Add On Tests General Criteria and Information
All add on tests must be on samples taken from the patient in the previous 72 hours
Procedure for requesting Add-On Tests Electronically
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Using i-Care, medical staff should select the patient for whom they wish to add-on a test.
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Expand the ‘Services’ folder on the left hand side of the screen and click on the link:
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View/create Pathology add on test
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If any add on tests have already been requested they will be listed here.
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Click the add new test link in the top right hand corner.
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Complete the form: date of sample, time of sample and test(s) are mandatory fields.
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Once the form is complete click the Submit button.
1. Requesting add on tests manually
This procedure must be followed when i-Care is unavailable (and for GHH requests) : Users are instructed via the Laboratory Medicine website (www.heftpathology.com) to complete the normal Combined Pathology request form in the usual way. The comment ‘Add-on request’ is added to the form and sent to the laboratory through the usual system. The form must be signed by a clinician – tests will not be added without a signature. In these instances the clinician will be informed, preferably by telephone. If this is not possible, then a Problem set (PRBLM) is added and a report issued with the comment ‘Add on test request not signed by clinician’.
If a test is required urgently, the requesting clinician should telephone the appropriate laboratory to alert staff as well as carrying out the requesting procedure . Laboratory staff should add a notepad message recording the name of the clinician making the verbal request.
Requests for additional tests from General Practice and other external users can be made by telephone.
Biochemistry Tests
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Criteria
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Action/ Analyte
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Samples normally received on ice
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No add ons
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Samples normally separated immediately
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No add ons
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Samples with limited stability
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Bicarbonate, LDH, Folate
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Tests which MUST NOT be added more than 8 hours after collection
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PTH (EDTA sample required)
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Tests which can only be added to a sample received within 4 hours of collection
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Glucose (serum)
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Tests which can only be added on to samples protected from light
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D Bilirubin
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Analyte unstable once samples stored at 2-8 oC
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Bicarbonate, LDH
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Tests which MUST NOT be added to AE/AMU samples
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Thyroid (TSH, FT4 or FT3)
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Samples greater than 72 hours old
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All other general chemistry tests may be added
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Immunology Tests
Tests which cannot be added ;
Tryptase, CH50, FCIN. Cryoglobulin – needs special collection conditions.
Haematology tests
Tests may be added on to the appropriate sample type if there is sufficient volume available. Generally Coagulation tests (INR, APTT and Fibrinogentest) can be added on only within 8 hours to a Citrate sample. Retics may be added to an EDTA sample within 12 hours and ESR within 24 hours of sample draw time. For all other tests, please consult the laboratory.
Microbiology requests
Microbiology requests cannot be dealt with via the Pathology ‘add-on’ facility. Microbiology require a separate, signed request for their tests. We can however provide sample for completion of these tests where a suitable specimen is available. Please contact Microbiology for details.
