What does the lab do?
We are like detectives at the Buena Vista Regional Medical Center laboratory. We use chemical and biological testing to track down clues, which lead to the diagnosis and treatment of diseases.
Say Mr. R comes to the ER complaining of headaches, excessive thirst and tiredness. His doctor orders blood and urine testing. The nurse or ER Secretary orders the labs into the computer and the lab receives them on their computer. The tech or phlebotomist then goes to the ER to draw the blood. Once the blood arrives in the lab, our work begins. The blood is analyzed to determine what may be causing Mr. R’s symptoms.
How many lab tests are done at BVRMC’s laboratory?
Annually, we performed nearly 13,500 blood collections and 184,500 in-house lab tests.
Blood Bank
First on the tour is blood banking. This is where blood typing is done. We also cross-match blood for transfusions. We cross-match approximately 700 units per year and transfuse around 520 units per year. We store 68 units for transfusion, which are supplied by Siouxland Blood Bank. So when you donate to SBB on the first Tuesday of every month, you are donating to those who may need it in the Storm Lake region.
Hematology
The main test we run in our hematology department is the complete blood count, or CBC, which includes a white blood cell count, red cell count, hemoglobin and platelets. An elevated white count may indicate infection, while chemotherapy or other conditions can cause a decreased white count. Hemoglobin is a test for anemia and the platelet count determines your blood’s clotting capability. We also do spinal fluid cell counts and semen analysis in the hematology department.
Coagulation
In the coagulation department, we use an instrument, the Beckman-Coulter ACL Elite, to determine the status of heparin therapy and coumadin therapy – two drugs used to “thin” the blood.
Urinalysis/Send-outs
Our urinalysis department uses an instrument called the Cliniteck Status to determine if a person’s urine is normal or if there are signs of infection, metabolic problems, liver problems or possible diabetes. We also examine the urine under a microscope and observe the number and type of cells seen.
Our urinalysis department is also the area where we process “send-outs” – tests we do not do here but send to a reference lab. Most are sent to Sioux Falls, SD.
Microbiology
In microbiology, we determine what bacteria is causing an infection and what antibiotic will kill it. When a culture of say, a wound, comes in, we rub the swab on several different small petri plates that contain nutrients for the bacteria. Based on how the bacteria react to the plates, we decide what kind of bacteria it is. An instrument called the Vitek gives us the definite answer. The Vitek also tests the bacteria against antibiotics, which tells the doctor which of the antibiotics will be effective in treating the infection.
When a test is done in the lab, how do you know the answer is correct?
Daily and up to three times per 24 hours, we run Quality Control on all instruments and against all tests we do. The reagents for the QC have known values and when our instruments attain these results, we know our patient results are correct as well.
Tell us about who works in the Lab:
We have 17 laboratory employees, which includes one supervisor, one full-time lab clerk, one part-time phlebotomist, nine full-time techs and six part-time techs. We have staffed our lab 24/7 since 1991. In total, we have 290 years of experience among us.
How is Mr. R mentioned at the beginning?
On Mr. R, we found an elevated glucose in his blood. His urine was positive for glucose, a small amount of protein and ketones, as well as showing some bacteria in the microscopic exam. His results were sent to the ER via the computer and correlated with his symptoms. The doctor determined that he was diabetic. On a side note, the culture we did on his urine grew out a gram-negative rod, E. Coli, which was sensitive to Bactrim. This would also explain his elevated white count.
In Summary
We in the lab at Buena Vista Regional Medical Center are laboratory scientists who perform analysis on blood and body fluids to obtain data from which a diagnosis of health or disease is made. The information given to the doctor influences the medical treatment a patient receives. The laboratory is an integral player in the healthcare team at BVRMC that determines the diagnosis, treatment and care of our patients.