Condensed Case

It was a busy day in the pediatric ambulatory clinic. At the change of shifts, a nurse discovered a labeled purple top tube sitting on the countertop with doctor's orders attached. The nurse had no idea when the sample was drawn, and neither did any of the other personnel. A CBC and differential were ordered. What is the next course of action?

Answer

This sample needs to be redrawn if in fact the physician is still interested in the results. CBC testing is best done within a 4-hour time period, and within 24 hours if the sample is refrigerated. Red cell morphology will be significantly affected within 2 to 3 hours at room temperature. Peripheral smears made within 12 hours on a refrigerated sample will still be viable. Testing personnel need to be aware of time limits and their effect on sample integrity.

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