Management of abnormal blood results in IUC
Pathology teams at NBT, BRI and WGH have defined thresholds for contacting SevernSide during the out of hour period with abnormal results.
These cases can be tricky, not least because patients are not expecting a call from us. We aim to manage these cases as early as possible, to try to avoid overnight calls. We encourage clinicians to understand the clinical context by reviewing EMIS before calling the patient. EMIS can also provide additional contact details if there are difficulties reaching the patient.
If there are other outstanding results which may influence your clinical management, you can:
- Compare current and previous results on EMIS.
- View the lab results link on Connecting Care or ICE. The results may update here more quickly than EMIS
- Speak directly to a lab for the latest results. The operational team can assist you in making this call. If requesting that they contact the lab, be specific about which results you require.
Useful resources to guide management:
- NBT’s Clinical Biochemistry in Primary Care (covers hypercalcaemia, hyperkalaemia, hypoglycaemia, hyponatraemia, and raised creatinine kinase).
- Managing high INRs in the community
- Troponin
- Hypomagnesemia
- Hypocalcaemia
- AKI
- Hypophosphataemia
- Abnormal LFTs
These cases require a clinical assessment to determine the level of concern and if any action is required during the out of hours period.
- Some patients may require hospital admission if the overall clinical picture suggests this is in their best interests. It may be possible to arrange this for the following morning to avoid a late night admission.
- It may be appropriate to consider a face to face assessment or repeat blood tests through SevernSide for some patients.
- Sometimes it will be most appropriate to hand the patient’s care back to their own practice for follow up the following day. You can do this by requesting a GP Connect appointment or a call to the surgery by the Practice Liaison Service (PLS).
You can speak to a Duty Biochemist for advice. Contact details including during the OOH period are here.
Urgent samples requested/ taken in OOH
Blood tests in OOH are indicated if the results will impact on the next steps in the patient’s care. Do not take bloods in OOH if the outcome of the test will not impact on urgent management.
On the occasion that samples are required but the results will not be available during the OOH period (such as swabs for virology or MCS, urine for MCS), please advise patients to liaise with their GP practice for results.
If requesting bloods in IUC, please ensure all demographic information is complete on both the samples and the request form. Label the bloods as urgent. Then forward the case to the Consult and Hold queue so that results are followed up within the service.