Biochemistry/ Immunology requests and results

Requests

All specimens must be labelled with full patient identification and be accompanied by a request form giving full clinical details and signed by a doctor, in accordance with UHSPE Pathology Sample and Request Form Labelling Requirements.

To allow us to process your request efficiently please use ICE requesting or the correct type of manual request form.

Information on how to access ICE Desktop.

Completing manual forms.

Prompt delivery of samples without exposure to either heat or cold is important to ensure validity of results - within 6 hours for many tests.

From July 2024 systems will be introduced in ICE to limit inappropriate repeat testing according to the Royal College of Pathologists guidelines (G147 National Minimum Retesting Intervals in Pathology, March 2021).

Consent to testing

It is the responsibility of the clinician requesting a test to give a patient sufficient information for them to give informed consent. Laboratory staff will assume consent has been given on all requests received.

Consent for genetic testing should be saved in local patient records and does not need to be sent with the request form. A Record of Discussion form can be downloaded alongside the relevant request form at the South East Genomic Laboratory Hub.

Sample requirements

Blood

Blood samples should be collected using the Greiner Vacuette^® System. Details of sample requirements for specific tests can be found on this site - please use the A to Z index or search function.

Urine and faeces

Requirements vary depending on the test - if in doubt check the listings using the A to Z index or search function.

24 Hour Urine Collections: Guide for Patients (LIC-BIO-24HR, revision 5, last reviewed 28.6.2023) This leaflet has been approved by the BSUH Carers and Patients Information Group and is also available on the UHSussex public site.

Cerebrospinal fluid (CSF)

Please refer to the CSF collection page.

Tests available

Please use the A to Z test index or search function for information on individual tests. Most routine automated biochemistry tests are available as a same day service; others may be done less frequently. If the test you are looking for is not listed please contact the laboratory if you need information.

Reference values shown are those currently used by this laboratory and are adult ranges unless otherwise stated. Please note that they may change periodically, and that some tests have age-related ranges - see the original written pathology report.

Referred tests 

Tests with this icon are not done locally. They can be very expensive and often require special transport arrangements. Specialist tests should only be used when simpler tests have failed to produce a clear answer to the clinical problem. Request forms should have the fullest possible clinical details to justify the test. Restrictions mean that greater selectivity and different investigations will have to be applied.

Our laboratory has no control over the time scale for the return of results from external laboratories. Note that additional time must be allowed for packing, dispatch and delivery of sample, and return and processing of results.

Key factors which may affect the validity of a test

All blood samples should be received in the laboratory within 24 hours of being taken. Where the period of validity of a sample is less than 24 hours, this is stated with specific information on the individual test pages - please use the A-Z listings or search function on this site.

Many general factors can affect test result validity. Test-specific information (e.g. known drug interferences) is listed on the test page.

Where there is suspicion that a result is incorrect after analysis (e.g. results suggestive of contamination by drip, haemolysed/ lipaemic/ icteric samples) results may be removed prior to authorisation and a comment made. A repeat sample may be requested. Contact the lab if further information is required or if you have information which suggest that a rejected result is valid and should be reinstated.

Adding requests to samples already in the laboratory

The lab receives a significant number of telephone requests for supplementary tests to be added to samples already in the laboratory. This can be very disruptive, particularly out-of-hours, and can result in delays in analysis and reporting of other results.

Supplementary request forms are available to all users and should be completed and returned to the lab. An ordinary request form with the patient and requester details completed, and clearly marked to say that the request is for a test or tests to be added to a previous request, is also acceptable. At RSCH please do not telephone the lab to say that a request is on its way (unless urgent). At PRH please complete and send the form but if out of hours also bleep the biochemistry BMS on-call.

Supplementary request form (LFc-BLD-SupplReqs, revision 2, last updated 28.10.21)

As long as the form is returned quickly (via airtube at RSCH) this should not have any significant effect on turnaround time of the supplementary test, but should be significantly less disruptive in terms of processing the routine workload.

We do not accept routine requests for additional tests on most routine samples that are more than 24 hours old. A repeat sample should be taken. Please note that some tests cannot be added as supplementary tests due to special processing requirements.

Drug testing

If medicolegal and/or child safeguarding issues seem likely, please use the chain of evidence form and accompanying sample collection instructions. Contact the laboratory before sending all chain of evidence samples. These must be received in normal working hours. If in any doubt please contact laboratory before obtaining the samples and consider supervised sample collection requirements and consent, as set out in chain of evidence form instructions. 

If you are collecting samples at The Royal Sussex County Hospital site, please use the BSUH chain of evidence form and instructions:

BSUH Chain of Evidence Form for Hospital Patients (LIA-BTX-COEFORMH, revision 0, last reviewed 25/06/2018)

Instructions for Collecting Samples for Chain of Evidence Toxicology Analysis in Hospital Patients (LIA-BTX-CHAININH, revision 3, last reviewed 6/3/2023)

If you are collecting samples at East Surrey Hospital, please use the SaSH chain of evidence form and instruction:

SaSH Chain of Evidence Form (last reviewed Feb 2019)

Research studies/drug trials

In all cases please discuss these with the Consultant Clinical Biochemist prior to sending any samples to the laboratory for investigation.

Reporting results

Results are viewable on ICE Desktop or on GP systems as soon as they are available.

Information on how to access ICE Desktop.

Urgent results and routine chemistry results that require particularly urgent attention are sent via air tube (RSCH) or telephoned to the relevant doctor, surgery or ward in accordance with departmental procedures.

Telephone action limits _{(from LIC-BIO-ACTION LIM, revision 22. Last reviewed 3/12/2024)}