointment only.
(DHR)
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DNA Analysis Active Peripheral blood K2EDTA 2 tubes for Hema- HKL a) Form: DNA Analysis for for alpha- adult tology / thalassemia syndromes & thalassemia 1 tube for Genetics hemoglobinopathy form paeds signed by specialist to (all to be include: latest result of FBC
filled until and Hb analysis. indicated b) To send together with
Pathology Dept,Pathology mark) parent's blood sample. c) Sample to be stored at 2°- 8°C. DNA Analysis Active Peripheral blood K2EDTA 2 tubes for Hema- IMR a) Form: DNA Analysis for for beta-globin adult tology thalassemia syndromes &
Hospital Handbook Taiping Laboratory 2018 chain 1 tube for hemoglobinopathy form (thalassemia / paeds signed by specialist to hemoglobin- (all to be include: latest result of FBC pathy) filled until and Hb analysis indicated b) For pediatric, need to mark) send together with parent's blood sample. c) Sample to be stored at 2°- 8°C. DNA Extraction Active Blood 2 EDTA tubes 1-2 x 2.5mL 5 days Molecular IMR Form: Requisition for & Storage (2.5mL) blood EDTA Diag- Molecular Diagnostic or dried nostics & Services. Send at ambient blood spots Protein temperature. If >3 hours,
keep sample cooled. Protect from freezing. No results will be returned to lab. Ebola Nucleic Active Serum, Tissue After After 1 - 5 days Virology IMR After consultation only. Acid biopsy consultation consultation only only
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Echinococcosis Active Serum Plain tube 2ml 5 days Para- IMR Keep and transport specimen
Serology sitology at 2-8°C.
Enterovirus - Active Serum Plain tube/ 1 - 3 ml 7 days Molecular MKAK 1) Specimen should be
Pathology Dept, RT-PCR Gel tube Unit collected < 5 days after onset (Pan Entero & (without of illness. EV71) anticoagulant 2) A brief concise history of ) illness and physical findings is required especially the
Hospital Taiping L date of onset of illness and date of specimen collection. 3) Keep and transport specimen at 2-8°C.
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boratory Handbookboratory 2018
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Enterovirus Active i) i) NPS: Sterile i) NPS: A 14 - 35 Virology IMR Keep and transport specimen Isolation, Acute Nasopharyngeal plastic vial flexible, fine days at 2-8°C. Inflammatory swab, contain 2-3ml shafter Myocardial ii) Throat swab, of VTM polyester Diseases iii) Cardiac ii) TS: Sterile swab. Use
biopsy, plastic vial different iv) Rectal swab, contain 2-3ml swab for each
Pathology Dept,Pathology v) Stool, of VTM nostrils vi) Pericardial iii) Organ ii) TS: Sterile aspirate biopsy: swab Sterile iii) Biopsy: containers Remove
Hospital Handbook Taiping Laboratory 2018 containing portions, VTM to keep about 1.5cm tissue moist cube of iv) Rectal various parts swab: Sterile of affected plastic vial organs contain 2-3ml iv) Rectal of VTM swab: Stool v) Stool: on sterile Sterile bottle swab vi) Pericardial moistened aspirate: with distilled Sterile plastic water
vial contain v) Stool: 2-3ml VTM >5gm (thumb size)
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Enterovirus Active i) i) NPA: Sterile i) NPA: 14 - 35 Virology IMR Keep and transport specimen
Isolation, Acute Nasopharyngeal plastic vial Mucous days at 2-8°C. Respiratory aspiration, contain 2-3ml secretion in Syndrome ii) of VTM VTM ii) Nasopharyngeal ii) NPS: NPS: A swab, Sterile plastic flexible, fine
Pathology Dept, iii)Throat swab, vial contain shafter iv) Throat gargle, 2 - 3ml of VTM polyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different
Hospital Taiping L vii) Nasal swab, contain 2-3ml swab for each viii) Organ of VTM iv) nostrils iii) TS: biopsies Throat Sterile swab gargle: Sterile iv) Nasal plastic swab: Sterile
a container swab. Use
boratory Handbookboratory 2018 v) BAL: Sterile different plastic tube swabs for container each nostrils vi) Sputum : v) Biopsy: Sterile plastic Remove container portions, vii) Nasal about 1.5cm swab : Sterile cube of plastic vial various parts contain 2-3ml of affected VTM organs viii) Biopsy: Sterile containers containing VTM to keep tissue moist
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Enterovirus Active i) i) NPS: Sterile i) NPS: A 1 - 5 days Virology IMR Keep and transport specimen Nucleic Acid, Nasopharyngeal plastic vial flexible, fine at 2-8°C. Acute swab, contain 2-3ml shafter Inflammatory ii) Throat swab, of VTM polyester Myocardial iii) Cardiac ii) TS: Sterile swab. Use
Diseases biopsy, iv) plastic vial different Rectal swab, contain 2-3ml swab for each
Pathology Dept,Pathology v) Stool, of VTM nostrils vi) Pericardial iii) Organ ii) TS: Sterile aspirate biopsy: swab Sterile iii) Biopsy: containers Remove
Hospital Handbook Taiping Laboratory 2018 containing portions, VTM to keep about 1.5cm tissue moist cube of iv) Rectal various parts swab: Sterile of affected plastic vial organs contain 2-3ml iv) Rectal of VTM swab: Stool v) Stool: on sterile Sterile bottle swab vi) Pericardial moistened aspirate: with distilled Sterile plastic water
vial contain v) Stool: 2-3ml VTM >5gm (thumb size)
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Enterovirus Active i) i) NPA: Sterile i) NPA: 1 - 5 days Virology IMR Keep and transport specimen
Nucleic Acid, Nasopharyngeal plastic vial Mucous at 2-8°C. Acute aspiration, contain 2-3ml secretion in Respiratory ii) of VTM VTM Syndrome Nasopharyngeal ii) NPS: ii) NPS: A swab, Sterile plastic flexible, fine
Pathology Dept, iii) Throat swab, vial contain shafter iv) Throat gargle, 2 - 3ml of VTM polyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different
Hospital Taiping L vii) Nasal swab, contain 2-3ml swab for each viii) Organ of VTM nostrils biopsies iv) Throat iii) TS: Sterile gargle: sterile swab plastic iv) Nasal
a container swab: Sterile
boratory Handbookboratory 2018 v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum: each nostrils Sterile plastic v) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing VTM to keep tissue moist
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Enterovirus Active Serum Plain tube/ 1 - 3 ml 21 days Serology MKAK 1) Specimen should be Serology Gel tube Unit collected < 5 days after onset HFMD (Without of illness. anticoagulant 2) A brief concise history of ) illness and physical findings
is required especially the date of onset of illness and
Pathology Dept,Pathology date of specimen collection. 3) Keep and transport specimen at 2-8°C. Enteroviruses Active Eye swab, i) Eye swab: i) Eye swab: 1 - 5 days Virology IMR Keep and transport specimen Antigen Lacrimal tears Sterile plastic Sterile swab at 2-8°C.
Hospital Handbook Taiping Laboratory 2018 Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal capillary tube tears: 10-20 µl tears Enteroviruses Active Eye swab, i) Eye swab: i) Eye swab: 14 - 35 Virology IMR Keep and transport specimen Isolation Lacrimal tears Sterile plastic Sterile swab days at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal
capillary tube tears: 10-20 µl tears
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Enteroviruses Active Eye swab, i) Eye swab: i) Eye swab: 1 -10 days Virology IMR Keep and transport specimen
Nucleic Acid Lacrimal tears Sterile plastic Sterile swab at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal
Pathology Dept, capillary tube tears: 10-20 ul tears Eosinophilic Active Blood/ Serum Plain tube Blood: 3 ml 14 days Allergy IMR Keep and transport specimen Cationic Protein Serum: 0.5 ml at 2-8°C.
Hospital Taiping L (ECP)
Epstein Barr Active Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice. Virus (EBV) - IgG ELISA
a
boratory Handbookboratory 2018 Epstein Barr Active Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice. Virus (EBV) - IgM ELISA
Epstein Barr Active Blood/ CSF EDTA tube/ Blood: 5 ml 2 days Micro- HSB Blood: Virus (EBV) DNA Sterile Bijou CSF: 2 ml biology 1) 2 EDTA tube. Genome Bottle (Mole- 2) Keep in -80 °C if sample >
Detection cular 24Hrs. Diagnostic 3) Packed in ice for Lab) transportation. CSF: Store at -20°C if keep more than 24 hours. *3 copies of request form
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Erythropoietin Active Blood Plain tube 3 mL Hema- Hospital tology Ampang
Estrogen/ Active Blood Plain tube 3 mL 7 days Bio- HRPB Form: PER.PAT 301
Estradiol chemistry Cop and sign specialist. Complete with diagnosis &
Pathology Dept,Pathology clinical history. Ethanol Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of Container requesting DR must be clear.
Hospital Handbook Taiping Laboratory 2018 Extractable Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen nuclear antigen Adult: immune at 2-8°C. screening (ENA 5-10 ml SC) Serum: 1-3 ml Everolimus Active Blood EDTA tube 3 ml 7 days Clinical HKL Form: TDM. Toxicology
Extractable Active Blood/ Serum Plain gel tube Child: 3 ml 16 days Auto- IMR Keep and transport specimen nuclear antigen Adult: immune at 2-8°C. specific (ENA 5-10 ml
SP) Serum: 1-3 ml Filariasis Active Whole Blood in EDTA tube or 2.5 ml 7 days Para- IMR Blood taken between 6 pm - Diagnosis - PCR EDTA, blood on slide mailer sitology 2 am. slides or filter or seal plastic paper bag
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Filariasis Active Serum Plain tube 2 ml 1 day Para- IMR Keep and transport specimen
Serology sitology at 2-8°C.
Flowcytometry active Peripheral blood K2EDTA 2 tubes, Urgent Hema- HKL 1) PER-PAT form with
Pathology Dept, Immunopheno- or (filled until verbal tology relevant clinical history & typing for Bone Marrow indicated report - specialist sign. Leukemia / Aspirate mark) 36 hrs 2) Sample to reach HKL on lymphoma Formal the day of sample collection, report -10 during office hours.
Hospital Taiping L days **Specimen kept more than 48hrs are not suitable for analysis. Flowcytometry Active Fresh peripheral K2EDTA 2 tubes, 10 days Hema- 10 1) PER-PAT form with Immunopheno- blood (Filled until tology HKL relevant clinical history &
a typing for PNH indicated specialist sign.
boratory Handbookboratory 2018 (CD55 / CD59) mark) 2) Sample to reach HKL on the day of sample collection, during office hours. **Specimen kept more than 48hrs are not suitable for analysis. Free Light Chain Active Blood Plain tube 3 mL 14 days Molecular IMR Form: Request Form for
(Kappa, Diag- Multiple Myeloma Serum Lambda) Ratio nostics & must reach the lab not more Protein than 7 days (at 2- 8⁰C) after collection date. Free Active Blood Plain tube 3 mL 7 days Bio- HRPB Form: PER.PAT 301 Triiodothyronin chemistry Cop and sign specialist. e FT3 Complete with diagnosis & clinical history.
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Fructosamine Active Serum Plain tube 3 mL 7 days Bio- Hospital Result Hb Analysis. chemistry Ampang
FSH Active Blood Plain tube 3 mL 7 day Bio- HRPB Form: PER.PAT 301
chemistry Cop and sign specialist. Complete with diagnosis &
Pathology Dept,Pathology clinical history.
Fungal PCR Active Blood in EDTA, Sterile 2 ml blood; 5 days Bacteri- IMR For better sensitivity, blood sterile body container other ology samplings should be fluids, CSF, samples as repeated 2 or 3 times, at 3-4
bronchial lavage, much as hours interval.
Hospital Handbook Taiping Laboratory 2018 tissue biopsies, possible Transportation at ambient sinus aspirates temperature. If delayed keep at 2-8°C. Galacto Screening Whole blood EDTA tube 6 mL 20 days Bio- IMR Form: IEM Request Form. cerebrosidase Suspended. chemistry Specialist need to contact Confirmatory IMR. Sample can only send need to call after consultation from IMR. Pakar Genetik Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C. Galactose-1- Active Whole blood EDTA tube 5 mL 20 days Bio- IMR Form: IEM Request Form.
phosphate chemistry Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
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Gamma- Active Blood/ Serum Plain gel tube Child: 3 ml 7 days Auto- IMR Keep and transport specimen
aminobutyric Adult: immune at 2-8°C. acid-b Receptor 5-10 ml (GABA) Serum: Antibody 1-3 ml
Pathology Dept, Gamma- Discontinued Blood/ Serum Plain gel tube Child: 3 ml 7 days Auto- IMR Keep and transport specimen aminobutyric Adult: immune at 2-8°C. acid-b Receptor 5-10 ml (GABA) Serum: Antibody 1-3 ml
Hospital Taiping L Gangliosides Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen antibodies CSF tube/Bijou Adult: immune at 2-8°C. Bottle 5-10 ml Serum: 1-3 ml a Gastrin Private Laboratory (Serum)
boratory Handbookboratory 2018
GGT Active Blood Plain tube 3 mL 7 day Bio- HRPB Form: PER.PAT 301 chemistry Cop and sign specialist. Complete with diagnosis &
clinical history. Glucagon Private Laboratory (Serum)
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Growth Active Blood Plain tube 0.5ml serum 20 days Chemical HKL Form: PER.PAT 301 Time of Hormone (GH) in plain tube Pathology Collection: Random, Fasting or 3.5ml sample, 5-10 min post whole blood exercise or 2h post-OGTT in EDTA (75gm glucose), insulin
tolerance test, other dynamic tests
Pathology Dept,Pathology **Random/fasting GH is of limited diagnostic value. H1N1 Active Throat swab, NP Viral 2 ml 3-5 days Molecular MKAI Using Polystyrene box, swab Transport consignment form attached Medium separately.
Hospital Handbook Taiping Laboratory 2018 (VTM) Keep and transport specimen at 2-8°C. Haemophilus Active Isolate Pure isolate Pure isolate 5 days Bacteri- IMR Pure isolate. influenzae ology
Hantavirus Active Serum, Tissue After After 1 - 10 Virology IMR After consultation only. Hemorrhagic Biopsy consultation consultation days Fever with only only Renal Syndrome Nucleic Acid
Hantavirus Discontinued Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Keep and transport specimen HFRS Antibody, at 2-8°C. IgG
Hantavirus Discontinued Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Keep and transport specimen HFRS Antibody, at 2-8°C. IgM
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Haptoglobin Active Blood Plain tube 3mL 10 days Chemical HKL Form: PER.PAT 301.
Pathology
HBe Ag EIA Active Blood Plain tube 3-5 ml 1-2 days Virology HKL Room temp. or in ice.
Pathology Dept,
HCV - RNA Active Blood Plain tube 4 ml 14 days Virology HKL Packed with ice. Only offered Genotyping Serum to gastroenterologist and
Hospital Taiping L hepatologist. *Must have HCV VIRAL LOAD result. HCV - RNA PCR Active Blood, Serum Plain tube 4 ml 7 days Virology HKL Full clinical history Viral Load (Baby : 2ml Packed with ice. a (Quantitative) above)
boratory Handbookboratory 2018
HCV - RNA PCR Active Blood EDTA tube 5 ml 2 - 3 days Micro- HSB 1) 2 EDTA tube. Viral Load biology 2) Keep in -80 °C if sample > (Quantitative) (Mole- 24Hrs. cular 3) Packed in ice for Diagnostic transportation.
Lab) *3 copies of forms, subsequent sample send after 6 months.
Helminth Active Fresh stool not Screw lid, air NA 9 days Para- IMR Fresh specimen. Culture Fixed tight sitology container
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Helminth Active Fresh stool not Screw lid, air NA 14 days Para- IMR Fresh stool in plain container Diagnosis - Fixed tight sitology (specimen to reach lab Culture container within 24hr at room temperature). Helminth/Larva Active Fresh Screw lid, air 5g 5 days Para- IMR Fresh specimen. Adult
Diagnosis - stool/Adult tight sitology worm/Larvae in sterile saline Microscopy worm/Larvae/Fix container (specimen to reach lab
Pathology Dept,Pathology ed stool within 24hr at room temperature). Hepatitis A Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Keep and transport specimen virus (HAV) at 2-8°C. Antibody
Hospital Handbook Taiping Laboratory 2018
Hepatitis A Active Blood Plain tube 3-5 ml 7 days Microbiol HRPB Keep and transport specimen virus (HAV)- ogy at 2-8°C. IgM EIA *Next sample: 3 months interval. Hepatitis B core Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Must have LFT result. Keep (HBc) Antibody and transport specimen at 2- 8°C.
Hepatitis B core Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Must have LFT result. Keep (HBc) Total and transport specimen at 2- 8°C.
Hepatitis B Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Must have LFT result. Keep envelope (Hbe) and transport specimen at 2- Antibody 8°C.
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Hepatitis B Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Must have LFT result. Keep
envelope and transport specimen at 2- (HBeAg) 8°C.
Hepatitis B Active Blood, Serum Plain tube 1-3 ml 1 -10 days Virology IMR Must have LFT result. Keep
Pathology Dept, surface (HBs) and transport specimen at 2- Antibody 8°C.
Hepatitis C Active Blood Plain tube 3-5 ml 14 days Micro- HRPB -Keep and transport Confirmation, biology specimen at 2-8°C.
Hospital Taiping L LIA
Hepatitis B Active Blood EDTA tube 5 ml 2 - 3 days Micro- HSB 1) 2 EDTA tube. DNA/ Viral Load biology 2) Keep in -80 °C if sample > (Mole- 24Hrs. a cular 3) Packed in ice for
boratory Handbookboratory 2018 Diagnostic transportation. Lab) *3 copies of form
Herpes Simplex Active Plasma / CSF / EDTA tube / 5 ml 2 days Micro- HSB 1) EDTA tube. Virus (HSV) I Tissue / BAL Sterile Bijou biology 2) Keep in -80 °C if sample > DNA Genome Bottle / (Mole- 24Hrs. Detection / HSV Sterile cular 3) Packed in ice for
VIRAL PCR container Diagnostic transportation. Lab) **3 copies of form
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Herpes Simplex Active CSF/ Serum Sterile screw 1 ml 7 days Molecular MKAK 1) Specimen should be Virus (HSV) PCR capped (CSF)/3ml Unit collected < 5 days after onset container (serum) of illness. 2) A brief concise history of illness and physical findings
is required especially the date of onset of illness and
Pathology Dept,Pathology date of specimen collection. 3) Keep and transport specimen at 2-8°C. Herpes Simplex Active Vesicular Sterile plastic Swabs to be 1 -10 days Virology IMR Keep and transport specimen Virus Antigen, swab/Scraping vial put into 2- at 2-8°C.
Hospital Handbook Taiping Laboratory 2018 Acute 3ml of VTM Neurological Syndrome Herpes Simplex Active Eye swab, i) Eye swab: i) Eye swab: 1 -10 days Virology IMR Keep and transport specimen Virus Antigen, Lacrimal tears Sterile plastic Sterile swab at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water tears: In ii) Lacrimal capillary tube tears: 10-20 µl tears
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Herpes Simplex Active Throat swab, i) TS: Sterile i) TS: Sterile 14 - 35 Virology IMR Keep and transport specimen
Virus Isolation, Stool, Rectal plastic vial swab days at 2-8°C. Acute swab, CSF, contain 2-3ml ii) Stool: Neurological Vesicular of VTM ii) >5gm (thumb Syndrome Swab/Scraping, Stool: Sterile size) Organ biopsies bottle iii) Rectal
Pathology Dept, iii) Rectal swab: Stool swab: Sterile on sterile plastic vial swab contain 2-3ml moistened
Hospital Taiping L of VTM with distilled vi) CSF: water Sterile iv) CSF: 1- container 3ml v) Vesicular v) Vesicular
a swab/scrapin swab/scrapin
boratory Handbookboratory 2018 g: Sterile gs: Swabs to plastic vial be put into 2- vi) Organ 3ml of VTM Biopsy: vi) Organ Sterile Biopsy: containers Remove containing portions, VTM to keep about 1.5cm tissue moist cube of various parts of affected organs
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Herpes Simplex Active Eye swab, i) Eye swab: i) Eye swab: 14 - 35 Virology IMR Keep and transport specimen Virus Isolation, lacrimal tears Sterile plastic Sterile swab days at 2-8°C. Conjunctivitis vial contain moistened 2-3ml of VTM with distilled ii) Lacrimal water
tears: In ii) Lacrimal capillary tube tears: 10-20
Pathology Dept,Pathology µl tears Herpes Simplex Active Blood Plain tube 3 ml Thurs-day Micro- HRPB Virus Serology biology (Type 1&2 IgM)
Hospital Handbook Taiping Laboratory 2018 Herpes virus Active Vesicular Sterile plastic Swabs to be 14 - 35 Virology IMR Keep and transport specimen Isolation swab/scraping vial put into 2- days at 2-8°C. 3ml of VTM
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Herpes viruses Active i)Nasopharyngea i) NPS: Sterile i) NPS: A 14 - 35 Virology IMR Keep and transport specimen
Isolation l swab, plastic vial flexible, fine days at 2-8°C. ii)Throat swab, contain 2-3ml shafter iii) Cardiac of VTM polyester biopsy, iv) ii) TS: Sterile swab. Use Rectal swab, plastic vial different
Pathology Dept, v) Stool, contain 2-3ml swab for each vi) Pericardial of VTM nostrils aspirate iii) Organ ii) TS: Sterile Biopsy: swab
Hospital Taiping L Sterile iii) Biopsy: containers Remove containing portions, VTM to keep about 1.5cm tissue moist cube of
a iv) Rectal various parts
boratory Handbookboratory 2018 swab: Sterile of affected plastic vial organs contain 2-3ml iv) Rectal of VTM swab: Stool v) Stool: on sterile Sterile bottle swab vi) Pericardial moistened aspirate: with distilled Sterile plastic water vial contain v) Stool: 2-3ml VTM >5gm (thumb size)
HFMD (Hand, Active Mouth swab/ VTM / Sterile – 21 days Virus MKAK Keep and transport Foot, Mouth Throat swab / container Isolation specimen at 2-8°C. Disease) Rectal swab / Unit Stool
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Histoplasma Active Blood Plain tube 5 ml 1 - 2 days Micro- HSB Keep and transport specimen Antibody biology at 2-8°C. (Serology *3 copies of request form. Lab) HIV - p24 Active Blood Plain tube 3-5 ml 7 days Virology HKL Room temp. or in ice.
Antigen paeds/baby : Conformation 2 ml
Pathology Dept,Pathology EIA HIV Viral load Active Blood EDTA tube 2 ml 14 days Micro- HPP/HSB 1) 4 EDTA tubes. biology 2) All tests for HIV PCR viral (Molecula load must be requested only r by specialist.
Hospital Handbook Taiping Laboratory 2018 Diagnostic 3) Repeated samples must Lab) be more than 6 months.
HIV-1 RNA PCR Active Blood (EDTA)/ EDTA 3 ml 7 days Virology HKL Packed with ice. Viral Load Plasma (EDTA) (Quantitative)
Homocysteine Active Blood EDTA tube 2ml of 10 days Bio- IMR Form: PER.PAT 301 Freeze (Total) plasma chemistry immediately, transport frozen in dry ice.
Human Active Blood, Plasma EDTA (2 5-10ml blood 40 days Virology IMR 1) 2 tubes EDTA. immunodeficie tubes) 2) Please fill in
ncy virus (HIV) IMR/Viro/HIV/24 form. Drug Resistance 3) Separate plasma within 2 Test hours of collection. 4) Transport in dry ice ASAP. 5) If delayed, keep in-70°C.
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Human Active Blood, Plasma EDTA 2.5ml blood 1 -10 days Virology IMR 1) Please fill IMR/Viro/HIV/2.
immunodeficie 2) Must be transported ncy virus (HIV) within 48 hours after Nucleic Acid collection at ambient (Baby 0-18 temperature. months) 3) Do not freeze.
Pathology Dept, Human Active Nasopharyngeal i) NPA: Mucous 1 -10 days Virology IMR Keep and transport specimen Influenza aspiration, BAL, Sterile plastic secretion in at 2-8°C. Viruses Antigen Sputum vial contain VTM 2-3ml of
Hospital Taiping L Virus Transport Media (VTM) ii) BAL: Sterile plastic
a tube
boratory Handbookboratory 2018 container iii) Sputum: Sterile plastic container
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Human Active i) i) NPA: Sterile i) NPA: 14 - 35 Virology IMR Keep and transport specimen Influenza Nasopharyngeal plastic vial Mucous days at 2-8°C. Viruses aspiration, contain 2 -3ml secretion in Isolation ii) of VTM VTM ii) Nasopharyngeal ii) NPS: NPS: A
swab, Sterile plastic flexible, fine iii)Throat swab, vial contain shafter
Pathology Dept,Pathology iv) Throat gargle, 2 - 3ml of VTM polyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different vii)Nasal swab, contain 2-3ml swab for each viii) Organ of VTM nostrils
Hospital Handbook Taiping Laboratory 2018 biopsies iv) Throat iii) TS: Sterile gargle: Sterile swab plastic vii) Nasal container swab: Sterile v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum : each nostrils Sterile plastic viii) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of
contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing
VTM to keep OutsourceService tissue moist
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Human Active i) i) NPA: Sterile i) NPA: 1 -10 days Virology IMR Keep and transport specimen
Influenza Nasopharyngeal plastic vial Mucous at 2-8°C. Viruses Nucleic aspiration, contain 2 -3ml secretion in Acid ii) of VTM VTM Nasopharyngeal ii) NPS: ii) NPS: A swab, Sterile plastic flexible, fine
Pathology Dept, iii) Throat swab, vial contain shafter iv) Throat gargle, 2 - 3ml of VTM polyester v) BAL iii) TS: Sterile swab. Use vi) Sputum, plastic vial different
Hospital Taiping L vii) Nasal swab, contain 2-3ml swab for each viii) Organ of VTM nostrils biopsies iv) Throat iii) TS: gargle: Sterile Sterile swab plastic vii) Nasal
a container swab: Sterile
boratory Handbookboratory 2018 v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum: each nostrils Sterile plastic viii) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing VTM to keep tissue moist
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Hydatid Active Serum, Blood Plain tube 2ml 5 days Para- IMR Keep and transport specimen Disease/Echino sitology at 2-8°C. coccosis Diagnosis - Serology
Iduronate-2- Active Whole blood EDTA tube 6 mL 20 days Bio- IMR Form: IEM Request Form. sulphatase chemistry Specialist need to contact
Pathology Dept,Pathology IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at
Hospital Handbook Taiping Laboratory 2018 2-8⁰C. IEM- Active Dried blood spot Whatmann 3 circles of 20 days Bio- IMR Form: IEM Request Form. Biotinidase in filter paper 903 Filter Dried blood chemistry Properly dried at room Enzyme Activity paper spot (DBS) temperature for 4 hours before putting in plastic bag. Wet blood spot will be rejected.
IEM- Active First morning Clean 5 mL 10 days Bio- IMR Form: IEM Request Form Characterizatio urine Universal chemistry Frozen sample immediately. n of MPS/GAGS bottle Glycosaminogly can (GAGS) /
Mucopolysacch a-ride (MPS), urine
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IEM- Galactose- Active Dried blood spot Whatmann 3 circles of 10 days Bio- IMR Form: IEM Request Form
1-phosphate 903 Filter Dried blood chemistry Properly dried at room Uridyl paper spot (DBS) temperature for 4 hours Transferase before putting in plastic bag. (GALT/G1PUT), Wet blood spot will be blood spot rejected.
Pathology Dept, IEM- Lysosomal Active Dried blood spot Whatmann 3 circles of 20 days Bio- IMR Form: IEM Request Form enzymes 903 Filter Dried blood chemistry Properly dried at room screening paper spot (DBS) temperature for 4 hours before putting in plastic bag.
Hospital Taiping L Wet blood spot will be rejected. IEM- Metabolic Active Dried blood spot 903 Filter 3 circles of 10 days Bio- IMR Form: IEM Request Form Screening, paper Dried blood chemistry Properly dried at room blood spot spot (DBS) temperature for 4 hours
a before putting in plastic bag.
boratory Handbookboratory 2018 Wet blood spot will be rejected.
IEM-5-hydroxy- Active 24 hr urine 24hr urine 5 ml of 24hrs 15 days Bio- IMR Form: IEM Request Form Indol-Acetic preserve in urine chemistry Frozen sample immediately. Acid (5-HIAA) 10mL 25% Record 24hrs urine volume HCI on the request form. IEM-Acid Alpha Screening Dried blood spot Whatmann 3 circles of 20 days Bio- IMR Form: IEM Request Form Glucosidase Suspended. 903 Filter Dried Blood chemistry Properly dried at room Confirmatory paper Spot (DBS) temperature for 4 hours need to call before putting in plastic bag. Pakar Genetik Wet blood spot will be rejected.
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IEM-Alpha Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. hexosaminidase chemistry Specialist need to contact (Alpha-N-acetyl IMR. Sample can only send glucosaminidas after consultation from IMR. e) Fill up column under others.
Must arrive to IMR within 3 days after collection. Store at
Pathology Dept,Pathology 2-8⁰C.
IEM-Alpha- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. fucosidase chemistry Specialist need to contact IMR. Sample can only send
Hospital Handbook Taiping Laboratory 2018 after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM-Alpha- Screening Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. galactosidase Suspended. chemistry Specialist need to contact Confirmatory IMR. Sample can only send need to call after consultation from IMR. Pakar Genetik Fill up column under others. Must arrive to IMR within 3 days after collection. Store at
2-8⁰C.
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IEM-Alpha- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
iduronidase chemistry Specialist need to contact IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3
Pathology Dept, days after collection. Store at 2-8⁰C.
IEM-Alpha- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
mannosidase, chemistry Specialist need to contact
Hospital Taiping L leucocytes IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at
a boratory Handbookboratory 2018 2-8⁰C.
IEM-Alpha- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. mannosidase, chemistry Specialist need to contact plasma IMR. Sample can only send after consultation from IMR. Fill up column under others.
Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM-Amino Acid Active Dried blood spot Whatmann 3 circles of 20 days Bio- IMR Form: IEM Request Form AA & in filter paper 903 Filter Dried blood chemistry Properly dried at room Acylcarnitines paper spot (DBS) temperature for 4 hours before putting in plastic bag. Wet blood spot will be rejected.
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IEM-Amino Active CSF Clean 1mL 25 days Bio- IMR Form: IEM Request Form Acid, CSF universal chemistry Must send together with bottle plasma. Frozen sample immediately (serum is accepted).
IEM-Amino Active Plasma Heparin tube 2mL 25 days Bio- IMR Form: IEM Request Form Acid, plasma chemistry Separate plasma Pathology Dept,Pathology immediately. Frozen sample immediately. IEM-Amino Active Random urine Sterile 2mL 25 days Bio- IMR Form: IEM Request Form. Acid, urine Universal chemistry Specialist need to contact
bottle IMR. Sample can only send
Hospital Handbook Taiping Laboratory 2018 after consultation from IMR. IEM-Aryl Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. sulphatase A chemistry Specialist need to contact IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. Arylsulphatase chemistry Specialist need to contact
B (N-acetyl IMR. Sample can only send galactosamine after consultation from IMR. 4-sulfatase) Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
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IEM-Aspartyl- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
glucosaminidas chemistry Specialist need to contact e IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3
Pathology Dept, days after collection. Store at 2-8⁰C.
IEM-Beta Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
Hospital Taiping L Hexosaminidas chemistry Specialist need to contact e A IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3
a days after collection. Store at boratory Handbookboratory 2018 2-8⁰C.
IEM-Beta Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. Hexosaminidas chemistry Specialist need to contact e A + B IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
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IEM-Beta- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. galactosidase chemistry Specialist need to contact IMR. Sample can only send after consultation from IMR. Fill up column under others.
Must arrive to IMR within 3 days after collection. Store at
Pathology Dept,Pathology 2-8⁰C.
IEM-Beta- Screening Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. glucosidase Suspended. chemistry Specialist need to contact Confirmatory IMR. Sample can only send
Hospital Handbook Taiping Laboratory 2018 need to call after consultation from IMR. Pakar Genetik Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM-Beta- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. glucuronidase chemistry Specialist need to contact IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at
2-8⁰C.
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IEM-Beta- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
mannosidase chemistry Specialist need to contact A+B (TOTAL) IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3
Pathology Dept, days after collection. Store at 2-8⁰C. IEM-Biogenic Active CSF Clean tube 2mL 25 days Bio- IMR Form: IEM Request Form amines, CSF chemistry Frozen sample immediately.
Hospital Taiping L Protect from light.(Easily destroyed by heat)
IEM-Biogenic Active Random urine Clean 2mL 25 days Bio- IMR Form: IEM Request Form amines, urine universal chemistry Frozen sample immediately. bottle Protect from light.(Easily
a boratory Handbookboratory 2018 destroyed by heat) IEM-Carnitine, Active Plasma Heparin tube 2mL 10 days Bio- IMR Form: IEM Request Form Total and Free, chemistry Separate plasma plasma immediately. Frozen sample immediately IEM-Carnitine, Active 24 hr urine 24 hour urine 5 mL 10 days Bio- IMR Form: IEM Request Form. urine bottle chemistry Specialist need to contact
IMR. Sample can only send after consultation from IMR.
IEM-Delta- Active Random urine / Protect from 2mL 25 days Bio- IMR Form: IEM Request Form Amino Levulinic 24-hour urine light chemistry Frozen sample immediately. Acids (D-ALA), Protect from light, D-ALA Urine easily destroyed by light.
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IEM-Galactose- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form. 6-sulphatase chemistry Specialist need to contact IMR. Sample can only send after consultation from IMR. Fill up column under others.
Must arrive to IMR within 3 days after collection. Store at
Pathology Dept,Pathology 2-8⁰C. IEM- Active Dried blood spot Whatmann 3 circles of 10 days Bio- IMR Form: IEM Request Form Galactosemia, 903 Filter Dried blood chemistry Properly dried at room Total/Screening paper spot (DBS) temperature for 4 hours , blood spot before putting in plastic bag.
Hospital Handbook Taiping Laboratory 2018 Wet blood spot will be rejected.
IEM-Glycogen Suspended Whole blood EDTA tube 6 mL 25 days Bio- IMR Form: IEM Request Form. branching chemistry Specialist need to contact enzyme IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM-Myoglobin Active Random urine Clean 5 mL 5 days Bio- IMR Form: IEM Request Form
& Hemoglobin, universal chemistry Frozen sample immediately. urine bottle
IEM- Active First morning Clean 5 mL 25 days Bio- IMR Form: IEM Request Form Oligosaccharide urine universal chemistry Frozen sample immediately. & bottle tetraglucoside,
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IEM-Organic Active Random urine Clean 5 mL 10 days Bio- IMR Form: IEM Request Form
Acids, urine universal chemistry Frozen sample immediately. bottle Organic acids easily destroyed by heat.
IEM-Orotic Active Random urine Clean 5 mL 20 days Bio- IMR Form: IEM Request Form Pathology Dept, Acids, urine universal chemistry Frozen sample immediately. bottle
IEM-Palmitoyl- Active Whole blood EDTA tube 6 mL 30 days Bio- IMR Form: IEM Request Form.
protein chemistry Specialist need to contact
Hospital Taiping L thioesterase IMR. Sample can only send after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at
a boratory Handbookboratory 2018 2-8⁰C.
IEM-Phytanic SUSPENDED Plasma EDTA/Hepari 1ml plasma 10 days Bio- IMR Form: IEM Request Form. Fill Acid, n chemistry up column under others. plasma/serum Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
IEM-Pipecolic Active Plasma Heparin tube 2mL 25 days Bio- IMR Form: IEM Request Form acid(PIPA) chemistry Separate plasma immediately. Frozen sample immediately. IEM-Pterins, Active CSF Clean 0.5ml CSF 25 days Bio- IMR Form: IEM Request Form CSF universal chemistry Cover from light, Transport bottle FROZEN. (Pterins easily destroyed by heat and light)
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IEM-Pterins, Active Random urine Clean 2mL 25 days Bio- IMR Form: IEM Request Form urine universal chemistry Cover from light, Transport bottle FROZEN. (Pterins easily destroyed by heat and light) IEM- Active Whole blood EDTA tube 5 mL 30 days Bio- IMR Form: IEM Request Form.
Sulphamidase chemistry Specialist need to contact IMR. Sample can only send
Pathology Dept,Pathology after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C .
Hospital Handbook Taiping Laboratory 2018 IEM-Uroporpho Active Random Urine Clean 5 mL 25 days Bio- IMR Form: IEM Request Form bilinogen, urine universal chemistry Frozen sample immediately bottle Protect from light.
IEM-Very Long SUSPENDED Plasma EDTA/Hepari 1mL 25 days Bio- IMR Form: IEM Request Form Chain Fatty Acid n chemistry Separate plasma (VLCFA) & immediately. Frozen sample Phytanic acid immediately. (VLC), plasma IgE, Specific Active Blood/ Serum Plain tube < 5 tests: 5 days Allergy IMR Keep and transport specimen RAST Blood: 3 ml at 2-8°C. (Radioallergo- Serum: 0.5
sorbent test) ml; > 5 tests: Blood: 5-10 ml Serum: 1-3ml
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IgE, Total Active Blood/ Serum Plain tube Blood: 3 ml 5 days Allergy IMR Keep and transport specimen
Serum: 0.5 ml at 2-8°C.
IGF-1 (Insulin Active Blood Plain tube 3 mL 30 days Diabetes IMR Form: PER.PAT 301
Pathology Dept, Like Growth and Keep the specimen frozen or Factor-1) Endocrine within 2-8⁰C during Unit transportation. Immunoglobuli Active Serum Plain tube 5 ml 10 days PID IMR Transported without ice. By n & appointment only.
Hospital Taiping L Complement Quantitation Immunoglobuli Active Blood Plain tube 3 ml 10 days Chemical HKL n A (IgA) Pathology
a
boratory Handbookboratory 2018 Immunoglobuli Active Blood Plain tube 3 ml 10 days Chemical HKL n G (IgG) Pathology
Immunoglobuli Active Blood Plain tube 3 ml 10 days Chemical HKL n M (IgM) Pathology
Immunoreactiv Private Laboratory (Serum) e Trypsin
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Influenza Active Nasopharyngeal i) NPS: Sterile i) NPS: A 14 - 35 Virology IMR Keep and transport specimen Viruses swab, Throat plastic vial flexible, fine days at 2-8°C. Isolation swab, Cardiac contain 2-3ml shafter biopsy, Rectal of VTM polyester swab, Stool, ii) TS: Sterile swab. Use
Pericardial plastic vial different aspirate contain 2-3ml swab for each
Pathology Dept,Pathology of VTM iii) nostrils Organ biopsy: ii) TS: Sterile Sterile swab containers iii) Biopsy: containing Remove
Hospital Handbook Taiping Laboratory 2018 VTM to keep portions, tissue moist about 1.5cm iv) Rectal cube of swab: Sterile various parts plastic vial of affected contain 2-3ml organs of VTM iv) Rectal v) Stool: swab: Stool Sterile bottle on sterile vi) Pericardial swab aspirate: moistened Sterile plastic with distilled vial contain water
2-3ml VTM v) Stool: >5gm (thumb size)
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Influenza Active Nasopharyngeal i) NPS: Sterile i) NPS: A 1 -10 days Virology IMR Keep and transport specimen
Viruses Nucleic swab, Throat plastic vial flexible, fine at 2-8°C. Acid swab, Cardiac contain 2-3ml shafter biopsy, Rectal of VTM polyes ter swab, Stool, ii) TS: Sterile swab. Use Pericardial plastic vial different
Pathology Dept, aspirate contain 2-3ml swab for each of VTM iii) nostrils Organ Biopsy: ii) TS: Sterile Sterile swab
Hospital Taiping L containers iii) Biopsy: containing Remove VTM to keep portions, tissue moist about 1.5cm iv) Rectal cube of
a swab: Sterile various parts
boratory Handbookboratory 2018 plastic vial of affected contain 2-3ml organs of VTM iv) Rectal v) Stool: swab: Stool Sterile bottle on sterile vi) Pericardial swab aspirate: moistened Sterile plastic with distilled vial contain water 2-3ml VTM v) Stool: >5gm (thumb size)
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Influenza (Flu Active Throat swab, NP Viral 2 ml 7 days Micro- HRPB 1. Form Swine Influenzae A/Flu B) swab Transport biology Using Polystyrene box, PCR Medium consignment form attached (VTM) separately. Keep and transport specimen
at 2-8°C. Insulin Active Blood Plain tube 3mL 20 days Chemical HKL Form: PER.PAT 301
Pathology Dept,Pathology Pathology
Insulin-like Private Laboratory (Serum) Growth Factor
Hospital Handbook Taiping Laboratory 2018 Binding Protein (IGFBP3) Interferon Active Blood Special 1 ml – TB Unit MKAK Appointment (Dr Salina, Gamma Release container MKAK) Assay (IGRA) need to collect from MKAK Japanese Active Serum Plain tube/ 1 - 3 ml 7 days Molecular MKAK 1) Specimen should be Encephaliti (JE) Gel tube Unit collected < 5 days after onset RT-PCR (Without of illness. anticoagulant 2) A brief concise history of ) illness and physical findings
is required especially the date of onset of illness and date of specimen collection. 3) Keep and transport specimen at 2-8°C.
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Japanese Active Serum Plain tube 1 - 3 ml 3 days Serology MKAK 1) Specimen should be
Encephaliti (JE) (serum) / Unit collected < 5 days after onset Serology EDTA of illness. (plasma) 2) A brief concise history of illness and physical findings is required especially the
Pathology Dept, date of onset of illness and date of specimen collection. 3) Keep and transport specimen at 2-8°C.
Hospital Taiping L Japanese Active CSF, Serum, After After 1 -10 days Virology IMR After consultation only. Encephalitis Organ biopsies consultation consultation Virus Nucleic only only Acid Ketone Active Blood Plain tube 3 mL 7 days Paediatric HKL Form: PER.PAT 301
a Labo- Separate serum into plain
boratory Handbookboratory 2018 ratory tube. Freeze at -20C⁰.
Lassa Nuclei Active Serum, Tissue After After 1 -10 days Virology IMR After consultation only. Acid biopsy consultation consultation only only
Lead Active Blood EDTA/Hepari 1ml 14 days Toxicology IMR Form: PER.PAT 301.
n & Pharmaco logy, Herbal Medicine Research Centre (HMRC)
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Legionella Active Urine Sterile 5 ml 3 days Micro- HKL pneumophilia container biology Antigen
Legionella Active Blood Plain 5ml 7 days Bacteri- MKAK Transport specimen at 2-8'C.
Serology tube/Serum ology (IgM/IgG)
Pathology Dept,Pathology Leishmaniasis Active Whole Blood in Slide mailer 2.5 ml 3 days Parasi- IMR Diagnosis - EDTA, Lymph or EDTA tube tology Microscopy biopsy film, Bone marrow film
Hospital Handbook Taiping Laboratory 2018 Leishmaniasis Active Whole blood in EDTA tube, 2.5ml 7 days Parasi- IMR Keep and transport specimen Diagnosis - PCR EDTA, skin / filter paper tology at 2-8°C. tissue scrapings
Leishmaniasis Active Serum, blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen Diagnosis- tology at 2-8°C. Serology
Leishmaniasis Active Lymph EDTA tube, 2.5ml 7 days Parasi- IMR Keep and transport specimen PCR node/tissue filter paper tology at 2-8°C. aspirate, Blood, Buffy coats,
Dried blood (filter paper) Leishmaniasis Active Serum Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen Serology tology at 2-8°C.
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Leprosy (Kusta) Active Tissue Sterile Kusta MKAK Transport specimen at 2-8'C.
C&S container
Leptospiral PCR Active i) Blood in EDTA: Blood in For ICU cases 5 days Bacteri- IMR For better sensitivity, blood
Pathology Dept, 3 ml EDTA; other & after ology samplings should be ii) Sterile body samples in consultation repeated 2 or 3 times, at 3-4 fluids, CSF, sterile only hours interval. bronchial lavage, container(3M Transportation at ambient Tissue L) temperature. If delayed keep
Hospital Taiping L biopsies/post at 2-8°C. mortem samples. Before antibiotics.
a LH Active Plain tube Plain tube 3 mL 7 days Bio- HRPB Form: PER.PAT 301
boratory Handbookboratory 2018 chemistry Cop and sign specialist. Complete with diagnosis & clinical history. Lipase Private Laboratory (Serum)
Lipoprotein (a) Suspended Serum Plain tube 3.0 mL 10 days Molecular IMR Form: Request Form for Electrophoresis Diag Multiple Myeloma Serum nostics & must reach the lab not more Protein than 7 days (at 2- 8⁰C) after collection date. Lithium Active Blood Plain tube 3 mL 7 days Bio- Hospital Form: TDM. chemistry Bahagia Ulu Kinta
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LPA for MDR TB Active Sputum only Sterile screw 2-5 ml 7 days Tuber- MKAI With result of Positive Direct (Line Probe capped culosis Smear. Assay) container
Lupus Active Plasma Trisodium 6 tubes Hema- Pusat Form: National Blood Centre
Anticoagulant: citrate 3.2% to fill until tology Darah Haematology / Serology i)Anti- Peripheral blood indicated Negara Request Form with relevant
Pathology Dept,Pathology cardiolipin in case of B2 Plain Gel mark clinical history to be signed antibody glycoprotein Tube in case For Lupus by attending physician. ii)Anti- antibody of B2 Anti- phospholipid glycoprotein coagulant antibody antibody alone; 2-3
Hospital Handbook Taiping Laboratory 2018 iii)B2 tubes, to be glycoprotein 1 filled until antibody indicated mark 2.5 ml in case of B2 glycoprotein antibody alone Lymphocyte Active Blood Sodium 5 ml 30 days PID IMR Transported without ice. By Transformation Heparin appointment only. Test
Macroprolactin Private Laboratory (Serum)
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Malaria Active Serum, blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen
Diagnosis- tology at 2-8°C. Serology
Marburg Active Serum, Tissue After After 1 -10 days Virology IMR After consultation only.
Pathology Dept, Nucleic Acid Biopsy consultation consultation only only
Measles IgM Active Serum/Blood Plain tube/ 1 ml for 4 days Serology MKAK 1. Collect specimen 4 to 28 Gel Tube serum/ Unit days after onset of rash.
Hospital Taiping L (Without 5 ml for 2. Keep and transport anticoagulant blood specimen at 2-8°C. ) MECP 2 Gene Active Blood K2/K3EDTA 5ml (3 tubes) Genetic HKL By Appointment Lab
a
boratory Handbookboratory 2018
Mercury Active Urine Urine 10ml 10 days Toxicology IMR Form: PER.PAT 301. container & Preservative: Pharmaco HNO3, pH2 logy, Herbal Medicine
Research Centre (HMRC) MERS-CoV RT- Active Blood Plain tube 5 ml 7 days Micro- HRPB PCR biology (Qualitative)
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MERS-CoV RT- Active Throat Swab, Plain sterile 2 ml 3 days Micro- HRPB 1. Form Mers-Cov. PCR Sputum Container, biology 2. Keep and transport (Qualitative) swab in VTM specimen at 2-8°C.
MERS-CoV RT- Active NPA, BAL, Plain sterile 1-2 ml 7 days Micro- HRPB Keep and transport specimen
PCR Tracheal Container biology at 2-8°C. (Qualitative) Aspirate
Pathology Dept,Pathology Metabolic Active Random urine Clean 2mL 10 days Bio- IMR Form: IEM Request Form Screening, universal chemistry Frozen sample immediately. urine bottle
Hospital Handbook Taiping Laboratory 2018 Metanephrine Private Laboratory (24HR Urine)
Methampheta Active Urine Urine 30mL 14-30 Drug HKL Form: Borang Ujian mine container days Labo- Pengesanan Dadah - UPD ratory (Pindaan 1) / PER-PAT 301 form. Methotrexate Active Serum Plain tube 3ml 18 hrs Clinical HKL Form: PER.PAT 301. (Red cap) days Toxicology
Methyl Malonic Active Blood 2 EDTA tubes 1-2 x 2.5mL 40 days Molecular IMR Form: Molecular Diagnostic Acidemia (2.5mL) blood EDTA Diag- Services Send at ambient or dried nostics & temperature. If >3 hours, blood spots Protein keep sample cooled. Protect from freezing.
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Methylation Active Blood 2 EDTA tubes 1-2 x 2.5mL 30 days Molecular IMR Form Molecular Diagnostic
Analysis - (2.5mL) blood EDTA Diag- Servies, To consult Clinical Angelman or dried nostics & Genetics, Genetic Syndrome blood spots Protein Department, HKL before take - Prader & sample. Form need to be Willi Syndrome detail clinical, biochemical,
Pathology Dept, imaging findings. Send at ambient temperature. If >3 hours, keep sample cooled. Protect from freezing.
Hospital Taiping L Microscopic Active Serum Plain tube 1ml 7 days Bacteri- MKAI Request form of MKA Sungai Agglutination ology Buloh. Only receive samples Test for with Rapid ELISA test result Leptospira except outbreak samples (MAT) (MAT test only).
a Mucopolysacch Active First Morning Clean 5 mL 10 days Bio- IMR
boratory Handbookboratory 2018 a-rides Urine universal chemistry Screening bottle (MPS), urine Mycobacterium Active Sputum, Pus, CSF Sterile For CSF 1-2 5 days Bacteri- MKAI For CSF send to lab tuberculosis & other body container ml ology immediately; for sputum (MTB) PCR fluids ideally collect 3 consecutive specimens. A single well
collected specimen is adequate. Specialist sign & stamp. Mycobacterium Active Sputum / Serous Sterile screw 3 - 5 ml / 1 -2 7 days TB Unit MKAK Specimen must arrive within tuberculosis Fluid, urine capped ml 7 days of collection; Complex by PCR (Ascetic fluid, container specimen >7 days will be method Pleural, rejected. Peritoneal)
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Mycophenolic Active Blood EDTA tube 3 ml 18 hrs Clinical HKL Form: PER.PAT 301. Acid days Toxicology
N- Suspended Whole blood EDTA tube 6 mL 25 days Bio- IMR Form: IEM Request Form.
acetylglucosami chemistry Specialist need to contact ne-6-sulphatase IMR. Sample can only send
Pathology Dept,Pathology after consultation from IMR. Fill up column under others. Must arrive to IMR within 3 days after collection. Store at 2-8⁰C.
Hospital Handbook Taiping Laboratory 2018 Neisseria Active Pure isolate Pure isolate 7 days Bacteri- IMR Pure isolate. meningitidis ology Serotyping
Nikel Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of Container requesting DR must be clear.
Nipah Virus Active Serum, CSF i) CSF: Sterile i) CSF: 1-3ml 5 - 14 Virology IMR Keep and transport specimen Antibody container ii) Serum: 1- days at 2-8°C. ii) Serum: 3ml Plain tube
Nipah Virus Discontinued Serum, CSF, After After 1 -10 days Virology IMR After consultation only. Nucleic Acid Organ biopsies consultation consultation only only
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Non-Polio Active Throat swab, i) TS: Sterile i) TS: Sterile 14 - 35 Virology IMR Keep and transport specimen
Enterovirus Stool, Rectal plastic vial swab days at 2-8°C. Isolation swab, CSF, contain 2-3ml ii) Stool: Vesicular of VTM ii) >5gm (thumb swab/scraping, Stool: Sterile size) Organ biopsies bottle iii) Rectal
Pathology Dept, iii) Rectal swab: Stool swab: Sterile on sterile plastic vial swab contain 2-3ml moistened
Hospital Taiping L of VTM with distilled vi) CSF: water Sterile iv) CSF: 1-3ml container v) Vesicular v) Vesicular swab/scrapin
a swab/scrapin gs: Swabs to
boratory Handbookboratory 2018 g: Sterile be put into 2- plastic vial 3ml of VTM vi) Organ vi) Organ Biopsy: Biopsy: Sterile Remove containers portions, containing about 1.5cm VTM to keep cube of tissue moist various parts of affected organs
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Non-Polio Active Throat swab, i) TS: Sterile i) TS: Sterile 1 -10 days Virology IMR Keep and transport specimen Enterovirus Stool, Rectal plastic vial swab at 2-8°C. Nucleic Acid swab, CSF, contain 2-3ml ii) Stool: Vesicular of VTM ii) >5gm (thumb swab/scraping, Stool: Sterile size)
Organ biopsies bottle iii) Rectal iii) Rectal swab: Stool
Pathology Dept,Pathology swab: Sterile on sterile plastic vial swab contain 2-3ml moistened of VTM with distilled vi) CSF: water
Hospital Handbook Taiping Laboratory 2018 Sterile iv) CSF: 1-3ml container v) Vesicular v) Vesicular swab/scrapin swab/scrapin gs: Swabs to g: Sterile be put into 2- plastic vial 3ml of VTM vi) Organ vi) Organ Biopsy: Biopsy: Sterile Remove containers portions, containing about 1.5cm VTM to keep cube of tissue moist various parts
of affected organs
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Noonan Active Blood 2 EDTA tubes 1-2 x 2.5mL 30 days Molecular IMR Form Molecular Diagnostic
Syndrome (2.5mL) blood EDTA Diag- Servies, To consult Clinical (PTPN11) or dried nostics & Genetics, Genetic blood spots Protein Department, HKL before take sample. To Send at ambient temperature. Form need to
Pathology Dept, be detail clinical, biochemical, imaging findings If >3 hours, keep sample cooled. Protect from
Hospital Taiping L freezing. Normeta- Private Laboratory (24HR Urine) nephrine
a Organism Active Bacterial culture Pure isolate Pure isolate 14 days Bacteri- IMR Send pure isolates with
boratory Handbookboratory 2018 identification ology clinical history. using 16sRNA
Organism Upon request Bacterial culture Pure isolate Pure isolate 14 days Bacteri- IMR Send pure isolates with identification only ology clinical history. using 16sRNA
Organo- Active Blood/Urine Plain 3 ml/ 5ml Toxicology Jabatan Form: Pemeriksaan Forensik/ phosphate Tube/Sterile Kimia, Ipoh Toksikologi. Sign & stamp of Container requesting DR must be clear.
Osteocalcin Private Laboratory (Serum)
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Osmotic Active Fresh peripheral 2 Heparinized 2.0 ml each 3 days Hema- HRPB a) Treating physician to make Fragility Test blood tube tology an appointment with haematopathologist. b) Mix the blood thouroughly, gently and
immediately after collection. c) Attach FBP result.
Pathology Dept,Pathology P Anti- Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Neutrophil Adult: immune at 2-8°C. Cytoplasmic 5-10 ml Antibody (P- Serum:
ANCA) 1-3 ml
Hospital Handbook Taiping Laboratory 2018 Parainfluenza Active Nasopharyngeal i) NPA: Sterile Mucous 1 -10 days Virology IMR Keep and transport specimen Viruses Antigen aspiration, BAL, plastic vial secretion in at 2-8°C. Sputum contain 2-3ml VTM of Virus Transport Media (VTM) ii) BAL: Sterile plastic tube container iii) Sputum: Sterile plastic container
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Parainfluenza Active Nasopharyngeal i) NPA: Sterile i) NPA: 14 - 35 Virology IMR Keep and transport specimen
Viruses aspiration, plastic vial Mucous days at 2-8°C. Isolation Nasopharyngeal contain 2-3ml secretion in swab, Throat of VTM VTM swab, Throat ii) NPS: ii) NPS: A gargle, BAL, Sterile plastic flexible, fine
Pathology Dept, Sputum, Nasal vial contain shafter swab, Organ 2-3ml of VTM polyester biopsies iii) TS: Sterile swab. Use plastic vial different
Hospital Taiping L contain 2-3ml swab for each of VTM nostrils iv) Throat iii) TS: Sterile gargle: Sterile swab plastic iii) Nasal
a container swab: Sterile
boratory Handbookboratory 2018 v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum: each nostrils Sterile plastic iv) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing VTM to keep tissue moist
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Paramy- Active Nasopharyngeal i) NPS: Sterile i) NPS: A 14 - 35 Virology IMR Keep and transport specimen xoviruses swab, Throat plastic vial flexible, fine days at 2-8°C. Isolation swab, Cardiac contain 2-3ml shafter biopsy, Rectal of VTM polyester swab, Stool, ii) TS: Sterile swab. Use
Pericardial plastic vial different aspirate contain 2-3ml swab for each
Pathology Dept,Pathology of VTM iii) nostrils Organ Biopsy: ii) TS: Sterile Sterile swab containers iii) Biopsy: containing Remove
Hospital Handbook Taiping Laboratory 2018 VTM to keep portions, tissue moist about 1.5cm iv) Rectal cube of swab: Sterile various parts plastic vial of affected contain 2-3ml organs of VTM iv) Rectal v) Stool: swab: Stool Sterile bottle on sterile vi) Pericardial swab aspirate: moistened Sterile plastic with distilled vial contain water
2-3ml VTM v) Stool: >5gm (thumb size) Paraneoplastic Gribbles Pathology (Sent to Australia) Hormone
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Paraneoplastic Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen
Neurological CSF tube/Bijou Adult: 5-10 immune at 2-8°C. Syndrome Bottle ml (PNS) Serum: 1-3 Antibodies or ml Anti Neuronal
Pathology Dept, Antibodies Parvovirus B19 Active Blood Plain tube 3-5 ml 7 days Virology HKL Room temp. or in ice. - IgG ELISA
Hospital Taiping L Parvovirus B19 Active Blood Plain tube 3-5 ml 7 days Virology HKL Room temp. or in ice. - IgM ELISA
a PCR for BCR- Active Peripheral blood K2/K3 EDTA Total 4-5 weeks Hema- Hospital Form: Hospital Ampang
boratory Handbookboratory 2018 ABL1 Bone marrow amount: 5 ml tology Ampang Special Haematology Lab aspirate (for new Requisition" Ha: Hema2017 cases) & 10ml 12/17/16 Form & to be (for follow up signed by specialist. cases) Samples to be transported Bone Marrow without delay preferably Aspirate: 1-2 within 24 hours at room
ml temperature. Do not freeze the sample.
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PCR for JAK2 Active Peripheral blood K2/K3 EDTA 1-2ml 8 weeks Hema- Hospital Form: Hospital Ampang gene mutation Bone marrow tology Ampang Special Haematology Lab aspirate Requisition" Ha: Hema2017 12/17/16 Form & to be signed by specialist.
Samples to be transported without delay preferably
Pathology Dept,Pathology within 24 hours at room temperature. Do not freeze the sample.
PCR for PML- Active Bone marrow K2/K3 EDTA 1-2 ml 6 weeks Hema- Hospital Form: Hospital Ampang
Hospital Handbook Taiping Laboratory 2018 RARA aspirate tology Ampang Special Haematology Lab Requisition" Ha: Hema2017 12/17/16 Form & to be signed by specialist. Samples to be transported without delay preferably within 24 hours at room temperature. Do not freeze the sample.
Phagocytic Discontinued Blood EDTA 2 ml 5 days PID IMR Transported without ice. By Function Test appointment only.
Phospholipase Active Blood/ Serum Plain gel tube 5ml 21 days Auto- IMR Send Immediately to the lab. A₂ Receptor immune antibody
OutsourceService
OutsourceService
Pneumocystis Active Induced Sterile 2 ml 7 days Micro- HKL
carinii sputum/BAL container (once a biology Immunofluores week) cence Pneumocystis Active Induced sputum Sterile 5-10 ml 5 days Bacteri- IMR Must be fresh specimen.
Pathology Dept, jirovecii oocyst or container ology detection bronchoalveolar lavage Polio Active Throat swab, i) TS: Sterile i) TS: Sterile 14 days Virology IMR Keep and transport specimen Virus/Acute Stool, Rectal plastic vial swab at 2-8°C.
Hospital Taiping L Flaccid Paralysis swab, CSF, Organ contain 2-3ml ii) Stool: (AFP) Isolation biopsies of VTM ii) >5gm (thumb Stool: Sterile size) bottle iii) Rectal iii) Rectal swab: Stool
a swab: Sterile on sterile
boratory Handbookboratory 2018 plastic vial swab contain 2-3ml moistened of VTM with distilled vi) CSF: water sterile iv) CSF: 1-3ml container v) Organ v) Organ Biopsy:
Biopsy: Remove Sterile portions, containers about 1.5cm containing cube of VTM to keep various parts tissue moist of affected organs
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Porphobilinoge Active Random urine Clean 5 mL 15 days Bio- IMR Form: PER.PAT 301 n universal chemistry Frozen sampel immediately bottle Protect from light, transport frozen in dry ice. Porphyrin Active Random urine Clean 5 mL 15 days Bio- IMR Form: PER.PAT 301
universal chemistry Frozen sampel immediately bottle Protect from light, transport
Pathology Dept,Pathology frozen in dry ice. Procalcitonin Active Blood Plain tube 3 mL 4-6 weeks Chemical Institut Form: PER.PAT 301. Pathology Kanser Request by specialist only. Negara Form complete with history. Specialists ordering the test
Hospital Handbook Taiping Laboratory 2018 need to call IKN before order test. Progesterone Active Blood Plain tube 3 mL 7 days Bio- HRPB Form: PER.PAT 301 chemistry Cop and sign specialist. Complete with diagnosis & clinical history. Progesterone, Active Blood Plain tube / 0.5mL serum 20 days Diabetes IMR Form: PER.PAT 301 17-OH EDTA / 3.5mL and Keep the specimen frozen or whole blood Endocrine within 2-8⁰C during Unit transportation. Pro-insulin Private Laboratory (Serum)
Prolactin Active Blood Plain tube 3 mL 7 day Biochemis HRPB Form: PER.PAT 301 try Cop and sign specialist. Complete with diagnosis & clinical history.
OutsourceService
OutsourceService
Prostate Active Blood Plain tube 3 ml 7 days Clinical HKL Form: PER.PAT 301.
Specific Antigen Toxicology (free)
Protozoa Active Corneal scrape, Sterile, air NA 9 days Parasi- IMR By Appointment only.
Pathology Dept, (Acanthamoeba Contact lens, tight or tology Medium in container: Sterile /Naegleria) Contact lens contact lens distilled water or saline. Culture suspension, storage Spinal fluid Purine and Active Urine Urine 5 ml Pediatric HKL Form: IEM Form HKL,
Hospital Taiping L Pyrimidine container Labo- Specialist sign. ratory
Pyruvate Active Blood & CSF Conical tube 2mL By batch Pae- HKL Form: PER.PAT 301 with 4mL 8% diatric 1) Draw 2mL of blood and a of perchloric Laborator dispense into conical tube
boratory Handbookboratory 2018 acid solution y containing cold 4mL of 8% (collected at perchloric acid solution. Cap Paediatric the tube and mix gently until Lab Counter, entire solution turns brown. HKL) Conical tube containing cold 4mL of 8% perchloric acid solution can be obtained
from counter Paediatric Lab HKL. 2) Transport in dry ice as soon as possible to the lab. Pyruvate Active Whole blood EDTA tube 1-2 X 2.5mL 40 days Molecular IMR Form: Molecular Diagnostic Dehydrogenase blood Diag- Services. Send at ambient Deficiency nostics & temperature. If >3 hours, (PDHA1) Protein keep sample cooled. Protect from freezing.
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qRT-PCR Active Throat swab VTM 3 ml 3-5 days Molecular MKAI 1) Use Dacron swab only, not Respiratory Biology cotton swab. Viruses 2) Cold chain (2 - 8°C).
qRT-PCR Active Throat swab VTM 3 ml 3-5 days Molecular MKAI 1) Use Dacron swab only, not
Respiratory Biology cotton swab. Viruses 2) Cold chain (2 - 8°C).
Pathology Dept,Pathology Rabies Virus Active Neck biopsy, After After 1 -10 days Virology IMR After consultation only. Antigen Brain biopsy consultation consultation only only
Hospital Handbook Taiping Laboratory 2018 Rabies Virus Active Neck biopsy, After After 14 - 35 Virology IMR After consultation only. Isolation Saliva, CSF, Brain consultation consultation days biopsy only only
Rabies Virus Active Neck biopsy, After After 1 -10 days Virology IMR After consultation only. Nucleic Acid Saliva, CSF, Brain consultation consultation (Rabies PCR) biopsy only only
Renin Active Plasma in EDTA 3 EDTA tubes 6 mL 21 days Endo- Hospital Form: PER.PAT 301 crinology Putrajaya Cop & sign specialist, fulfill the criteria (State in the form: clinical history, drug
history, latest potassium level >4.0 mmol/L, requested by specialist/endocrine specialist only, record of patient`s position (supine/upright).
OutsourceService
OutsourceService
Respiratory Active Nasopharyngeal i) NPA: Sterile Mucous 1 -10 days Virology IMR Keep and transport specimen
Syncytial Virus aspiration, BAL, plastic vial secretion in at 2-8°C. (RSV) Antigen Sputum contain 2-3ml VTM of Virus Transport Media (VTM)
Pathology Dept, ii) BAL: Sterile plastic tube container iii) Sputum:
Hospital Taiping L Sterile plastic container
a
boratory Handbookboratory 2018
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Respiratory Active Nasopharyngeal i) NPA: Sterile i) NPA: 14 - 35 Virology IMR Keep and transport specimen Syncytial Virus aspiration, plastic vial Mucous days at 2-8°C. (RSV) Isolation Nasopharyngeal contain 2-3ml secretion in (Culture and IF) swab, Throat of VTM VTM swab, Throat ii) NPS: ii) NPS: A
gargle, BAL, Sterile plastic flexible, fine Sputum, Nasal vial contain shafter
Pathology Dept,Pathology swab, Organ 2-3ml of VTM polyest er biopsies iii) TS: Sterile swab. Use plastic vial different contain 2-3ml swab for each of VTM nostrils
Hospital Handbook Taiping Laboratory 2018 iv) Throat iii) TS: Sterile gargle: Sterile swab plastic iv) Nasal container swab: Sterile v) BAL: Sterile swab. Use plastic tube different container swabs for vi) Sputum: each nostrils Sterile plastic v) Biopsy: container Remove vii) Nasal portions, swab : Sterile about 1.5cm plastic vial cube of
contain 2-3ml various parts VTM of affected viii) Biopsy: organs Sterile containers containing
VTM to keep OutsourceService tissue moist
OutsourceService
Respiratory Active Sputum / Sterile screw 1 ml 21 days Virus MKAK 1) Specimen should be
Virus - Nasopharyngeal capped Isolation collected < 5 days after onset Virus Isolation aspirate / Swab container / Unit of illness. (Adenovirus, Sterile 2) A brief concise history of Influenza A container illness and physical findings & B, with 2.0-2.5 is required especially the
Pathology Dept, Parainfluenza ml of VTM date of onset of illness and 1,2 & date of specimen collection. 3, and 3) Keep and transport Respiratory specimen at 2-8°C.
Hospital Taiping L Syncytial Virus) Respiratory Active Sputum, Sterile 3-5ml 3-5 days Serology MKAI Keep and transport specimen Viruses Antigen Nasopharyngeal container at 2-8°C. Detection: IF aspirate, leak proof a. Influenza A Bronchiole
a virus, alveolar,
boratory Handbookboratory 2018 b. Influenza B Tracheal aspirate virus, c. Parainfluenza 1 virus, d. Parainfluenza 2 virus, e. Parainfluenza
3 virus, f. Adenovirus, g. Respiratory Syncytial virus, h. Human Rickettsia Active Serum Plain tube 3-5 ml Micro- HRPB serology/ IIP biology
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Rift Valley Active Serum, CSF, After After 1 -10 days Virology IMR After consultation only. Nucleic Acid Organ biopsies consultation consultation only only
Rubella - IgG Active Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice.
ELISA
Pathology Dept,Pathology Rubella - IgM Active Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice. ELISA
Hospital Handbook Taiping Laboratory 2018 Rubella Discontinued Blood, Serum Plain tube Child: 3 ml 1 -10 days Virology IMR Keep and transport specimen Antibody, IgG Adult: at 2-8°C. 5-10 ml Serum: 1-3 ml Rubella Discontinued Blood, Serum Plain tube Child: 3 ml 1 -10 days Virology IMR Keep and transport specimen Antibody, IgM Adult: at 2-8°C. 5-10 ml Serum: 1-3 ml Rubella- IgM Active Blood Plain tube 3-5 ml 14 days Micro- HRPB ELISA biology
S.pneumoniae Active Bacterial culture Pure isolate Pure isolate 6 days Bacteri- IMR Pure isolate. Isolate ology Confirmation & AST Verification
OutsourceService
OutsourceService
Salmonella Active Bacterial culture Nutrient agar Pure isolate 2 months Bacteri- IMR PFGE will be done for
Serotyping slant ology Salmonella Typhi.
SARS Active Nasopharyngeal After After 14 - 35 Virology IMR After consultation only.
Pathology Dept, Coronavirus aspiration, consultation consultation days Isolation Nasopharyngeal only only swab, Throat swab, Throat gargle, BAL,
Hospital Taiping L Sputum, Nasal swab, Organ biopsies, Stool SARS Active Nasopharyngeal After After 1 -10 days Virology IMR After consultation only. Coronavirus aspiration, consultation consultation
a Nucleic Acid Nasopharyngeal only only
boratory Handbookboratory 2018 swab, Throat swab, Throat gargle, BAL, Sputum, Nasal swab, Organ biopsies, Stool Schistosomiasis Active Serum, Blood Plain tube 2 ml 5 days Para- IMR Keep and transport specimen
Serology sitology at 2-8°C.
SCN1A Related Active Blood 2 EDTA 1-2 x 2.5mL 30 days Molecular IMR Form: Molecular Diagnostic Seizure tubes(2.5mL) blood EDTA Diag- Services. Send at ambient Disorder or dried nostics & temperature. If >3 hours, blood spots Protein keep sample cooled. Protect from freezing.
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Selenium Active Blood Plain tube 3 mL Toxicology Jabatan Form: Pemeriksaan Forensik/ Kimia, Ipoh Toksikologi. Sign & stamp of requesting DR must be clear.
Serum Bile Acid Active Serum Plain tube 5ml Bio- H. Selayang Form: Per.Pat 301. Cop Pakar
chemistry with clinical history & diagnosis. Serum separate to
Pathology Dept,Pathology plain tube. To Inform Pn Hadibah in H.Selayang before sending. Serum and Active Blood & Urine Plain tube & 3 mL (blood) 30 days Molecular IMR Form: Request Form for Urine Protein Sterile bottle & 25mL of Diag- Multiple Myeloma Cop
Hospital Handbook Taiping Laboratory 2018 Electrophoresis (urine) 24hr or early nostics & Pakar. Serum & urine must /paraprotein morning Protein reach the lab not more than (SPE/UPE) urine/rando 7 days (at 2-8°C) after (Comfirmatory m urine collection date. Urine is Profiling) refrigerated after collection. Serum and Active Blood & Urine Plain tube & 3 mL (blood) 30 days Molecular IMR Form: Request Form for Urine Protein Sterile Bottle & 25mL of Diag- Multiple Myeloma Cop Electrophoresis (urine) 24hr or early nostics & Pakar. Serum & urine must /paraprotein morning Protein reach the lab not more than (SPE/UPE) urine/rando 7 days (at 2-8°C) after (Screening m urine collection date. Urine is Profiling) refrigerated after collection.
Sex Hormone Active Blood Plain tube 3 mL Endocri- Hospital Form: PER.PAT 301 Binding (SHBG) nology Putrajaya Cop and sign specialist. Complete with diagnosis & clinical history.
Shigella Active Bacterial culture Nutrient agar Pure isolate 2 months Bacteri- IMR Pure Isolate. Serotyping slant ology
OutsourceService
OutsourceService
Sialic Acid, Total Active First morning Clean 5 mL 25 days Bio- IMR Form: IEM Request Form
and Free urine universal chemistry Frozen sample immediately. bottle
Sirolimus Active Blood EDTA tube 3 ml 7 days Clinical HKL Form: TDM.
Pathology Dept, Toxicology
Skin Antibodies Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen (PPA: Adult: immune at 2-8°C.
Hospital Taiping L Pemphigoid 5-10 ml and Pemphigus Serum: antibodies) 1-3 ml Specific Liver Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Antibodies Adult: immune at 2-8°C. a 5-10 ml
boratory Handbookboratory 2018 Serum: 1-3 ml S- Active Random Urine Clean 2mL 25 days Bio- IMR Form: IEM Request Form Sulphocysteine, universal chemistry Frozen sample immediately. urine bottle
St. Louis Active Serum, CSF, After After 1 -10 days Virology IMR After consultation only. Encephalitis Organ biopsies consultation consultation only only
Stool for Active Stool Plain sterile Not 1 day Micro- HRPB Consult with HRPB Specialist. Rotavirus container Applicable biology Below 5 years old, send (Rapid urgently. Detection)
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Stool for: Active Fresh stool or Screw lid, air 6 g 5 days Parasi- IMR Fresh stool in plain container 1) Fixed stool tight tology (specimen to reach lab Opportunistic container within 24hr at room protozoa temperature) Fixed stool 2) must be in PVA or SAF.
Cryptosporidiu m spp
Pathology Dept,Pathology 3) Microsporidium spp Stool Ova and Active Fresh stool or Screw lid, air 5 g 5 days Parasi- IMR Fresh stool in plain container Cysts: Test may Fixed stool tight tology (specimen to reach lab
Hospital Handbook Taiping Laboratory 2018 include some or container within 24hr at room all listed below temperature) Fixed stool depending on must be in PVA or SAF. volume of stool received. 1) Direct wet mount 2) Fecal concentration 3) Trichrome stain 4) Modified DMSO
5) Gram Chromotrope
Stool Reducing Active Stool, Urine Urine 5mL 7 days Pae- HKL Form: PER.PAT 301. Sugar, Urine container diatric Reducing Sugar Laborator
y OutsourceService
OutsourceService
Succinylacetone Active Random urine Clean 5 mL 25 days Bio- IMR Form: IEM Request Form
,urine universal chemistry Frozen sample immediately. bottle Cover from light.
Sugar & Polyols, Active Random urine Clean 5 mL 25 days Bio- IMR Form: PER.PAT 301.
Pathology Dept, urine universal chemistry bottle
Sulfatides Active Blood/ Serum/ Plain gel Child: 3 ml 14 days Auto- IMR Keep and transport specimen CSF tube/Bijou Adult: immune at 2-8°C.
Hospital Taiping L Bottle 5-10 ml Serum: 1-3 ml Sulphite (Urin Active Random urine Clean 5 mL Paediatric HKL Form: IEM HKL. For walk in Dipstick) Universal Laborator patient only. a bottle y
boratory Handbookboratory 2018
Sweat Test Active Sweat NA NA 24 hours Paediatric HKL By appointment. Patient Lab must be reviewed by Paediatric Chest Specialist. Call ext. 6902 to set appointment.
T & B Cell Active Blood EDTA 2ml 5 days PID IMR Transported without ice. By Subset appointment only. Enumeration
Tacrolimus (FK Active Blood EDTA tube 3 ml 7 days Clinical HKL Form: TDM. LEVEL) Toxicology
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Taeniasis / Active Serum, Blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen cysticercosis - tology at 2-8°C. Serology
Taeniasis Active Serum Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen
Serology tology at 2-8°C.
Pathology Dept,Pathology TB Gene-Xpert Active i) Sputum i) Sterile 1 - 5 ml 1 day Micro- HRPB Use TIBI form. ii) CSF/body Container, biology Keep and transport specimen fluids/urine screw capped at 2-8°C. Specialist sign & iii) Gastric lavage ii) Sterile stamp.
Hospital Handbook Taiping Laboratory 2018 (without any Bijou Bottle, additive) screw capped *reject fluid sample if grossly blood stained.
Testosterone Active Blood Plain tube 3 mL 7 days Bio- HRPB Form: PER.PAT 301 chemistry Cop and sign specialist. Complete with diagnosis & clinical history.
Thyroglobulin Active Blood/Whole Plain tube 3 mL 30 days Diabetes IMR Form: PER.PAT 301 blood and Keep the specimen frozen or
Endocrine within 2-8⁰C during Unit transportation. Typhoid/ Private Laboratory Parathyphoid
OutsourceService
OutsourceService
Toxocariasis Active Serum, Blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen
Diagnosis - tology at 2-8°C. Serology
Toxoplasma Active Blood Plain tube 3-5 ml 14 days Micro- HRPB Keep and transport specimen
Pathology Dept, IgM ELISA biology at 2-8°C.
Toxoplasmosis Active Serum Plain tube 2 ml 14 days Parasi- IMR Keep and transport specimen Serology tology at 2-8°C.
Hospital Taiping L
Transferrin Active Blood Plain tube 3mL 5 days Molecular IMR Form: Request Form for Diag- Multiple Myeloma Serum nostics & must reach the lab not more a Protein than 7 days (at 2°C-8°C) after
boratory Handbookboratory 2018 collection date. Transferrin Active Serum Plain tube 3 mL 30 days Molecular IMR Form: Request Form for Isoform Diag- Multiple Myeloma Serum nostics & must reach the lab not more Protein than 7 days (at 2- 8⁰C) after collection date. Transferrin Private Laboratory (Serum)
Receptor
Trichinellosis Active Serum, Blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen Diagnosis - tology at 2-8°C. Serology
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Triple Antigen Active Blood/ Serum Plain gel tube Child: 3 ml 14 days Auto- IMR Keep and transport specimen Test (TA): Adult: immune at 2-8°C. Tissue 5-10 ml antibodies Serum: 1-3 ml
Triptase Private Laboratory (Serum)
Pathology Dept,Pathology
Thrombophilia Active Plasma Trisodium 6 tubes Hema- Pusat Form: National Blood Centre Screening citrate 3.2% to fill until tology Darah Haematology / Serology a) Antithrombin indicated Negara Request Form with relevant
Hospital Handbook Taiping Laboratory 2018 Activity mark clinical history to be signed b)Protein C by attending physician. Activity c)Protein S Activity d)Free Protein S e)Lupus Anticoagulant
Trypanoso Active Cerebrospinal Slide Mailer NA 3 days Parasi- IMR Send Cerebrospinal fluid miasis fluid, Thick blood or Sterile air tology within 24 hours in ice. Diagnosis - film, Lymph tight lid
Microscopy node film container Trypanoso Active Serum, Blood Plain tube 2 ml 5 days Parasi- IMR Keep and transport specimen miasis tology at 2-8°C. Diagnosis- Serology
OutsourceService
OutsourceService
Trypanoso Active Whole blood in EDTA tube, 2.5ml 7 days Parasi- IMR Keep and transport specimen
miasis EDTA, skin / filter paper tology at 2-8°C. Diagnosis tissue scrappings Diagnosis - PCR Tryptase Active Blood/ Serum Plain tube Blood: 3 ml 14 days Allergy IMR Tryptase test: Within 15 min
Pathology Dept, Serum: 0.5 ml up to 24 hr after onset of allergic symptoms; Tryptase test after anaphylaxis: 1st sample within 15 min up to 3 hrs after onset of symptoms,
Hospital Taiping L 2nd sample after 24-48 hrs to confirm return to baseline level, 3rd sample after 1-2 wks if incidents of mastocytosis or other causes
a of elevated basal levels are
boratory Handbookboratory 2018 suspected UR Active Urine Urine 5 mL 1 day Bio- HRPB Cop and sign specialist. Microalbumin/ container chemistry Microalbumin-First morning Creatinine Ratio urine (preferred). Random urine is acceptable if a first- morning urine is not available.
Urine Cysteine Active Urine Urine 5 mL 7 days Pediatric HKL Form: PER.PAT 301. container Laborator y
Urine for fat Private Laboratory globulin
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Urine Active Fresh urine Clean 5 mL 5 days Bio- IMR Form: PER.PAT 301 Hemoglobin universal chemistry Transport in ice. (HB) bottle
Urine Active Fresh urine Clean 5 mL 5 days Bio- IMR Final concentration.
Myoglobin universal chemistry (Qualitative, if quantitative, bottle need to send H. Ampang but
Pathology Dept,Pathology got special requirement for specimen taking). Urine Active Urine Sterile 5 mL Toxicology Jabatan Form: Pemeriksaan Forensik/ Toksikologi Container Kimia, Ipoh Toksikologi. Sign & stamp of requesting DR must be clear.
Hospital Handbook Taiping Laboratory 2018
Vancomycin Active Bacterial culture Pure isolate Pure isolate 7 days Bacteri- IMR Send pure isolates with resistant ology clinical history. Enterococci (VRE) Isolate Confirmation & AST Verification Varicella Zoster Active Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice. Virus (VZV) / Herpes Zoster - Antigen Detection
(IFAT) or Chickenpox Varicella Zoster Discontinued Blood Plain tube 3-5 ml 14 days Virology HKL Room temp. or in ice. Virus (VZV) / Herpes Zoster - IgG ELISA or Chickenpox
OutsourceService
OutsourceService
Varicella Zoster Discontinued Smears on slide Plain Sterile - 7 days Virology HKL Packed with ice.
Virus (VZV) / container Herpes Zoster - IgM ELISA or Chickenpox Vasopressin Private Laboratory (Serum)
Pathology Dept,
Vibrio cholerae Active Bacterial culture Nutrient agar Pure isolate 2 months Bacteri- IMR PFGE will be done for slant ology outbreak cases only.
Hospital Taiping L
Viral PCR Active Blood/serum, TS, Sterile screw 1-3 ml serum 7 days Virus MKAK 1) Specimen should be Stool/RS, Vesicle capped 1ml Isolation collected < 5 days after onset Swab*, CSF*, container / CSF/BAL/TA / Unit of illness. Broncho-alveolar Swabs should Organ 2) A brief concise history of
a boratory Handbookboratory 2018 lavage be put into biopsies: illness and physical findings (BAL)/Tracheal 1.5-2 ml of 1.5cm cube in is required especially the aspirate (TA)* VTM a date of onset of illness and (*when clinically few drops of date of specimen collection. indicated), VTM. 3) Keep and transport Tissue specimen at 2-8°C. biopsies (cardiac,
liver, lung, brain stem etc) Vitamin B1 Private Laboratory (Serum) (Thiamin)
Vitamin B12 Private Laboratory (Serum) (Cobalamin)
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Vitamin B3 Private Laboratory (Serum)
Vitamin B6 Private Laboratory (Serum) (Pyridoxin)
Vitamin D Active Blood Plain tube 3 mL Endo- Hospital Form: PER.PAT 301 crinology Putrajaya Cop and sign specialist.
Pathology Dept,Pathology Complete with diagnosis &
clinical history.
Hospital Handbook Taiping Laboratory 2018
Vitamin E Private Laboratory (Serum)
Von Willebrand Active Plasma Trisodium 3 tubes fill Hema- Pusat a) Form: National Blood Factor Assay citrate 3.2% until tology Darah Centre Haematology / a)VWF Antigen indicated Negara Serology Request Form with
b)VWF Activity mark relevant clinical history to be c)VWF : Ricof signed by attending d)Collagen physician.
Binding Assay (CBA)
OutsourceService
OutsourceService
West Nile Virus Active Serum, CSF, After After 1 -10 days Virology IMR After consultation only.
Nucleic Acid Organ biopsies consultation consultation only only
Pathology Dept, Yellow Fever Active Serum, Tissue After After 1 -10 days Virology IMR After consultation only. Nucleic Acid Biopsy consultation consultation only only
Zika Nucleic Active i) Serum i) Blood: Plain i) Blood: 1 -10 days Virology IMR Keep all specimens at 2-8'C
Hospital Taiping L Acid (only for ii) Urine tube with gel Minimum and transport immediately in microcephaly iii) Tissue separator 5ml ice. and GBS) iv) CSF ii) Urine: ii) Urine: v) Seminal Fluid Sterile Minimum vi) Vaginal universal 10ml a Secretion container iii) CSF: 1ml
boratory Handbookboratory 2018 vii) Amniotic iii) Tissue: iv) Vaginal Fluid Sterile secretion: container Swab in VTM containing v) Amniotic VTM to keep fluid: 2ml tissue moist iv) CSF: Bijoux
sterile tube v) Vaginal secretion: Swab vi) Amniotic fluid: Bijoux sterile tube
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Zika RT-PCR Active Serum/ Urine Plain sterile Not 1 day Micro- HRPB Inform microbiology lab in container Applicable biology HRPB before taking blood. Stamp & sign by Specialist.
Zinc Active Blood Plain tube 3 mL Toxicology Jabatan Form: IEM Request Form.
Kimia, Ipoh Sign & stamp of requesting DR must be clear.
Pathology Dept,Pathology
Hospital Handbook Taiping Laboratory 2018
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Outsource Service 196
5. REPORTING AND DESPATCHING OF RESULTS
1. All the results from Chemistry, Hematology and Microbiology Unit will be enveloped according to the requesting hospital/clinic. Reports for HIV, HEPB, HEPC & VDRL will be sealed in envelope.
2. The results will be recorded inside the dispatch book and kept till collected by the district hospital/health clinic.
3. Personnel from district hospital/health clinic collect the results and acknowledge by signing in the dispatch book.
6. RETENTION PERIOD OF SPECIMENS AND RESULTS/REPORTS
1. Soft copy of the consignments and results of the outsourced sample will be backed up every week in hard-disk.
2. Hard copy of the consignments sent kept in file for 1 year.
Pathology Dept, Hospital Taiping, Laboratory Handbook 2018
Appendix 198
APPENDIX 1
PER-PAT 301 FORM
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 199 Appendix
APPENDIX 2
PREPARATION OF THICK BLOOD SMEAR
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 200
APPENDIX 3
HISTOPATHOLOGY FORM HOSP TAIPING (HTPG/JP/03/04)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 201 Appendix
APPENDIX 4
CRITICAL FINDINGS FOR ANATOMICAL PATHOLOGY
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 202
APPENDIX 5
BORANG PERMOHONAN PAP SMEAR ((PS 1/98 PINDAAN 2007))
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 203 Appendix
APPENDIX 6
HEMATOLOGY/SEROLOGY REQUEST FORM PDN (PDN/HA/QP-01/01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 204
APPENDIX 7
GUIDELINES FOR SAMPLE COLLECTION
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 205 Appendix
APPENDIX 8
BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI JABATAN KIMIA (KIMIA 15-Pin. 1/2004) PAGE 1
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 206
APPENDIX 9
BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI JABATAN KIMIA (KIMIA 15-Pin. 1/2004) PAGE 2
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 207 Appendix
APPENDIX 10
LABORATORY REQUEST FORM FOR DENGUE AND FLAVIRUS (MKAK – BPU – D02)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 208
APPENDIX 11
MEASLES-BORANG PERMOHONAN DAN KEPUTUSAN UJIAN MKAK SG. BULOH (MKAK – MSLF 01/2004)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 209 Appendix
APPENDIX 12
MKAK REQUEST FORM (MKAK-BPU-U01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 210
APPENDIX 13
LAB REQUEST FORM FOR SUSPECTED CASE OF SWINE INFLUENZA (KKM/BKP/H1NI/2009/3)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 211 Appendix
APPENDIX 14
NATIONAL ENTEROVIRUS SURVEILLANCE FORM (MKAK – BPU U01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 212
CYTOGENETICS REQUEST FORM HKL (HKL/HA/TPM/N-1-(1)) PAGE 1 APPENDIX 15
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 213 Appendix
APPENDIX 16
CYTOGENETICS REQUEST FORM HKL (HKL/HA/TPM/N-1-(1)) PAGE 2
APPENDIX 17
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 214
REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 1
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 215 Appendix
APPENDIX 18
REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 2
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 216
APPENDIX 19
REQUISITION FOR MOLECULAR DIAGNOSTICS SERVICES IMR (IMR/SDC/UMDP/MOLDX/REQUEST FORM) PAGE 3
APPENDIX 20
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 217 Appendix
REQUEST FORM AIRC IMR (IMR/AIRC/PID/RF)
APPENDIX 21
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 218
AIRC GUIDELINES
APPENDIX 22
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 219 Appendix
BONE MARROW CYTOGENETICS FORM IMR
APPENDIX 23
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 220
DNA ANALYSIS FOR THALASSEMIA SYNDROMES IMR (IMR/CaRC/HAEM/22/2203/03(1)/REQForm) PAGE 1
APPENDIX 24
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 221 Appendix
DNA ANALYSIS FOR THALASSEMIA SYNDROMES IMR (IMR/CaRC/HAEM/22/2203/03(1)/REQForm) PAGE 2
APPENDIX 25
CONGENITAL HYPOTHYROIDISM CORD BLOOD SCREENING TEST
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 222
APPENDIX 26
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 223 Appendix
TDM REQUEST FORM
APPENDIX 27
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 224
BORANG PERMOHONAN UJIAN TIBI MKA (TBIS 20C)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 225 Appendix
APPENDIX 28
THERAPEUTIC DRUG MONITORING REQUEST FROM HKL (HKL/JPDR/AK-07-01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 226
APPENDIX 29
HLA TYPING TEST REQUEST FORM IMR (IMR/AIRC/TI/RF-2)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 227 Appendix
APPENDIX 30
HOSPITAL AMPANG SPECIAL HEMATOLOGY REQUISITION PAGE 1 (HA.HEMA 2017)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 228
APPENDIX 31
HOSPITAL AMPANG SPECIAL HEMATOLOGY REQUISITION PAGE 2 (HA.HEMA 2017)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 229 Appendix
APPENDIX 32
TORCHES PROGRAMME
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 230
APPENDIX 33
IEM REQUEST FORM IMR (IMR/SDC/BC/FORM-RQ) PAGE 1
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 231 Appendix
APPENDIX 34
IEM REQUEST FORM IMR (IMR/SDC/BC/FORM-RQ) PAGE 2
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 232
APPENDIX 35
ACUTE FLACCID PARALYSIS FORM
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 233 Appendix
APPENDIX 36 BRUCELLOSIS LAB0RATORY REQUEST FORM IMR (IMR/IDRC/BACT/BRUCE/01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 234
APPENDIX 37
PERKHIDMATAN GENETIK & METABOLIK HKL (HKL/JG/MG/IEM/PK-01-01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 235 Appendix
APPENDIX 38
HIGH RISK SCREENING FOR POMPE IMR
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 236
APPENDIX 39
MERCOV REQUEST FORM IMR & MKAK
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Pathology Dept, Hospital Taiping Laboratory Handbook 2018 237 Appendix
APPENDIX 40
BORANG PERMOHONAN UJIAN MAKMAL HFMD MKAK
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 238
APPENDIX 41
LEPTOSPIROSIS LABORATORY REQUEST FORM (IMR/IDRC/BACT/LEPTO/01)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 239 Appendix
APPENDIX 42
REQUEST FORM FOR MULTIPLE MYELOMA AND SPECIFIC PROTEINS IMR (IMR/SDC/UMDP/PROTEIN/REQUEST FORM)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 240
UJIAN SEROLOGI BAGI PENYAKIT HIV IMR (IMR/VIRO/HIV/1) APPENDIX 43
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 241 Appendix
APPENDIX 44
UJIAN POLYMERASE CHAIN REACTION (PCR) UNTUK HIV DI KALANGAN BAYI (IMR/VIRO/HIV/2)
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 Appendix 242
APPENDIX 45
BORANG PERMINTAAN UJIAN PENGESAHAN DADAH (UPD-1 (PINDAAN 2))
Pathology Dept, Hospital Taiping Laboratory Handbook 2018 243 Appendix
APPENDIX 46
BORANG PERMINTAAN UJIAN PENGESAHAN DADAH (UPD-1 (PINDAAN 2))
Pathology Dept, Hospital Taiping Laboratory Handbook 2018