I asked at the time the bloods were taken if their freezer worked, as I thought it required being chilled etc, but the nurse explained to me: being on ICE was this ( and she showed me) paperwork and it stood for something Computer Evaluation or so. She could not remember exactly. But the paper work was done on it, so how come it still said this ( see above) on my records???
Does anyone here know more about the ICE ?
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totallyFrustrated
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A quick Google search told me this......ICE (Integrated Clinical Environment) system is an established web-based service installed in more than 60% of Acute NHS Trusts and accessed by more than 5'000 GP practices. Sunquest ICE allows clinical requests to be made from wards, clinics and GP surgeries, offering full tracking from the point of request. It also includes a feature that allows GPs to view details from pathological investigations carried out on their patients whilst under our care (e.g. inpatient results).
Thank you BeachArt, that is useful to know. Thank you so much for taking the time to type all this info, I know most days, just striking a few keys on a keyboard can seem like climbing mount everest. With similar shortness of breath. So , much appreciated.
Just still makes me wonder why it says" not sent on ICE"
Ah ha! This could have potentially meant one of two things, but in this case it sounds like it will be the ICE system used for order communications and result reporting, allowing Pathology and Radiology to be accessed on line.
Some pathology tests are very sensitive to temperature, and that could have been the other one. Sending blood for pathology tests is far more complex than it first appears. Blood's fine when it's in a vein, but when it's taken into a syringe, things start happening. It starts to clot immediately, and this can only be offset by the addition of anticoagulant chemicals. Some of these bind calcium, so they interfere with the blood chemistry, but they're OK for haematology. Some inhibit the coagulation pathways, but don't stop platelets from clumping. Some tubes have other stuff in them to stop the cells gobbling up the glucose, so we can measure blood sugar. That's why when you put your arm out, there can be several different coloured tubes used. Then, there's temperature. Generally, the lower the temperature the better, so long as freezing is avoided, but some tests actually suffer when the temperature is lower.
Electronic order communication and reporting greatly simplifies the 'front end' of pathology testing, so by the time the sample gets to the lab, it's largely already requested and can be processed promptly. If there's no electronic request via ICE, someone has to input all the data to identify you, and the sample, and the tests required, and link all these together. It's a big stumbling block, but IT systems have improved things. Not to say that things don't go wrong. The labs can always [or should be able to] process stuff that's not been electronically communicated, but stuff can go astray between leaving the vein and meeting the analysers.
Ahhh thank you so much for that excellent reply, I love this chat I have learned more here (about B12 and related things at least) in the last 6 month than in 5 years college. So the info you just gave me raises another question ( don't all answers just give rise to more questions??? lol )
When they take my blood, they cannot use those tubes with built in vacuum, as my veins pop the moment the vacuum tube gets put in. So they have to draw my blood the old fashioned way, with a syriinge and pulling back on the .... pushything... Gosh I loose my word more and more, and then they inject that into the test tube. would that give the blood time to make any of the changes you mentioned that what is in the tubes is meant to prevent?
Some folks do have veins that are prone to collapsing when we stick needles anywhere hear them. I was dragged up using needles and syringes, and done properly I don't think the risk is too bad, although the technique is different. The vacuum draw tubes [such as Vacutainer and Greiner Vacuette] do a good job anticoagulating the blood, as it's straight in to the additives. A further variant is the Sartsedt Monovette, which is effectively a plastic syringe that works with the same sort of 'double-ended' needle but can be use either pre-evacuated, or as a conventional draw device. [No, I don't work for any of these companies and I won't recommend one over the other!] They're all good. However, Monovette was my favourite.
Using those tubes with a conventional needle and syringe poses a further problem, and feel free to criticise someone if you see this happening: they take your loaded syringe, and jab the needle through the tube stopper, squirting the blood into the tube. Then needle out, and through the next one, and so on. This is technically very bad, plus dangerous. The phlebotomist is at risk of injecting themselves with your sample. Plus stabbing the needle through the cap and injecting the blood will cause haemolysis of the red cells due to turbulence. Then you get a call to have a repeat, because there's something wrong with your blood. If it turns out that your serum potassium is raised, but isn't when repeated, then that was probably an artefact down to mishandling. Anyone who disagrees is welcome to a discussion outside in the car park... Life's difficult enough already!
this is what the nurse did, she drew my blood, then injected it into the test tubes, a bit into this one then the rest into the next one, same needle and everything.....
Well, she's a disgrace to her profession, OR her employer is rubbish at staff training. Or both. You can tell her from me! I trained staff to do this, and gave them the reasons why, but it's another 'horses and water' thing. It may seem a logical approach, but it's wrong, dangerous and stupid. In my experience, the higher up the greasy pole folks are, the more likely they are to adopt this practice. Telling a doctor he's doing it wrong takes courage, but once he's missed the tube cap and jabbed it into his own flesh? Maybe he'll listen.
I can't say about lab testing in UK. However, the two largest labs in the US, LabCorp and Quest Diagnostics, require only blood serum for B12 testing be transported and handled at room temperature.
B12 is quite stable in a sample, but folate is less forgiving. Red cell folate [requiring an anticoagulated sample, typically in EDTA] is also more stable. Coagulation tests don't like temperature abuse. Some chemistry tests are more stable, but it's an issue with samples being sent long distances. Samples for serum tests in 'serum gel tubes' are better centrifuged, and I know of some GP practices that have a centrifuge, but it's certainly not common.
Thank you for that clarification Flipper. These two labs do use gel-tubes so I'm assuming collection sites may centrifuge locally before sending off to a central lab.
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