Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
7
Page 1 of 19
D Seddon
INFORMATION FOR USERS OF THE
HAEMATOLOGY DEPARTMENT
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 2 of 19
D Seddon
CONTENTS
1. LABORATORY LOCATION .......................................................................................... 3
2. KEY STAFF CONTACT DETAILS ................................................................................ 4
3. LABORATORY OPENING TIMES ................................................................................ 5
4. TRANSPORTING SAMPLES ....................................................................................... 5
5. HEALTH AND SAFETY REQUIREMENTS .................................................................. 6
5.1 Collection, labelling and dispatch of specimens .................................................... 6
5.2 High Risk specimens ............................................................................................. 6
6. INSTRUCTIONS FOR COMPLETING REQUEST FORMS .......................................... 7
7. CLINICAL ADVICE AND INTERPRETATION ............................................................... 8
8. UNCERTAINTY OF MEASUREMENT.......................................................................... 8
9. SERVICE DESCRIPTION……………...……………………………………………………7
10. TIME LIMITS FOR REQUESTING ADDITIONAL EXAMINATIONS ........................... 9
11. TEST REPERTOIRE TURNAROUND TIMES, RANGES AND IMPORTANT
INFORMATION ............................................................................................................... 10
12. ADDITIONAL CLINICAL INFORMATION ................................................................. 19
12.1
12.2
Oral anticoagulation treatment ......................................................................... 19
Thrombophilia Investigtions ............................................................................. 19
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 3 of 19
D Seddon
1. LABORATORY LOCATION
(For Blood Transfusion please see Blood Transfusion Laboratory user handbook)
The Haematology department is part of Pathology at Wigan and Salford (PAWS). PAWS
is an integrated pathology services between Salford Royal NHS Foundation Trust and
Wrightington, Wigan and Leigh NHS Foundation Trust created in February 2013. This
services provides a comprehensive and wide ranging diagnostic, analytical, interpretive
and clinical advisory services across the two Trusts and General Practitioners and reginal
services in several specialist areas.
Haematology’s main laboratory site is at Salford Royal (Turnberg Building, level 2) (See
site map SRFT Hospital Site Map ) with an essential service laboratory based at Royal
Albert Edward Infirmary (RAEI) in Wigan (Wigan Hospital Site Map) with both laboratory’s
providing a comprehensive 24 hour 365 day analytical service for Salford Royal Hospitals
NHS Foundation Trust (SRFT), and Wigan, Wrightington , Wigan and Leigh NHS
Foundation Trust (WWL) and Salford, Wigan, Wrightington and Leigh GPs. Wigan
haematology user information. There is a satellite laboratory based at Wrightington
providing inpatient test, open Mon-Fri 9.00 until 17.00.
Haematology is fully accredited by Clinical Pathology Accreditation (CPA) and is a
member of the National External Quality Assurance Scheme (NEQAS) to ensure quality of
service and laboratory results. All our qualified Biomedical Scientists are also registered
with the Health and Care Professions Council (HCPC) to ensure high standards of service
are maintained.
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
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Page 4 of 19
D Seddon
2. KEY STAFF CONTACT DETAILS
Laboratories
Haematology Lab
SRFT
Haematology Lab
RAEI
Haematology Lab
Wrightington
Blood Transfusion
SRFT
Blood Transfusion
RAEI
Blood Transfusion
Wrightington
Medical Staff
Consultant and Laboratory Lead
Consultant
Consultant
Consultant
Consultant
Consultant
Consultant & Lab Lead (WWL)
Specialist Registrars
Specialist Registrars
Scientific Staff
Haematology and Blood
Transfusion manager
Deputy Haematology and Blood
Transfusion manager
Transfusion Practitioner SRFT
Transfusion Practitioner WWL
Nursing Staff
Specialist Nurse SRFT
Specialist Nurse SRFT
Specialist Nurse SRFT
Specialist Nurse WWL
Specialist Nurse WWL
Specialist Nurse WWL
Secretarial Support
Secretary SRFT
(Dr Thomas-Dewing)
Secretary SRFT
(Dr Jowitt & Dr Ravenscroft)
Secretary WWL
(Dr’s Ahmad, Gregory, Patel)
Secretary WWL
(Dr’s Ahmad, Gregory, Patel)
Name
09:00-17:30 ONLY
out of hours Bleep 3077
24/7
Telephone No.
0161 206 4981
09:00-17:00 ONLY
out of hours call RAEI
09:00-17:30 ONLY
out of hours Bleep 3077
RAEI 24/7
01257 25 6311
09:00-17:00 ONLY Mon - Fri
out of hours call RAEI
Name
Dr Simon Jowitt (SRFT)
Dr Hitesh Patel (WWL)
Dr Sonya Ravenscroft (SRFT)
Dr Rowena Thomas-Dewing (SRFT)
Dr Claire Barnes
Dr Chris Gregory (WWL)
Dr Usman Ahmad (WWL)
SRFT
WWL
Name
01257 25 6338
Mrs Deborah Seddon
Mr Jim Wesson
Mrs Lydia Baxter
Sister Louise McCreery
Name
Sister Catherine Redshaw
Sister Lisa Crabtree
Sister Linda Ryan
Sister Janet Magee (Anticoagulation)
Sister Louise McCreery (Transfusion)
Sister Susan Gee (VTE)
Name
Mrs Debbie Connelly
Mrs Linda Burns
Christine Hesketh
Angela McGavock
01942 82 2146
0161 206 4994
0161 206 4997
01942 82 2145
Telephone No.
0161 206 4984
01942 82 2139
0161 206 4985
0161 206 4986
0161 206 0207
01942 82 2140
01942 77 3316
0161 206 4987
01942 77 3350
Telephone No.
0161 206 4996
01942 82 2138
0161 206 4992
01942 82 2138
0161 206 2137
01942 77 3182
Telephone No.
0161 206 2173
0161 206 0210
0161 206 2173
01942 82 2964
01942 77 3182
01942 77 3331
Telephone No.
0161 206 4982
0161 206 4983
01942 77 3329
01942 82 2139
** Please note that the internal numbers do not work between the two Trusts **
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 5 of 19
D Seddon
3. LABORATORY OPENING TIMES
Routine laboratory opening hours are Monday to Friday from 09:00 until 17:30 but the
department has qualified scientific staff on-site at SRFT and RAEI at all times.
Haematology Medical staff are available for advice at all times. During normal working
hours they can be contacted using the phone numbers provided above and via
switchboard at all other times.
Out of core hours the department runs a continuous processing work shift system (CPW).
Main Laboratory SRFT
Between 17:30 and 22:00 Monday to Friday the core laboratory is staffed by two BMS staff
and a minimum of two MLA’s. At weekend one BMS is on-site between 17:00 and 21:45.
At the ESL between 17:30 and 20:30 is staffed by one BMS and one MLA staff and at the
weekend there is only one BMS on-site.
One BMS covers each night of the week between 22:00 and 07:30
Two MLA staff cover 06:00 – 10:00 and 18:00 – 22:00 Monday to Friday.
There are BMS staff and MLA cover on Saturdays and BMS staff only on Sunday.
ESL RAEI
Between 17:30 and 20:30 Monday to Friday the core laboratory is staffed by one BMS
staff and one MLA/AP. At weekend one BMS is on-site only.
One BMS covers each night between 20:00 and 07:30
4. TRANSPORTING SAMPLES
At both SRFT and RAEI an air-tube pod system is also available from certain locations
within the Trust’s for transporting samples to the laboratory. There are regular transports
between RAEI and SRFT during core hours (provided by SRFT Royal Transport
Department). Non-urgent in-patient samples should reach the laboratory’s before
11.00am on weekdays and 10.00am on Saturdays to avoid delays in processing. All
sample requests should be delivered to Central Pathology Reception. Any urgent X-match
requests must be phoned through to the blood bank and the request handed to a member
of staff in central reception.
At SRFT a collection/delivery service for other hospitals is operated by SRFT transport
department (see the Timetable) and there is a messenger service for non-urgent samples
within Salford Royal Hospital (see Messenger service). Salford CCG commissions
transport providers for Salford GP surgeries.
At WWL a collection service for GP surgeries and the Dave Whelan Centre (DW) is
operated by WWL transport department. There are regular transports to RAEI from
Wrightington Hospital, Leigh Infirmary and the Thomas Linacre Out-Patients centre
provided by WWL transport department.
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 6 of 19
D Seddon
5. HEALTH AND SAFETY REQUIREMENTS
5.1
Collection, labelling and dispatch of specimens
Staff responsible for the collection of specimens and transporting them to the laboratory for
investigation are responsible under the Health & Safety at work Act and the COSHH
regulations to do so in a safe manner.
A common high standard of Health and Safety must be applied to all samples. This
includes using appropriate specimen containers and sealing the container in the bag
attached to the request card.
Strict national (DOH) and international (WHO) regulations are applied to the transportation
of infectious materials (including clinical specimens) by road or post.
5.2
High Risk specimens
Specimens from individuals known, or suspected of Blood Borne Viruses (BBV)
eg. Hepatitis B or HIV should have the following information included on the Specimen(s)
and Request Card:
 A ‘Danger of Infection’ label attached to each specimen and on the accompanying
request card.
 Clinical details on the request form should be adequate to convey information of the
suspected hazard to the staff who handle the specimens.
 To maintain patient confidentiality during transit to the laboratory, it is recommended to
seal the specimen and request in a suitable envelope.
Specimens presenting a risk of BBV Include:
 Blood
 CSF
 Urine
 Other body fluids
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 7 of 19
D Seddon
6. INSTRUCTIONS FOR COMPLETING REQUEST FORMS
It is the responsibility of the requesting clinician to ensure that samples are correctly
labelled and request forms completed to the agreed standard.
Standard operating procedures for the receipt of samples and request forms are put in
place to ensure the safety of the patient. They are intended to ensure that the appropriate
investigation is performed on each sample. Clinical details must also be provided.
Before accepting a clinical specimen, laboratory staff must ensure certain minimum criteria
for sample identification are met.
The table below outlines the acceptable minimum required information to identify a
specimen on receipt in the laboratory.
Without this minimum information the sample will only be processed in exceptional
circumstances.
Please refer to the Specimen Acceptance Policy on SRFT Synapse or the Pathology
Collection, Transportation and Receipt of Clinical Specimens Policy on WWL intranet.
Samples must be labelled with at least TWO unique identifiers from:
 Patient’s Full Name i.e. Forename and Surname
 NHS number
 Date of birth
 Hospital number
Samples that are not labelled with at least two unique identifiers will not be
processed
Samples must be accompanied by a request form.
The request form MUST have at least TWO unique identifiers.
The information on the sample must match what is on the request form.
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 8 of 19
D Seddon
We can generate Pathology reports most effectively when the request
form is completed with the following information:
 The patient’s location/destination for the report- this can be a
location code
 Test required
 Name of consultant or GP
 Name of the requestor and contact number (bleep or
extension)
 Patient gender
 Date and time of specimen collection
 Anatomical site and type of specimen (where relevant)
 All relevant clinical information
 Patient address for GP requests
When your patient is going to label the sample container please advise
them of the labelling requirements. The sample container must also
contain the date of collection.
7. CLINICAL ADVICE AND INTERPRETATION
Haematology Medical staff are available to give advice at all times. They can be contacted
via telephone during the normal working day and via switchboard at all other times.
8. UNCERTAINTY OF MEASUREMENT
All biomedical results are subject to a degree of uncertainty. This is due to biological
variation, analytical measurement imprecision and pre-analytical factors (sample stability
etc.). If you are concerned about the confidence limits and interpretation of an individual
result please contact the Haematology department.
9. SERVICES DESCRIPTION
The department treats patients referred within the North West sector of Greater
Manchester (Bolton, Wigan and Salford). Haematology at Salford and RAEI provides a
Level 2 haemato-oncology service treating leukaemias, lymphoma and myeloma.
The laboratory provides general haematology tests, haemoglobinopathy screening for
Wigan (low prevalence area), thrombophilia screening and a blood transfusion service.
Daily anticoagulant clinics are held at several locations within the Wigan area.
Clinical haematology is supported by haematology nurses and runs a number of
haematology clinics.
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 9 of 19
D Seddon
10. TIME LIMITS FOR REQUESTING ADDITIONAL EXAMINATIONS
Requests for additional tests on haematology samples will normally only be available for
the day the specimen was taken. However the following tests can be added on within the
time limits stated.
SPECIMEN TYPE IN LAB
TEST TO BE ADDED
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
EDTA
CITRATE
ESR
HbA1c
Reticulocytes
Infectious Mono. screen
G6PD
Malarial Parasites
Blood film
Haemoglobinopathy screen
HFE gene
JAK2
BCR-ABL
PT,APTT,INR,Anti-Factor
Xa, D-dimer, Fibrinogen
and Thrombin time
TIME LIMIT FROM
SAMPLE BEING TAKEN
Within 6 hours
Within 3 days
Same day
Same day
Within 7 days
Same day
Same day
Within 7 days
Within 2 days
Within 2 days
Within 2 days
Same day
N.B. Samples may be disposed of before time limit is reached.
STORAGE
CONDITIONS
Cold room
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
Q -Pulse Revision No:
6
HH-INF-39
11.
Page 10 of 19
D Seddon
TEST REPERTOIRE TURNAROUND TIMES, RANGES AND
IMPORTANT INFORMATION
GENERAL HAEMATOLOGY TEST REPERTOIRE
TESTS
SPECIMEN
REQUIRED
TURNAROUND
TIMES
Full Blood Count
(FBC)
3.4 ml red top
EDTA
4 hrs
Erythrocyte
Sedimentation Rate
(ESR)
Reticulocyte count
3.4 ml red top
EDTA
6 hrs
3.4 ml red top
EDTA
3.4 ml red top
EDTA
3.4 ml red top
EDTA
4 hrs
3.4 ml red top
EDTA
4 hrs
Rapid test within
1 hr.
Haemoglobinopathy
screen (Sickle
screen)
Glycated
haemoglobin (HbA1c)
3.4 ml red top
EDTA
3 days
Urgent requests
will be
processed
3.4 ml red top
EDTA
2 days
Glucose-6-phosphate
dehydrogenase
(G6PD)
Paediatric full blood
count (inc. retics and
nucleated red blood
cells
Bone marrow aspirate
3.4 ml red top
EDTA
3 days
1.4 ml red top
paediatric
EDTA
4 hrs
Bone marrow
14 days
Discuss with
Haematologist
Bone marrow
trephine biopsy
Bone marrow
14 days
Discuss with
Haematologist
Blood film (manual
differential)
Infectious
mononucleosis
screen (Glandular
fever)
Malarial Parasites
SPECIAL
INSTRUCTIONS
Minimum
volume 2ml
24 hrs
8 hrs
KEY FACTORS
AFFECTING TEST
PERFORMANCE OR
INTERPRETATION
Cold red cell
autoagglutinnins
Lipaemia
(these are corrected in lab)
Cold red cell
autoagglutinnins
(test will not be reported)
Provide relevant clinical
details.
Some patients do not
produce antibody.
In early stage antibody may
be undetectable.
If initial screen negative this
should be repeated if strong
suspicion of malaria present
Requestor should indicate if
patient has been recently
transfused
Test unavailable if patient
has homozygous
haemoglobinopathy
Raised reticulocyte count
may result in false normal
result
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 11 of 19
D Seddon
NORMAL HAEMATOLOGICAL VALUES IN CHILDHOOD
Automated FBC
< 3 Days
Hb
G/L
12
RBC
x10 /L
HCT(PCV)
ratio
MCV
fl
MCH
pg
MCHC
G/L
RDW
9
WBC
x10 /L
9
Neut
x10 /L
9
Lymph
x10 /L
9
Mono
x10 /L
9
Eos
x10 /L
9
Baso
x10 /L
9
Platelets
x10 /L
Full Differential WBC (Manual)
NEUTROPHILS
LYMPHOCYTES
MONOCYTES
EOSINOPHILS
BASOPHILS
RETICULOCYTES (%)
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
135-195
5.0-7.0
0.44-0.64
105-130
24.0-34.0
273 - 327
11.5-14.5
10.0-26.0
1.5-7.0
2.0-5.0
0.3-1.1
0.2-2.0
< 0.1
150-400
1.5-7.0
2.0-5.0
0.3-1.1
0.2-2.0
< 0.1
2.0-6.0
3 Days - 12
Wks
95-135
3.2-4.8
0.32-0.44
87-103
23.0-31.0
305 - 350
11.5-14.5
10.0-26.0
12 Wks-1
Year
105-135
3.6-5.2
0.32-0.44
70-86
23.0-31.0
305 - 350
11.5-14.5
10.0-26.0
150-400
150-400
1 Year - 6
Years
120-140
4.1-5.5
0.36-0.44
76-92
23.0-31.0
305 - 350
11.5-14.5
6.0-18.0
2.0-6.0
5.5-8.5
0.7-1.5
0.3-0.8
< 0.1
150-400
2.0-6.0
5.5-8.5
0.7-1.5
0.3-0.8
< 0.1
6 Years -12
Years
115-145
4.0-5.4
0.37-0.45
77-91
24.0-30.0
305 - 350
11.5-14.5
4.5-13.5
150-400
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
Q -Pulse Revision No:
6
HH-INF-39
Page 12 of 19
D Seddon
NORMAL ADULT HAEMATOLOGICAL VALUES
Automated FBC
Hb
RBC
HCT(PCV)
MCV
MCH
MCHC
RDW
WBC
Neut
Lymph
Mono
Eos
Baso
PLATELETS
G/L
12
x10 /L
Ratio
Fl
Pg
G/L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
Male
Female
Pregnancy (3rd trimester)
130-180
115-165
95-165
4.5-6.5
0.40-0.54
80-100
27.0-32.0
305 - 350
11.5-14.5
4.0-11.0
2.0-7.5
1.5-4.0
0.1-1.6
<0.4
< 0.1
150-400
3.8-5.8
0.37-0.47
80-100
27.0-32.0
305 - 350
11.5-14.5
4.0-11.0
2.0-7.5
1.5-4.0
0.1-1.6
<0.4
< 0.1
150-400
3.5-5.8
0.35-0.47
80-100
27.0-32.0
305 - 350
11.5-14.5
4.0-11.0
2.0-11.0
1.5-4.0
0.1-1.6
<0.4
< 0.1
150-400
Full Differential WBC (Manual)
NEUTROPHILS
LYMPHOCYTES
MONOCYTES
EOSINOPHILS
BASOPHILS
RETICULOCYTES
(%)
ESR (mm in first
hour)
All ages
HbA2 (%)
HbF (%)
Glycated Hb
(HbA1c)
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
9
x10 /L
Adult Male and
Female
1.8 – 7.5
1.5 – 4.0
0.2 – 0.8
<0.4
<0.1
0.2 – 2.0
Male
Female
0-27 mm
2.3 – 3.5
0.1 -1.2
20 – 42 mmol/mol
(IFCC)
0-27 mm
2.3 – 3.5
0.1 -1.2
20 – 42 mmol/mol
(IFCC)
Pregnancy
2.3 – 3.5
<5.0
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Page 13 of 19
D Seddon
COAGULATION TEST REPERTOIRE
TESTS
Clotting Screen (PT +
APTT)
INR (oral anticoagulation)
APTT ratio (unfractionated
heparin)
Anti-factor Xa (Low
molecular weight heparin)
D-Dimer (DD)
Fibrinogen (FIBC)
Thrombin time (TT)
Clotting tests (paediatric)
Coagulation factors
(II,V,VII,VIII,IX,X,XI,XII,
FXIII:Ag)
Von Willebrand Screen
(VWD) (FVIII, FVIII:Ag,
FVIII: Act)
Lupus anticoagulant
screen
Thrombophilia screen (AT,
PC, FPS, APC, Lupus, TT)
SPECIMEN
REQUIRED
TURNAROUND
TIMES
4.3ml green
top citrate
3 hours
4.3ml green
top citrate
4.3ml green
top citrate
4.3ml green
top citrate
4.3ml green
top citrate
4.3ml green
top citrate
4.3ml green
top citrate
1.4 ml
citrate
paediatric
green tube
2 x 4.3ml
green top
citrate
2 x 4.3ml
green top
citrate
3 x 4.3ml
green top
citrate
3 x 4.3ml
green top
citrate
SPECIAL
INSTRUCTIONS
KEY FACTORS
AFFECTING TEST
PERFORMANCE OR
INTERPRETATION
All coagulation tests
require a good clean
venepuncture to avoid
sample activation
3 hours
3 hours
3 hours
3 hours
3 hours
3 hours
3 hours
Weekly
Discuss with
Haematologist
Weekly
Discuss with
Haematologist
2 weeks
2 weeks
Indicate if patient on
anticoagulants
See guidelines
below
Patient should be
minimum 1 month post
anticoagulant therapy or
post thrombotic episode
NOTES ON COAGULATION TESTS
Where indicated advice from Consultant Haematologist should be sort prior to request.
Some tests e.g. thrombophilia screens should only be requested according to protocol
(refer below to 12.2). These tests are expensive.
For advice on anticoagulant treatment please refer to the following Trust policies:
For SRFT: Trust Oral Anticoagulant Policy.
Prevention of Hospital Acquired Thrombosis (HAT)
For WWL: Trust Anticoagulation Guidelines
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
D Seddon
NORMAL ADULT COAGULATION RANGES
TESTS
NORMAL RANGE
Clotting Screen
(PT + APTT)
INR (oral anticoagulation)
APTT ratio (unfractionated
heparin)
Anti-factor Xa (Low
molecular weight heparin)
D-Dimer (DD)
Fibrinogen (FIBC)
Thrombin time (TT)
Clotting tests (paediatric)
Coagulation factors
(II,V,VII,VIII,IX,X,XI,XII,
FXIII:Ag)
Von Willebrand Screen
(VWD) (FVIII, FVIII:Ag,
FVIII: Act)
Lupus anticoagulant
screen
PT
APTT
Thrombophilia screen (AT,
PC, FPS, APC, Lupus, TT)
9.2 – 12.7 sec
28.0 – 34.0 sec
<230 ng/ml
2.0 – 4.0 g/l
10 - 17 sec
50 – 150 iu/dl
FVIII
50 – 150 iu/dl
FVIII: Ag 50 - 200 iu/dl
FVIII:Act 50 – 200 iu/dl
Antithrombin
80 – 120 iu/dl
Protein C
70 - 120 iu/dl
Free Prot. S (Female) 53 – 109 iu/dl
Free Prot. S (Male)
64 – 129 iu/dl
Act. Prot. C resist.
2.05 – 4.05 ratio
Page 14 of 19
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
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Page 15 of 19
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TESTS REFERRED TO OTHER HOSPITALS
TEST
SPECIMEN
REQUIRED
Haemochromatosis
gene (HFE)
3.4 ml red top
EDTA
JAK2 Gene
analysis (JAK2)
BCR-ABL (BCR)
10.0 ml red top EDT
A (3 tubes)
10.0 ml red top
EDTA (3 tubes)
TURNAROUND
TIME
SPECIAL
INSTRUCTIONS
3 weeks
4 weeks
4 weeks
Factor V Leiden
(F5LM)
4.3 ml green
CITRATE
2 weeks
Discuss with
Haematologist
Prothrombin gene
variant (PTGV)
4.3 ml green
CITRATE
2 weeks
Discuss with
Haematologist
VWF Multimers
(VWD)
4.3 ml green
CITRATE
4 weeks
Factor VIII inhibitor
screen (F8IN)
4.3 ml green
CITRATE
24 hrs
Hb DNA studies
3.4 ml red top
EDTA
2 – 6 weeks
(depends on
complexity)
3.4 ml red top
EDTA
2 -5 working days
3.4 ml red top
EDTA
2 weeks
PNH Screen (PNH)
3.4 ml red top
EDTA
2-5 working days
Needs to be tested
within 24 hrs.
Vitamin K and
PIVKA
9ml clotted (brown
GEL)
3 weeks
Protect from light
Oncology
Cytogenetics
Marrow/3.4 ml red
top
4 weeks
Plasma viscosity
(PV)
Confirmation
haemoglobinopathy
screen (HBOR)
ADAMTS13
Citrate and Serum
2 weeks
DO NOT refrigerate
Double spin
samples. Divide into
4 aliquots. Keep
frozen at -70.Must
be sent on dry ice
REFERRED TO
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Specialist
Coagulation Lab
Central Manchester
NHS Trust
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
South Manchester
Hospitals NHS
Trust
Queens Medical
Centre, Nottingham
HMDS St James’s
University Hospital,
Leeds
Haemophilia Centre
St. Thomas
Hospital, London
Christie Hospital
NHS Trust
Sheffield
Haemophilia and
Thrombosis Centre
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
Pyruvate Kinase
>1.0 ml red top
EDTA Patient &
date matched
control sample.
Hereditary
Spherocytosis
Screen (EMA-eosi5-maleimide)
binding assay.
3.4 ml red top
EDTA
PFA-100 (Platelet
function assay)
2 x 4.3 ml green
CITRATE
TCGR (T-cell
receptor gene
rearrangement)
Bone marrow or 10
ml 3.4 ml red top
EDTA
Positive Malaria
Slides
3.4 ml red top
EDTA
Page 16 of 19
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1 week
Retic count and
FBC results of
patient. Stained &
unstained/unfixed
blood film of patient.
Control FBC results
Pathology Centre G
Block
Hammersmith
Hospital
24 hrs.
Sample must be
kept at room
temperature
DO NOT refrigerate
Immunology
Department
Central Manchester
NHS Trust
24 hrs.
Send directly to
specialist
coagulation lab at
Central
Manchester.
DO NOT centrifuge.
Must arrive within 2
hrs. Use taxi.
10 days
Molecular
Diagnostics Centre
Central Manchester
NHS Trust
Specialist
Coagulation Lab
Central Manchester
NHS Trust
Samples should
preferably be less
than 24hrs old but
no older than 48hrs
Liverpool School of
Tropical Medicine
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
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Page 17 of 19
D Seddon
NOTES ON REFERRED TESTS
Factor V Leiden will only be requested by the laboratory to confirm a positive Activated
Protein C result.
Prothrombin gene variant will only be requested on advice of Consultant Haematologist.
The laboratory will screen all referred tests to ensure they are clinically appropriate.
Turnaround times will be periodically audited.
ADDRESSES OF REFERRAL HOSPITALS
Central Manchester NHS Trust
Molecular Diagnostics Centre
TOP Floor
Multipurpose Building
Manchester Royal Infirmary
Oxford Rd
Manchester
Tel: 276 4809
Central Manchester NHS Trust
Autolab
Manchester Royal Infirmary
Oxford Rd
Manchester.
Tel: 276 8039
HMDS
Level 3 Bexley Wing
St James’s University Hospital
Beckett St
Leeds
LS9 7TF
Tel: 01132067851
Haematology Department
South Manchester NHS Trust
Wythenshawe Hospital
Wythenshawe
Manchester
Tel:291 2126
Haematology Laboratory
Red Cell Laboratory
Queens Medical Centre
Derby Rd
Nottingham
NG7 2UH
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
Q -Pulse Revision No:
6
D Seddon
Sheffield Haemophilia and Thrombosis Centre
Coagulation Laboratory
Floor H
Royal Hallamshire Hospital
Glossop Rd.
Sheffield
S10 2JF
Tel:01142712955
Haemophilia Centre
1st Floor Wing
St. Thomas Hospital
Lambeth Palace Rd
London
SE1 7EH
Oncology Cytogenetics
Pathology Department
Christie Hospital NHS Trust
Withington Rd
Tel:446 3161
Lynn Robertson
Principle Biomedical Scientist
Diagnostic Haematology
Pathology Centre G Block
Hammersmith Hospital
Du Cane Rd
London
W12 0HS
Tel: 02033132448
Liverpool School of Tropical Medicine
Pembroke Place
Liverpool
L3 5QA
Tel: 0151 705 3100
Page 18 of 19
Haematology Department
Pathology at Wigan and Salford
Title: Information for users of the haematology
department
Q-Pulse Ref:
Authorised By:
HH-INF-39
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Page 19 of 19
D Seddon
12.
ADDITIONAL CLINICAL INFORMATION
12.1
Oral anticoagulation treatment
SRFT please refer to Trust Oral Anticoagulant Policy
WWL please refer to Trust Anticoagulation Guidelines
12.2
Thrombophilia investigations
Investigation of patients for an inherited marker of Thrombophilia is frequently
unnecessary and seldom has a significant impact on the clinical management of a patient.
It may be considered, along with other tests, in the following circumstances:

Spontaneous venous thrombosis at <45years age.

Venous thrombosis at unusual sites.

A strong family history of venous thrombosis.

A history of recurrent fetal losses.
Patients should first have a full clinical assessment for evidence of an acquired cause for a
prothrombotic tendency, as well as a full blood count to exclude such conditions as iron
deficiency, myeloproliferative disorders, haemolytic anaemia and PNH.
Screening for a Lupus Anticoagulant/Anti Phospholipid Syndrome should be considered in
all patients with recurrent fetal losses or an apparent tendency to venous and/or arterial
thrombosis.
A screen for inherited markers of a predisposition to venous thromboembolism, if
indicated, will include tests for Activated Protein C Resistance, Antithrombin III, Protein C
and Protein S. Avoid taking the relevant samples around the time of an acute thrombotic
event or when the patient is receiving anticoagulant therapy.
If the APCR is positive, the presence of the Factor V (Leiden) mutation will be confirmed
by genetic testing, but this, and testing for the Prothrombin Gene Variant, are not routinely
performed in all cases.