Balanced heparin syringe
(*Please note that different brands of syringe with different size and heparin content are used in NTEC hospitals.)
Minimum blood volume: 0.6 mL (using 1 mL syringe containing 30 IU balanced lithium heparin)
Minimum blood volume: 1.6 mL (using 3 mL syringe containing 80 IU balanced lithium heparin) |
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Authorisation code required |
No |
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24 Hr available service |
Yes |
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Precaution |
Blood Taking Procedure
Avoid using sample collection devices containing EDTA, citrate, oxalate, and fluoride anticoagulants. These anticoagulants have a significant effect on blood pH and ionised calcium.
Avoid using excessive levels of heparin anticoagulants. Excessive levels of heparin anticoagulants cause calcium-heparin chelation and falsely decrease calcium levels. |
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Method |
Ion selective electrode |
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Reference interval |
(Source: Lentner C ed. Geigy Scientific Tables 3: 82 - 83, 1984. 8th Edition, Ciba - Geigy Ltd.) |
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Clinical indication |
Diagnosis of hypercalcaemia and hypocalcaemia. Calcium occurs in plasma as ionised, complexed and protein bound forms. It can be measured as total calcium, ionised calcium, or corrected calcium (in which total calcium is corrected, usually in relation to the patient’s albumin level). Ionised calcium is required if complexed calcium is likely to be very high (e.g. during massive transfusion), if pH is abnormal or if an abnormality in calcium is marginal. |
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Result interpretation |
Elevated ionised calcium levels are detected in patients with primary / tertiary hyperparathyroidism; malignancy especially lung, multiple myeloma, kidney, bony metastases; sarcoidosis; vitamin D or vitamin A toxicity.
Decreased ionised calcium levels are detected in patients with hypoparathyroidism, renal failure, osteomalacia or rickets. |
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Measurement of uncertainty |
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Frequency of measurement |
Daily |