Glucose Whole Blood

Centralized Core Laboratory - : Chemistry

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. Glucose Whole Blood
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

GLUWB

Test Workstation :

BGAS

Specimen Type:

Blood

Tube Type:

Heparinized syringe, Green top (lithium heparin) microtainer or macrotainer, or heparinized capillary tubes. NO GEL SEPARATOR TUBES.

Collection Volume:

0.5 mL(minimum 250 uL) or 4.0 mL Green Top Tube

Minimum Volume:

250 uL microtainer or 0.5 mL syringe; (2) 125 uL capillary tubes; 1.5 mL macrotainer.

Preferred Volume:

500 uL microtainer or 0.5 mL syringe; (2) 125 uL capillary tubes; 1.5 mL macrotainer.

Cause for Rejection:

Clotted, air bubbles, tubes with gel separator.

Storage:

Room Temperature

Availability:

Daily,24 hours; STAT

Methodology:

amperometric electrode

Special Instructions:

Deliver immediately to laboratory at room temperature. For Outpatients, test should only be drawn in outpatient locations within the Hospital on the Akron campus.

Lab/Phone:

330-543-8418

TAT:

30 min.

Additional Info:

Reference range:

0-1 day = 50-80 mg/dL

2-28 days = 40-60 mg/dL

29 days to end of life 70-99 mg/dL

Criteria for Diagnosis of Diabetes(Effective 6/6/11): Fasting specimen (no caloric intake for at least 8 hours).<100 mg/dl Normal100-125 mg/dl Increased Risk for Diabetes>125 mg/dl Diagnostic for Diabetes Random Glucose (any time of day without regard to last meal).>=200 mg/dl plus Classic Symptoms of Diabetes

CPT Code:

82947