1. Off hour, holiday or weekend specimens
   The message on the flow voice mail directs clinicians to contact the resident on call with these specimens. Your handbook covers this.

   1. Specimens received after hours on a week night:
      Normal hours for the flow cytometry laboratory are Monday through Friday 9 a.m.- 5:30 p.m. Blood and bone marrow specimens can be stored overnight under the following conditions.
      

2. Instruct the clinician to enter orders in CRIS under Anatomic Pathology / Flow Cytometry and leave a message at 301-402-1716 with patient name, specimen type, and clinical question. Collect and store specimens as follows:
   

   • Peripheral bloods: Collect blood in green top sodium heparin tubes. Make three smears. Deliver specimen to B1B58 at room temperature. Enter orders in CRIS.

   • Bone marrow: Bone marrows need heparin.  Notify the CCR Hematology lab that flow immunophenotyping is being performed (301-496-4473). The hematology bm collection tech will bring a BM transport media tube to the specimen collection site and prepare an extra smear for the Flow Cytometry Laboratory.

     • The fellow should reposition the needle before aspirating for the flow cytometry specimen and only aspirate 3ml.

     • Instruct the clinician to dispense 3 ml bone marrow aspirate into the 50ml conical transport media tube. 

     • Cap and mix well.  Store bone marrow with heparin in the cytology refrigerator.

     • Enter a CRIS order for the Flow Cytometry bone marrow specimen or testing may be delayed.
   • CSFs: Studies show CSFs transported without media have 50% cell loss after 1 hour. Collect CSF into Flow CSF transport media tubes (4ml of RPMI 1640 with 10% heat inactivated FBS in 15ml conical tube). Enter orders in CRIS. Specimens deteriorate in 3 hours, so make Emergency Contact with Maryalice or alternate and store in cytology refrigerator.

    

   1. Specimens received on a weekend or holiday:
      Ask if this is an emergency. We only accept emergency specimens on weekends and holidays. Non-emergency specimens can be sent at the clinical branch’s expense to Quest Diagnostics, 301-621-5202x1337 (code15048X, leuk panel = $1543.50 and up).

• Making Emergency contact: In an emergency, call Maryalice at home (301-929-0865). If no reply, leave a message on the voice mail, including the page number of the clinical fellow! Primary backup: Greg Jasper at 240-631-0892. Leave a detailed message! Secondary backup: Cathy McCoy at 301-696-0625. Leave a detailed message! Someone will contact the clinical fellow directly to get the specimen delivered.
• For specimen collection and storage: It is vital that you review with the fellow how to collect and store the specimen. See peripheral blood and bone marrow instructions, above.

3. Lost Flow Cytometry Specimens during normal working hours:
   Blood and fresh bone marrow aspirates that make their way to histology or the grossing room must be redirected immediately to the flow cytometry lab, B1B58. They are either flow or molecular diagnosis specimens and must be processed immediately. Call the flow lab at 301-402-1716. If no answer between 9 a.m. - 5:30 p.m., please verify the order has been entered in CRIS and deliver to the flow lab at B1B58.

Last Updated 11/10/2009 2:33:29 PM