Gases, Capillary
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Gases, Capillary | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
GASC
Test Workstation :
MBG1
Specimen Type:
Blood
Tube Type:
Deliver to lab immediately 2 Heparinized Capillary tubes
Collection Volume:
(2) 125 uL capillary tubes
Minimum Volume:
(2) 125 uL capillary tubes
Preferred Volume:
(2) 125 uL capillary tubes
Cause for Rejection:
Clotted, air bubbles
Storage:
Room Temperature
Availability:
Daily, 24 hours; STAT
Methodology:
Ion selective electrode/Calculations
Special Instructions:
Notify lab if patient's temperature is other than 37C to correct results (temperature dependent). If collecting blood in capillary tubes from a finger or heel, place a warm, moist towel on hand or foot for 10 minutes prior to lancet puncture. Deliver to lab immediately.
For Outpatients, test should only be drawn in outpatient locations within the Hospital on the Beeghly campus.
Lab/Phone:
330-746-9623
TAT:
30 minutes
Additional Info:
Reference Range is available on patient report.
CPT Code:
82803
Panel Includes:
Total Hgb, pH, pCO2, pO2, HCO3, TCO2, O2 Saturation, O2 Hgb, Std Base Excess.
