UCSF Navigation Bar

UCSF Departments of Pathology & Laboratory Medicine Home Page

Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

Internal Resources

Emergency (STAT) Services and Tests



  1. AVAILABILITY AND EXPECTED TURNAROUND TIMES (TAT)

Specified STAT services are available at all times. Any test not specifically listed in the following table requires prior approval by a Laboratory Medicine Resident for STAT analysis.


  1. DEFINITIONS

STAT laboratory tests and services are those that are needed immediately in order to manage medical emergencies. STAT test requests are given the highest priority by the Clinical Laboratory for processing, analysis and reporting. If less urgent tests are also ordered STAT, a backlog may develop and each specimen will be processed in order of receipt, thereby delaying the reports for true emergencies.


A CRITICAL laboratory test is a test that is vital to patient management, requiring adherence to a defined rapid turnaround time from test ordering to results reporting. Results are reported to a responsible, licensed care giver.


A critical laboratory test is distinguished from a CRITICAL VALUE or CRITICAL RESULT, which is defined as a test result that exceeds reference limits to an extreme degree that may indicate a life-threatening condition. See below, Reference Ranges and Critical Values, for a complete list of defined critical values that trigger efforts to report immediately upon identification of a critical result.


  1. PROCEDURE

Each test on the requisition and the biohazard bag containing the specimen must be marked “STAT.” In unusually critical circumstances, it is best to hand deliver the specimen to the laboratory.


  1. DELIVERY OF SPECIMENS TO LABORATORY

Messenger Service: The messenger service pickup schedule is listed under the Delivering Specimens section of this manual. STAT specimens and specimens collected when regular messenger service is unavailable must be delivered by a ward employee, physician or special messenger.

NOTE: In order to ensure STAT processing, STAT specimens must be delivered to the STAT window. The Laboratory cannot guarantee STAT processing for STAT specimens dropped off at the ROUTINE window.


  1. REPORTS:

STAT results will be telephoned to any patient-care unit lacking a computer terminal. A written record of test results telephoned to patient care areas must be made by the physician, nurse or other individual who receives the report. “Read-back” (with confirmation) of all critical results (including both stat and critical values) reported verbally or by telephone is required to verify values and assure accuracy, in accordance with Joint Commission’s National Patient Safety Goals.

For further information about specific tests, call Clinical Laboratory General Information, 206-8590.


DEFINED EMERGENCY (STAT) TESTS

The tests listed below are available 24 hours a day on a priority basis, with minimum delay, after receipt in the Laboratory. Refer to the Microbiology Procedure section for information about Microbiology (STAT) Tests. If test results fall in the critical range, the results will be called to the ordering physician or patient care unit immediately.


* ND = Turn Around Time (TAT) Not Defined

EMERGENCY (STAT) TESTS

LABORATORY

Pneumatic tube station #

TAT

Acetaminophen (Tylenol)

Clinical Chemistry

21

1 hour

Acute Stroke Coagulation Panel (ASCP)

Hematology

21

30 mins

Albumin

Clinical Chemistry

21

1 hour

Ammonia (on ice)

Clinical Chemistry

21

1 hour

Antibody Screen

Blood Bank

22

ND

Arterial blood gases

Hematology

Do not tube

30 mins

B-type natriuretic peptide (BNP)

Clinical Chemistry

21

1 hour

β-hydroxybutyrate

Clinical Chemistry

21

1 hour

Bilirubin

Clinical Chemistry

21

1 hour

Blood urea nitrogen (BUN)

Clinical Chemistry

21

1 hour

Calcium

Clinical Chemistry

21

1 hour

Calcium, ionized

Hematology

Do not tube

30 mins

Carbamazepine (Tegretol)

Clinical Chemistry

21

1 hour

Carbon Dioxide (Electrolytes)

Clinical Chemistry

21

1 hour

Cell Count:
(CSF & body fluids with diff)

Hematology

Do not tube

ND

Chloride (Electrolytes)

Clinical Chemistry

21

1 hour

Complete Blood Count:
(WBC, RBC, HGB, HCT, RBC indices & PLT)

Hematology

21

45 mins

Cooximetry

Hematology

Do not tube

ND

Cortisol

Clinical Chemistry

21

1 hour

Creatinine

Clinical Chemistry

21

1 hour

Crossmatch

Blood Bank

22

ND

Cryptococcal Antigen

(CSF only )

Microbiology

Do not tube

2 hours

Digoxin

Clinical Chemistry

21

1 hour

Dilantin (Phenytoin)

Clinical Chemistry

21

1 hour

Direct Antiglobulin (Coombs)

Blood Bank

22

ND

Electrolytes:
Serum/Heparinized plasma

Clinical Chemistry

21

1 hour

Ethanol

Clinical Chemistry

21

1 hour

Ethylene glycol

Clinical Chemistry

21

ND

Fibrinogen

Hematology

21

1 hour

Gentamicin

Clinical Chemistry

21

1 hour

Glucose, fasting or random (serum, plasma)

Clinical Chemistry

21

1 hour

Glucose, CSF

Clinical Chemistry

Do not tube

1 hour

Gram Stain

Microbiology

Do not tube

ND

HCG

Clinical Chemistry

21

1 hour

Influenza A and B viral antigen

Microbiology

Do not tube

2 hours

Iron

Clinical Chemistry

21

1 hour

Lactate (on ice)

Clinical Chemistry

Do not tube

1 hour

Lithium

Clinical Chemistry

21

1 hour

Magnesium

Clinical Chemistry

21

1 hour

Malaria Smear (Blood parasites exam)

Microbiology

21

ND

Metabolic Panel, Basic

Clinical Chemistry

21

1 hour

Methanol

Clinical Chemistry

21

ND

Osmolality (serum, urine)

Clinical Chemistry

21

1 hour

Phenobarbital

Clinical Chemistry

21

1 hour

Phenytoin (Dilantin)

Clinical Chemistry

21

1 hour

Phosphorus

Clinical Chemistry

21

1 hour

Potassium (Electrolytes)

Clinical Chemistry

21

1 hour

Pregnancy test (urine)

Hematology

21

ND

Protein, CSF Screen

Clinical Chemistry

Do not tube

1 hour

Prothrombin Time (PT)

Hematology

21

1 hour

RSV antigen on children < 5 years old

Microbiology

Do not tube

1 hour

Salicylate (Aspirin)

Clinical Chemistry

21

1 hour

Sodium (Electrolytes)

Clinical Chemistry

21

1 hour

Strep Group A Antigen (Throat Swab)

Microbiology

Do not tube

1 hour

Theophylline

Clinical Chemistry

21

1 hour

Tobramycin

Clinical Chemistry

21

1 hour

Troponin

Clinical Chemistry

21

1 hour

Type and Screen

Blood Bank

22

ND

Uric Acid

Clinical Chemistry

21

1 hour

Urinalysis

Hematology

21

ND

Valproic Acid

Clinical Chemistry

21

1 hour

Vancomycin

Clinical Chemistry

21

1 hour




DEFINED CRITICAL TEST(S)



The test(s) listed below are identified are as vital to patient management. Adherence to a defined rapid turnaround time from time of order to result, and immediate reporting of critical test result(s) to a responsible licensed care provider is required.



Critical Test

LABORATORY

TAT (Receipt - Result)

TAT (Order - Result)

Intraoperative Parathyroid Hormone

Clinical Chemistry

30 mins

45 mins

UCSF home page UCSF home page About UCSF Search UCSF UCSF Medical Center