LABORATORY SERVICES CRMC Laboratory Draw Station is located in the Out Patient Services area. We are available 6AM to 6PM daily. No appointment is necessary. (Please note that due to lower weekend and after hours staffing, your wait time may be longer on weekends and after stated hours.) We must have a copy of your physician’s orders for your lab work. Please ask your physician to fax a copy of your laboratory test orders to CRMC Scheduling or to provide you with a written order for lab testing. You will be registered through our Admissions Department. Please bring a copy of your insurance card with you if possible. If your physician has instructed you to collect laboratory specimens at home for testing at out hospital lab, you may drop off your specimens at the OP Services desk. Please make sure your specimen has your name on it and inform the clerk that you are dropping a specimen off for the Lab. Listed below are some basic instructions for preparation for your lab test or for collecting your lab specimen. If you have questions, please contact your physician or CRMC Laboratory for more information. PATIENT PREPARTION FOR BLOOD TESTS
LIPID PROFILE For optimal results, the patient should be on a stable diet for 2-3 weeks prior to testing. Patient should fast for 12 to 14 hours before blood collection. Fasting should be no food or drink except for water. GLUCOSE TOLERANCE TEST (NON-PREGNANT) Patient should be fasting for 12 to 14 hours (no food or drink, except for water). A blood specimen will be drawn and tested. You will then be given a special drink. Your blood will be drawn once each hour after you finish the drink. The number of hours may vary from 2 to 6. Your doctor will decide how many hours you will be tested. Please allow plenty of time for this test to be completed. You will need to allow approximately one hour more than the number of hours your physician requested. For example, if your physician ordered a 3 hour glucose tolerance, please allow 4 hours for the test to be completed.
CORTISOL Cortisol may be tested in blood or urine.
If blood cortisol levels are requested by your physician, you may be asked to have your blood drawn once (random cortisol) or multiple times. Your physician will inform you if you are having multiple blood draws for your cortisol testing. Cortisol blood tests may be drawn at about 8 am, when cortisol should be at its peak, and again at about 4pm, when the level should have dropped. Sometimes a resting sample will be obtained late in the evening. If your physician requests a urine cortisol, you will be asked to collect either a 24-hour urine or a single first morning specimen. Your physician will inform you of the type of urine collection you will need. Please obtain a collection container from Outpatient services or the laboratory if after hours. Be sure to contact your physician for specific instructions. VITAMIN B12 AND FOLATE A fasting specimen (no food or drink, except for water) for 12- 14 hours before blood is drawn is preferred. However, your doctor may request that you have your blood drawn when you are not fasting. C-PEPTIDE Patient should be fasting (no food or drink, except for water) for 12-14 hours before blood is drawn. DIGOXIN LEVEL Blood should be drawn 6-8 hours after the last dose of digoxin was taken. PRENATAL GLUCOSE TOLERANCE TESTS For our pregnant patients: Your physician may order glucose tolerance testing during your pregnancy. 50 GRAM 1 HOUR GLUCOSE TOLERANCE TEST (GESTATIONAL DIABETES SCREEN) 1. No special patient preparation is required. 2. This test is done without regard to the time of day or time of last meal. You do not
3. You will be given a special drink and your blood will be drawn one hour after you
4. Please allow at least 1 ½ hours for this test to be completed. 100 GRAM 3 HOUR GLUCOSE TOLERANCE TEST (GESTATIONAL DIABETES) 1. This test should be performed in the morning after an overnight fast of at least 8 hours
but not more than 14 hours and after at least 3 days of unrestricted diet and activity.
2. A blood specimen will be drawn and tested. 3. You will then be given a special drink. 4. Your blood will be drawn once each hour after you finish the drink for three hours.
5. Please allow plenty of time for this test. You will need to allow at least 4 hours for
PATIENT PREPARATION FOR OTHER LAB TESTS URINE SPECIMENS 24-HOUR URINE SPECIMENS Please follow these instructions in collecting your 24-hour urine specimen. You will find it more convenient to void (urinate) into the smaller container provided and transfer the urine into the larger collection container. Do not add anything but urine to the container and do not pour out any liquid or powder that may already be in the collection container. These substances may cause burns if touched. The collection container should be kept cool throughout the collection period. You may place in a refrigerator or in a pan with ice during collection. 1. Upon arising in the morning, urinate into the toilet, emptying your bladder
completely. Do not collect this sample. Note the exact time and print it on the container label. 2. Collect all urine voided for 24 hours after this time in the container provided. All
urine passed during the 24-hour time period (day and night) must be saved. Urine passed during bowel movements must also be collected. Be careful not to contaminate urine specimen with feces.
3. Refrigerate the collected urine between all voidings or keep in a cool place. 4. At exactly the same time the following morning, void completely again (first time
after awakening) and add this sample to the collection container. This completes your 24-hour collection.
5. Be sure to label specimen with patient’s name, date and time the collection began and 6. Take the 24-hour specimen to the Outpatient service area as soon as possible. CONTAINERS: Sterile containers and 24 hr urine containers may be picked up at Outpatient service between the hours of 6am to 6pm. After hours, please contact laboratory for container. COMMON 24- HOUR URINE TESTS ORDERED
24-HOUR CREATININE CLEARANCE COLLECTION 1. Obtain a collection container from Outpatient services/ or laboratory if after hours. 2. Follow the directions for 24-hour urine collections. 3. Keep the collection container with urine refrigerated or on ice. 4. Have your blood drawn either at the beginning, during or end of the collection period.
A blood sample is needed in conjunction with the 24-hour urine collection in order to complete the testing.
5. Please label the container with the patient’s name, date, and time the collection began 6. Include the patient’s height and weight. 7. Return patient collection container to Outpatient Services or laboratory. 24-HOUR URINE –TOTAL PROTEIN COLLECTION 1. Obtain a collection container from Outpatient Services/or laboratory if after hours. 2. Follow instructions for 24-hour urine collection. 3. Keep the collection container refrigerated or on ice. 4. Please label the container with patient’s name, date and time the collection began and 5. Return patient collection container to Outpatient Services or laboratory. 24-HOUR CATECHOLAMINE and/or METANEPHRINE COLLECTION 1. Talk to your doctor about your diet and medications you’re taking prescription,
supplements and over the counter drugs (Drugs may affect catecholamine levels.)
2. Diet and exercise may also affect catecholamine and/or metanephrine levels. 3. Avoid foods such as coffee (including decaf), tea, chocolate, vanilla, bananas,
oranges and other citrus fruits several days prior to and during the collection.
4. Minimize vigorous exercise, emotional and physical stress prior and during collection
as well. These precautions will insure the sample will reflect a true metabolic condition and not an interference or aberration.
5. Obtain a collection container from Outpatient Services/or laboratory if after hours. 6. Follow instructions for 24-hour urine collection. 7. Keep the collection container refrigerated or on ice. 8. Please label the container with patient’s name, date and time the collection 9. Return patient collection container to Outpatient Services or laboratory. 5-HIAA 24-HOUR URINE COLLECTION 1. Talk to your doctor about medications that can affect the 5-HIAA test
since a variety of medications can affect test results.
2. Foods such as avocados, bananas, pineapples, plums, walnuts, tomatoes, kiwi fruit, and eggplant should be avoided 3 days prior to and during urine collection. 3. Obtain a collection container from Outpatient Services or laboratory if 4. Follow the instructions for 24-hour collection 5. Keep container refrigerated or on ice during the collection 6. Please label the container with patient’s name, date and time the collection began and 7. Return collection container to Outpatient’s Services or laboratory. URINE FOR URINALYSIS AND/OR CULTURE
Obtain a sterile container from your physician’s office, Outpatient services and/or the laboratory. Please avoid touching the inside of the container and/or the lid in order to maintain sterility.
1. Female: The patient should be seated on the toilet or bedpan with legs separated.
Separate labia minor (inner folds), cleanse opening of urethra three times with cleansing pads. Allow the initial stream of urine to pass, and then collect urine into a sterile container.
2. Male: cleanse glans three times with cleaning pads. Allow the initial stream of
urine to pass, and then collect urine into a sterile container.
3. Please label the specimen with patient’s name, date and time of collection. 4. The specimen should be returned as soon as possible. If there is a delay, the
1. Obtain a sterile container from your physician’s office, Outpatient services or
the laboratory if after hours. Avoid touching the inside of the container and/or lid in order to maintain sterility.
2. Obtain a first morning specimen. 3. Return the specimen to Outpatient services within 30 minutes of collection. 4. Please label the specimen with patient’s name, date and time of collection.
STOOL SPECIMEN COLLECTIONS STOOL FOR OCCULT BLOOD Diet and drugs may affect results of occult blood testing. Please talk to your physician before making any changes in diet or medications prescribed for you.
¾ For three days before and during stool collection eat a well balanced diet
including fiber such as bran cereals, fruits and vegetables. Avoid red meats, including beef, lamb, and liver.
¾ There are also some common over-the-counter drugs that may affect results of the
testing. For seven days before and during the stool collection period, avoid non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, or aspirin.
o Note: Aspirin may be taken if not in excess of one adult aspirin or 325mg
o Acetaminophen (Tylenol) may be taken as needed.
¾ For three days before and during the stool collection period, avoid vitamin C in
excess of 250mg/day from supplements, citrus fruits, and juices.
¾ Iron supplements may be taken if they do not contain more than 250 mg of
1. Your doctor or laboratory will give you one or more test “cards”. 2. You will collect a separate sample from three different stools, usually on consecutive
days. Each stool specimen should be collected into a clean container and should not be contaminated with urine or water.
3. Each card should be labeled with your name and the date and time of collection. 4. Open the flap on the card. 5. With an applicator stick, apply a thin smear of stool onto each filter
paper/square/window contained on the card.
6. Allow the filter paper to dry. Once it is dry, it is stable. 7. Collect all of the consecutive samples, and then return them to Outpatient services or
your physician office. If you have been given a mailer, please return the collection cards by mail.
STOOL COLLECTION FOR OTHER TESTS You may be asked to collect a stool specimen for laboratory testing. You may collect this specimen in a clean container with a tightly fitting lid or in the collection kit provided by CRMC. If you are instructed to collect specimens for stool culture plus O&P, please use the stool collection kit provided by CRMC Lab. This kit gives optimum specimen preservation for testing. PATIENT INSTRUCTIONS NOTE: Prior to collecting a stool specimen, avoid consuming the following: These products can interfere with Test Results SPECIMEN COLLECTION 1. Collect stool specimen into a clean, dry, disposable container.
(Cut off milk carton, cottage cheese or ice cream container, plastic bag, etc)
Do not allow urine or toilet water in container with stool
Note: If you have not been provided with special containers for returning your specimen, you may collect the specimen in a clean container with a tight fitting lid. Label the container with the patient’s name and the date of collection and return to CRMC lab as soon as possible. If you have been provided with a set of stool specimen vials, please follow these directions. 2. Each vial has a "spoon-scooper" attached in the lid to help in adding stool to the vial. If present, select areas of the stool that is watery, bloody, slimy, or loose. Add stool to each vial according to these directions:
¾ ORANGE CAP VIAL and PINK CAP VIAL:
Add enough stool for the solution in the vial to reach the RED FILL LINE
Mash any solid stool on the inside of the vial to break up.
¾ WHITE CAP VIAL (this vial is empty):
Add stool to empty vial, but not above the RED FILL LINE. A normal
3. On each vial write your name, date, and time of collection. Check-mark the box that best describes what your stool looks like. Place vials back in zip lock bag. 4. Store vials with orange and pink caps at room temperature. Refrigerate the white capped vial. 5. Follow your physician's orders of where to take your specimens after collection: (ie: return to clinic, take to CRMC Outpatient Services) Please note that if you have any questions, you may either call your physician's office, or you may call Capital Region Medical Center Microbiology: 1-573-632-5240 to speak to a Micro Tech. OTHER SPECIMENS
SEMEN ANALYSIS 1. Refrain from sexual intercourse or masturbation for between 2 and7 days. 2. Produce the sample by masturbation without artificial lubricants. Do not use a
condom, as condoms contain spermicidal agents.
3. Collect the sample into the clean, wide mouth container supplied. It is important that
the whole ejaculate is collected. If not, the specimen should be labeled as incomplete.
4. Within 1 hour of collection, bring the sample to Outpatient services or to the
laboratory. Keep the specimen warm in a pocket near your body.
5. Label the specimen with name, date, and time of the collection. 6. Complete the patient questionnaire (found in OP registration or Lab front desk) and
return to Outpatient services or laboratory with the specimen.
7. Samples may also be produced in a room at the laboratory. SPUTUM FOR CULTURE AND ACID FAST MYCOBACTERIUM (AFB) 1. Patient should rinse mouth and gargle with water immediately prior to collection. 2. Collect specimen from deep cough into a sterile container. 3. Patient should avoid any contamination with saliva. 4. Return specimen as soon as possible. If there is a delay, specimen should be
refrigerated. Please label the specimen container with patient’s name, date and time.
Please note that if you have any questions, you may call your physician’s office or Capital Region Medical Center Laboratory at 1-573-632-5230. Thank you for allowing us to provide laboratory services for you and your family.
COMUNE DI ALBIGNASEGO Verbale di deliberazione della Giunta Comunale N. 19 del 27/01/2000 L'anno duemila , addì ventisette del mese di gennaio , alle ore 18,20 , nella Residenza Municipale di Villa Obizzi , si è riunita sotto la presidenza del Sindaco Lanfranco Casale la Giunta Comunale. Partecipa all'adunanza ed è incaricato della redazione del presente verbale Il Segret
Description de Halitherium fossile, Gervais. Extract Bull. Soc. Géol. France III-14; pp. 483-518, 3 plts. Notes concerning manatees and dugongs. Journal of Mammalogy 16 (3):216-220. Some early notices on American manatees and the mode of their capture. Journal of Mammalogy 27 (3):234-239. Distribution and abundance of manatees (Trichechus manatus) in the Dominican Republic. Analyses of propel