engleski

Phlebotomy, stat testing and laboratory organization : an intriguing relationship

Stat or urgent testing is a conventional circumlocution, which is used to designate timely or “rush” performance of laboratory tests. The term “stat” is literally derived from the Latin word “statim”, which actually means “immediately”. In the daily practice, this concept is used to define a series of activities or processes required to obtain rapid test results for the immediate management of life-threatening conditions, and thereby involves typically rapid access information on blood gases, glucose, electrolytes, coagulation tests, enzymes of acute cytolysis (e.g., alanine aminostransferase or lipase) and cardiac troponins, among others. It thereby designates the highest degree of medical priority, so that the laboratory staff should ideally interrupt what they are doing to run the test immediately. In a broader perspective, this definition can be enlarged to embrace all those conditions – even when not really life-threatening – that would require rapid diagnostic or therapeutic decision, either clinically or organizationally driven. Typical cases may be those of patients urging therapeutic adjustment or rapid diagnostic testing before undergoing surgery, or requiring fast test results for being discharged from the emergency department (ED) or intensive care unit (ICU). The ideal – although not really exclusive – stakeholders of stat testing are thereby the emerging physicians (and/or nurses) working in EDs or ICUs, whereby time is always critical for both clinical (i.e., serious pathologies) and organizational (i.e., overcrowding) issues. While in the past laboratory professionals have often overlooked timeliness as an important attribute, clinicians often judge the adequacy of laboratory services by the speed with which results are reported. In the last decades, however, both for the developments of point-of-care (POC) technologies and reorganization of acute care in hospitals, laboratory professionals have considered this important issue more in-depth.

laboratory organization; phlebotomy; preanalytical variability; stat testing; urgent testing

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