DEPARTMENT SERVICES

BLOOD BANK

o      Blood Typing

●      ABO – Typing

●      Rh – Typing

●      Du – Typing

o      Anti – Globulin Test (Coomb’s Test)

●      Direct – Anti – Globulin Test

●      Indirect Anti – Globulin Test

o      Provision of Blood and Components

●      Donor – phlebotomy

●      Donor – unit Testing for Transfusion – Transmitted Diseases

●      Component Processing

□      Packed red blood cells

□      Platelet concentrates

□      Fresh frozen plasma / Frozen plasma

□      Washed red blood cells

●      Cross – matching

●      Transfusion – reaction investigation

Patient preparation for Blood Bank procedures:

In general, minimal patient preparation is required for the various tests offered by the Blood Bank. For donors, although a 3 – 4 hour fast prior to phlebotomy is advised to maximize use of plasma, meal intake per se is not a reason for deferral of donation.

Whole blood specimens are most acceptable in red – top tubes, although occasionally lavender–top tubes are also used. For inquires regarding specimen handling, you may call the Blood Bank at (02) 528–8106.

CLINICAL CHEMISTRY

o      Blood Chemistries:

●      FBS

●      RBS

●      OGTT (100 grams) (75 grams)

●      OGCT

●      Post- Prandial Blood Sugar

●      HbA1c

●      Triglycerides

●      Cholesterol

●      HDL, LDL, VLDL

●      BUN

●      Creatinine

●      Uric Acid

●      Sodium (Na)

●      Potassium (K)

●      Chloride (Cl)

●      Magnesium (Mg)

●      Calcium (Ca- Total)

●      Inorganic Phosphorus

●      Ammonia

●      Total Protein/AG ratio

●      Albumin

●      Globulin

●      SGOT/AST

●      SGPT/ALT

●      Bilirubin

●      GGT

●      LDH total

●      Alkaline Phosphatase

●      Acid Phosphatase

●      Amylase

●      Lipase

●      CPK

●      CK – MB Mass

●      TROP I (Qualitative)

●      TROP I (Quantitative)

●      Troponin T

●      Myoglobin

●      Serum Iron

●      Serum TIBC

●      hs CRP

o      24 Hours Urine Collection Test

●      Total Protein

●      Sodium (Na)

●      Potassium (K)

●      Calcium (Ca)

●      Creatinine Clearance

●      Glucose

●      Creatinine

●      Uric Acid

●      Urea

●      Phosphorus

●      Magnesium

●      Amylase         

o      Other Body Fluids (CSF, Synovial, Pleural, Others)

●      Sugar

●      Protein

●      LDH                                           

o      Other Tests:

●      Micral Albumin (Micral Test)

●      Stone Analysis

●      Random Urine:

□      Soduim (Na)

□      Potassium (K)                        

Procedures for Clinical Chemistry:

1                Fasting from food from eight (8) hours to twelve (12) hours is required for various tests (check with Medical Technologist on duty).

2                Timed twenty-four (24) Hour Volume: for accurate quantitative results, chemical testing.

2.1               Ask Patients to avoid at the start of 24-hour timed urine specimen collection.

(e.g. 7:00 AM) Discard this first specimen and note the time.

2.2               Collect all urine voided at the end of the 24-hour period in a clean, properly capped bottle/container. It is not necessary to measure the volume of individual voiding unless specifically ordered.

2.3               Let patient void at the end of the 24-hour period.

(e.g. 7:00 AM) To conclude the collection. Add Urine from this last voiding to the specimen in the container.

2.4               Refrigerate collection bottle after patient has voided or place it in an iced container.

2.5               Transport bottle of urine sample immersed in ice and send to the laboratory as soon as collection is finished, preferably within one (1) hour after collection is finished.

2.6               Bring patient to the laboratory for blood extraction if blood sample is required for the procedure.

(e.g. Creatinine Clearance)

CLINICAL MICROSCOPY

o      Routine Urinalysis

o      Sugar Albumin

o      Acetone / Ketone

o      Specific Gravity

o      Pregnancy (Urine/Serum)

o      Semen Analysis

o      Bence Jones Protein

o      Routine Fecalysis

o      Occult Blood

o      Bilirubin (Qualitative)

o      Urobilinogen (Qualitative)

o      E. Histolytica Antibody Test (ELISA)

o      Apt’s Test

o      H. pylori (stool)

o      Merthiolate – Iodine – Formaline (MIF)

o      Stool Concentration Methods

o      ZnSO4

Procedures for Clinical Microscopy:

1                Procedures for Collecting Urine Specimens

1.1               Clean – Catch (Midstream) Urine: For random collection and bacterial culture

1.1.1             Clean genital (Urethral) area with soap and water.

1.1.2             Rinse well

1.1.3             Begin voiding. At midstream, collect about five milliliters (5 ml.) of urine in a clean dry container.

1.1.4             Cover specimen container tightly, label properly and send immediately to the laboratory.

1.2               Urine of Infants

1.2.1             Attach a disposable collection apparatus (plastic bag with adhesive backing) to the perineal area or around the penis to allow voiding directly into the bag.

1.2.2             Carefully remove specimen bag and transfer urine in an appropriate container (Sterile Container with Tight Fitting Lids for Culture Studies)

1.3               First Morning Urine Specimen: Best for nitrate, protein, pregnancy tests, microscopic examination and routine screening.

1.4               Random Urine Specimen: For chemical screening, routine screening, and microscopic examination.

1.5               Second (Double – Voided) Urine: For diabetic monitoring, usually collected after fasting.

1.5.1             Discard the first morning urine specimen.

1.5.2             Collect the second urine specimen for testing.

1.6               Postprandial Urine: For glucose determination, diabetic monitoring.

1.6.1             Collect sample urine two hours after a meal.

2                Semen Analyses:

2.1               Collection of specimen should be done preferably after at least four (4) to seven (7) days of sexual abstinence

2.2               Collection is by self – production and should be done in the men’s room of the laboratory.

2.3               The patient should note the time of the first emission.

2.4               Patient is instructed to collect the whole volume of the specimen in a container provided by the laboratory.

2.5               Specimen collected should be submitted immediately to the medical technologist on duty.

DRUG TESTING LABORATORY

Office hours are from 8:00 AM to 4:00 PM Mondays to Saturdays.

Please note that the patient should present a valid identification card before he or she is accepted for testing. It is illegal for the laboratory to do otherwise.

The following are the list of examinations that are performed in this section:

o         Amphetamine / Methamphetamine

o         Marijuana (Tetrahydrocannabinol or THC)

o         Opiates

HEMATOLOGY

o      Complete Blood Count (CBC) – Includes Hemoglobin, Hematocrit, RBC count, WBC count, Differential count, Platelet estimate

o      Hemoglobin

o      Hematocrit

o      Platelet count

o      Hematocrit and Platelet count

o      Reticulocyte Count

o      WBC Count (Total/ Differential Count)

o      RBC Indices: MCV, MCH, MCHC

o      Peripheral Blood Smear

o      Malarial Parasite Examination (Manual/Immunologic)

o      LE Preparation

o      Ham’s Test (Acidified Serum test)

o      Sugar Water Test (Sucrose Hemolysis Test)

o      Bleeding Time (Duke)

o      Bleeding Time (Ivy)

o      Lee and White Clotting Time

o      Prothrombin Time (PT)

o      Activated Partial Thromboplastin Time (APTT)

o      PTT with mixing test

o      Clot Retraction Time (CRT) Clot Retraction Time

o      D-Dimer

o      Examination of CSF and other Body Fluids

o      Crystals in Synovial Fluid

Procedures for Hematology:

1.              Results will be available at the computer terminal at the nurse’s station three (3) hours after the receipt of specimen in the laboratory.

2.              The computer print outs will be delivered in the respective floor within the day.

3.              Results of STAT request are ready 1-1/2 hours after receipt. Printouts will be delivered as soon as available.

4.              Request from Special Areas such as ICU, ER, NICU, OR and DR are considered as STAT request.

5.              Examinations such as peripheral smears and malarial identification with parasite count will be available within twenty-four (24) hours after submission of sample.

                  Time of Specimen Receipt                    Releasing of Results

                  05:00 AM to 07:00 AM                               10:00 AM

                  08:00 AM to 10:00 AM                               01:00 PM

                  10:00 AM to 12:00 Noon                            04:00 PM

                  01:00 PM to 03:00 PM                               06:00 PM

IMMUNOLOGY AND SEROLOGY

o      ASO Titer

o      Protein C

o      H. Pylori Test

o      RA / RF Test

o      RPR

o      HIV (AIDS) Test

o      ANA Screen

o      Antibodies Against:

●      DSDNA

●      Sm

●      SSAa / Ro

●      SSB / La

●      RNP

●      Jo – 1

●      Scl – 70

●      Centromere

o      Hepatitis Tests

●      Hbs Ag

●      Hbe Ag

●      Anti – HBs

●      Anti – Hbe

●      Anti – HBc IgM

●      Anti – HBc total

●      Anti – HCV

●      Anti – HAV IgM

●      Anti – HAV total

o      Tumor Markers

●      AFP

●      CA – 125

●      CA – 19-9

●      CA – 15-3

●      Others

o      Therapeutic Drugs

●      BNP

●      Phenytoin

●      Phenobarbital

●      Digoxin

●      Valproic Acid

Procedures for Hematology:

1.              Tests are performed daily from Mondays to Saturdays unless otherwise specified. Results of specimens received by the laboratory by 10:00 AM are available by 3:00 PM of the following day. Otherwise, the results will be ready by 3:00 PM of the following day.

2.              HIV tests are done daily from Mondays to Fridays only. Result of specimen’s received by 12:00 Noon are available by 3:00 PM of the same day.

3.              Allergy testing is performed only on Mondays. Results of specimen received by 10:00 AM are available by 3:00 PM of the same day.

4.              Anti-Nuclear Antibody (ANA) Screen and LE Panel tests are run every Tuesdays, Thursdays and Saturdays only. Results of specimen received by 10:00 AM are available by 3:00 PM of the same running date.

Time of Specimen Receipt           Releasing of Results

05:00 AM to 07:00 AM                   10:00 AM

08:00 AM to 10:00 AM                   01:00 PM

10:00 AM to 12:00 Noon                04:00 PM

11:00 PM to 03:00 PM           06:00 PM

MICROBIOLOGY

o      Culture and Sensitivity

●      Bacterial (Aerobic and Anaerobic)

●      Fungal

●      Others

o      Smear/Stain

●      AFB Stain

●      Gram’s Stain

●      Giemsa Stain

●      India Ink Stain

●      KOH

●      Tzank’s smear

●      Others

o      Wet Mount

●        Trichomonas, Monilia, Gardnerella

●        Others

o     Antibody Detection Test

●        Cytomegalovirus IgM / IgG

●        Dengue IgM / IgG

●        Herpes IgM / IgG

●        TORCH 1

●        TORCH 2

●        TPHA (Qualitative/Quantitative)

●        Rubella titer (Rubagen)

●        Toxoplasma IgM/IgG

●        Salmonella EIA (Typhidot)

●        Leptospira

●        Others

o      Antigen Detection Test

●      Cryptocaccal Antigen (CALAS)

●      Latex Agglutination Test (Wellcogen / Phadebact)

●      Chlamydia Trachomatis

●      Others

Procedures for Microbiology

1.              Sputum Collection: For Gram Stain, AFB Stain, and Culture.

1.1.            Early morning sample is the ideal specimen to be collected.

1.2.            Remove dentures, if any.

1.3.            Rinse mouth with water and gargle, if possible.

1.4.            Patient should first clear nose and throat, take three (3) to four (4) deep breaths,  follow with a series of short coughs, then inhale deeply and cough forcefully to raise a sputum specimen.

1.5.            Expectorate the sputum in a sterile capped container. A one (1) to two (2) milliliters (ml) sample is adequate.

1.6.            Sample should be taken to the laboratory as soon as possible, preferably within one (1) hour after collection.

2.              Results of Gram Stain, KOH, Wet Smear, Tzank’s Smear, Dengue IgM and IgG, Salmonella EIA IgM and IgG, Phadebact, CALAS, Chlamydia, AFB, Giemsa Stain, and India Ink will be ready 1:00 PM of the same day if the specimen is submitted by 10:00 AM. Second batch of test results of specimens will be available by 1:00PM the following day if samples are submitted after 12:00 PM.

3.              Results of STA request for various smears and test will be released after 1 – 1 ½ hours except for Salmonella testing.

4.              Results of TORCH test will be available after three (3) days.

5.              Bacterial Cultures.

5.1.            Cultures of body fluids such as urine, stool, and other exudates are available after 5 days.

5.2.            Blood culture will have final results after five (5) days.

5.3.            Anaerobic cultures are ready in seven (7) days.

6.              Fungal Cultures

6.1.            Results are available after twenty-one (21) days. However, one can inquire regarding the preliminary reports of these various cultures after twenty-four (24) hours of submission as they are checked daily.

SURGICAL PATHOLOGY (HISTOPATHOLOGY) SECTION

This section is open for queries during office hours from 8:00 AM to 4:00 PM.

Receiving of specimens and releasing of results are entertained at the Laboratory Information Counter twenty-four (24) hours a day and seven (7) days a week.

The following are the list of examinations that are performed in this section:

o      Routine Histopathology

o      Frozen Section

o      Cytology

●      Cervicovaginal Smear (Papsmear)

●      Fine Needle Aspirate

●      Body Fluid Cytology

o      Slide Review

o      Immunohistochemistry

●      ERA (Estrogen Receptor Assay)

●      PRA (Progesterone Receptor Assay)

●      HER – 2 / neu

o      Autopsy

●      Complete

●      Partial

Procedures for Surgical Pathology (Histopathology) Section:

1.              Routine Histopathology

1.1.            Specimens for routine tissue processing should be immersed in 10% Neutral Buffered formalin (volume of fixative should be at least 20 times the volume of the specimen).

1.2.            The specimen container should be properly labeled with the patient’s name, the requesting physician, room number, and the specific type or name of the specimen submitted.

1.3.            The specimen should be accompanied by a properly filled-up Histopathology Request Form.

2.              All frozen section procedures and CT Scan/Ultrasound guided Biopsy procedures should be scheduled one (1) day prior to the contemplated operation or radiographic examination. Any procedure scheduled two (2) hours before is considered as STAT request and appropriate fees will be charged.

3.              Body fluids for cytology are submitted within an hour after collection.

4.              Cases read from other institutions can be referred for second opinion known as slide review. The slide(s) and/or paraffin block(s) can be submitted together with the Histopathology/Cytology Report. The slide(s) and/or paraffin block(s) are returned when the patient claims the Slide Review Report.

5.              Immnuhistochemical Staining (ERA, PRA and Her-2/Neu Receptor Assays) are done every Thursday provided that the slide and paraffin block are submitted before 12:00 Noon on Wednesday of the same week.

6.              Autopsies are done within office hours (8:00 AM – 4:00 PM) everyday except Sundays and Holidays.

7.              Results

7.1.            Surgical Pathology (Including frozen sections) reports are available after three to four working days of specimen submission in Histopathology.

7.2.            Cytology Reports (cervico-vaginal pap smear, FNA samples) without cell block are usually ready after two working days upon receipt of the specimen.

7.3.            Requests for cytology with cell block have results ready after three to four working days upon receipt of specimen.

7.4.            Immunohistochemistry Staining (ERA, PRA and HER-2/Neu Assay) are released Mondays following the running week. If retesting is needed, the patient or the doctor will be notified.

7.5.            A final autopsy report is available two weeks after the autopsy and completion of autopsy requirements unless special tests are needed that will take more than two weeks to complete the report.

8.              All report generated in the Section of Histopathology are considered confidential.

9.              A representative can claim the patient’s report provided that an authorization letter from the patient and the patient’s identification card are shown.