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We discussed this with our Neurosurgeons in 2009 when developing local guidelines. They did not think out of hours provision was necessary. The argument being - if my memory serves me right - because angiography wouldn't happen until the day anyway. We offer 9-5, 7 days a week but do occasionally run them outside of this if staff can cope. Stuart -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Barlow Ian (NORTHERN LINCOLNSHIRE AND GOOLE HOSPITALS NHS FOUNDATION TRUST) Sent: 14 November 2012 15:49 To: [log in to unmask] Subject: Re: Xanthochromia --- This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within. The identified sender is [log in to unmask] --- That is certainly the way we work. If a significant patient management decision will be made on the basis of the CSF result - either referral for angiography or a discharge then we will do the Xanthochromia at any time day or night. Medicine is 24 hours these days, therefore we must be responsive to that and help ensure continuity of care. Why should a patient have to wait for a result next day when that result could influence his or her immediate management and provide reassurance? Regards Ian -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay Sent: 14 November 2012 15:29 To: [log in to unmask] Subject: Re: Xanthochromia I hear that argument a lot. I disagree about the impossibility of sending a patient home before the result of the test is available. If we restricted that process to very low risk patients, documented the discharge policy and could be reasonably sure that someone could seek medical attention if the patient deteriorated between discharge and the result being available the next morning I don't think that we would be anywhere near negligence. Is anyone working that way already? Jonathan On 14 Nov 2012, at 09:59, Paul Masters wrote: > Xanthochromia is rarely requested because there is a genuine expectation of an SAH. By far the commonest scenario is the MAU wants to discharge a patient who had a negative CT and is clinically well enough to go home. The medical team will not discharge until they have done an LP and excluded xanthochromia. Since patients are now discharged 24/7 we are expected to proved a lab service to support that. Occasionally we do get an unexpected high NBA, which just re-inforces the clinicans' insistence on doing an LP before discharge. Medico-legally they would be in a difficult position if they discharged without LP and the patient had a second bleed. It's become the standard of care. > Is that a misuse of the test? > > Paul Masters > > ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ******************************************************************************************************************** This message may contain confidential information. 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