Gases, Venous
| 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, Venous | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
GASV
Test Workstation :
MBG1
Specimen Type:
Blood
Tube Type:
Heparinized syringe or Green top (lithium heparin) macrotainer NO GEL SEPARATOR TUBES.
Collection Volume:
0.5 mL Heparinized syringe; 1.5 mL Green top (lithium heparin) tube
Minimum Volume:
0.5 mL syringe; 1.5 mL macrotainer.
Preferred Volume:
1 mL syringe; 1.5 mL macrotainer.
Cause for Rejection:
Clotted, air bubbles.
Sample in microtainer gel separator tube will not be accepted.
Storage:
Room Temp
Availability:
Daily, 24 hours; STAT
Methodology:
ion selective electrode/Calculations
Special Instructions:
Air bubbles should be expelled from the syringe. Notify lab if patient's temperature is other than 37C to correct results (temperature dependent). Deliver to lab immediately at room temperature.
Lab/Phone:
330-746-9623
TAT:
30 minutes
Additional Info:
Reference range is available on patient report
CPT Code:
82803
Panel Includes:
Temperature, Hemoglobin, pH, pCO2, pO2, Tco2, O2 Saturation, O2 Hemoglobin, Std. Base Excess
Synonyms:
Venous Gases
Venous Blood Gases
