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Tips on Ordering Certain Tests

For labs that you have obtained yourself, you can actually send the fluid through the tube system in a well-sealed biohazard bag and the label affixed. However, important tests that required a

Labwork that Requires Special Procedures

  1. Hematology consult is required for certain heme tests e.g. hypercoaguable work up, HIT assay
  2. Cytology requisition required for cytology, certain tumor markers (CEA, CA-125)
  3. Bodily fluids that you have obtained yourself (e.g. cerebrospinal fluid) should be personally transported to the laboratory
  4. VBG/lactate
    1. VBGs can be done by the phlebotomist, however, can take longer to obtain. A venous lactate can be added to this.
    2. If it is urgent, you can perform an ABG and add an arterial lactate.
  5. ABG
    1. To collect and send: enter in CPOE, click box stating “Collected by RT/MD”, labels should print at nearest label-printer
  6. Consent is required for HIV tests

Imaging

In the ER – if patient is not yet admitted:

  • Fill a yellow paper requisition (usually near where charts are – can ask a ward clerk to help you find), notify your patients RN that you have requested an imaging test.
    1. X-Rays: bring yellow sheet to X-Ray room in ER. If no XRAY tech is present, page them at the number posted on the door. There are two X-Ray rooms in ER – one in major and one in minor.
    2. Other tests: page radiology on call if urgent or if needs to be done during the evening or weekend.

If patient is admitted:

  • Enter on Soarian
  • You must page radiology if it is urgent or needs to be done during the evening or weekend
    • (Not required for X Rays – but if urgent, you should call the X-Ray tech or ask the patients nurse in order to get it faster)
  • During the daytime, you may contact the radiologist who reads the particular imaging modality you are interested in (call/page or visit the radiology department) in order to discuss imaging technique and to expedite urgent studies.

To obtain urgent radiology interpretations:

  • Daytime:
    • Call locating and ask to page the radiology staff reading the particular imaging modality. They can give you a verbal report if not yet reported. You may also want to visit the radiologist themselves and review it with them.
    • E.g. CT PE – ask locating to page or connect you to chest imaging, CT head – ask for neuroimaging
  • Overnight:
    • A preliminary report will print to the printer in which the patient is situated e.g. ER, 14CC. Check for the report, if not yet provided, you can page the radiology resident on call to give you a verbal report.

Special Imaging Modalities: 

  1. Ultrasound:
    • Generally not available on evenings and weekends.
    • On occasion they may come in for emergencies. If you need an ultrasound done on the weekend, you may call the radiology resident on call who may know if the tech is in, as they can sometimes fit in non-emergent ultrasounds if they are in anyways.
  2. MRI
    • Needs a completed MRI screening form found at nursing stations or you can print a blank form HERE – have it faxed to ext. 5114.
    • MRI Scan Room 864-5783
  3. CT
    • Scan Room 864-5663
  4. Interventional Radiology
    • Enter in CPOE
    • You may wish to page the interventionalist on call to discuss
    • Generally not available after-hours
  5. Echocardiography
    • Enter in Soarian
    • Transesophogeal Echo requires a cardiology consult
    • Urgent ECHO overnight:
      1. Typically anyone needing an urgent ECHO will not be appropriate for GIM ward. However, if you need an urgent TTE overnight to assess for tamponade, pericardial effusion, right heart strain etc., page cardiology on call.