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: |
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Test ID :
GASC
Test Workstation :
BGAS
Specimen Type:
Blood
Tube Type:
Heparinized capillary tubes. NO GEL SEPARATOR 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, tubes with gel separator.
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 Akron campus.
Lab/Phone:
330-543-8418
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
