Common on-call topics in clinical pathology

Author: Mikael Häggström

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

• Minimal depth
• (Moderate depth)
• ((Comprehensive))

Most useful local documents

If you're on-call, know where to find local policies, manuals and procedures that are relevant to the departments you may receive calls from. The following local documents are generally most important:

• Blood bank:

• Cutoff values for blood product transfusions. Further information: Blood bank
• The NHSN Biovigilance document on evaluating suspected transfusion reactions.

• Chemistry

• Package inserts for instruments used in the laboratory
• Cutoffs for classifying various test results as critical, and how you are going to proceed in such cases.

Also keep an updated telephone list, including the supervisors for relevant departments.

Blood bank

Topics with individual articles:

• Blood bank

• Irradiated blood
• Transfusion reaction

Plasma compatibility

		Donor
		O	A	B	AB
	O
	A
	B
	AB

Incompatible plasma

In emergencies, it is acceptable to approve plasma that is ABO incompatible or possibly incompatible (such as from a type A donor to a recipient with unknown blood type).

Other topics with individual articles

• Low blood glucose
• Suspected blasts on peripheral blood smear

Suspected falsely low TSH

If a clinician thinks a TSH result is falsely low (generally signs of hypothyroidism but TSH is not elevated), first check with the lab if their TSH assay is susceptible to high patient biotin levels, and if it is, ask the clinician if the patient takes biotin supplementation, which can explain the low TSH levels.

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