I have becomce increasingly concerned with regard to this assay, especially as such a low net absorbance, i.e. >0.007 is significant. The results also seem to be used now as a final check before patients with, for example migraine, are discharged home and a precious hospital bed released. I am particularly concerned with the way that samples are transported to the laboratory and in particular that they are seldom protected from light. Finally, in my own area we introduced this test to be helpful, within existing resources and therefore to be available only 09.00 - 17.00 Monday to Friday but now find ourselves under intense pressure to provide the service 24/7. Do other labs. provide this level of service and do they reject or accept samples which the feel have not been transported correctly?
 
Mike
 
 
Dr Mike Bosomworth
Consultant Clinical Biochemist


>>> "Dr Robert Hill, Consultant Clinical Chemistry @KMH"              <[log in to unmask]> 10/08/2004 16:44:25 >>>
In trying to put into place the UK NEQAS guidelines for CSF xanthochromia we find ourselves in competition with our microbiologists for the same third or fourth sample (to avoid contamination from a bloody tap). It seems that a guideline for medical staff is required in our hospital whereby  the third or fourth CSF specimen is split into two aliquots - one for meningitis screening, the other for xanthochromia testing.

The question arises  - is it appropriate to test for meningitis and xanthochromia on all patients with headache from whom a CSF sample is taken? Although both of these conditions can present with symptoms of meningeal irritation, does not the presence or absence of fever give a clue to the more likely diagnosis?
I suppose on the other hand it would be wrong to let an important diagnostic opportunity slip on a precious sample.

Any comments?

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