Who considers " Trace" RBCs in a urine dipstick as Abnormal
Our facility currently flags all urine dipstick results at the “Trace” level as being Abnormal.
I personally believe that due to the improved sensitivity of dips sticks with most manufacturers, that the detection of myoglobin is now more common that it was 15-20 years ago and that trace is a normal physiologic occurrence when physical
activity is factored in.
I would appreciate input from other facilities as to at what level of detection you are flagging the result as abnormal. (Trace, 1+, 2+, 3+)
Thank you in advance to anyone who responds.
Gregory A. Olsen, MT(ASCP)SBB
Director, Clinical Laboratories
Boys Town National Research Hospital
Omaha, NE 68131
531-355-6055
Excellence implies more than competence...it implies a striving for the highest possible standard."
This message is privileged and confidential and is intended only for the use of the addressee. Unauthorized use of this message is strictly prohibited. If you received this transmission in error, please immediately
contact the sender and destroy the message. Thank you.
| Topic | Replies | Likes | Views | Participants | Last Reply |
|---|---|---|---|---|---|
| Hemochron Sig Elite use outside of manufacturer temperature range | 0 | 0 | 39 | ||
| EPOC scanner issue post software update | 6 | 0 | 289 | ||
| PFA-100 | 0 | 0 | 119 |
Our central lab converts trace to negative, so we adopted the same practice at the Point of Care. All trace results are seen as negative in the chart.
We flag trace as Abnormal. It is up to the physician to determine if the trace result is clinically significant or not.
I would agree with Bryan. We also flag trace as abnormal. I don't think that's a call the laboratory should be making for the physician. It also strikes me a bit as manipulating the manufacturer's intent on what they state as sensitivity/performance characteristics on the kit insert.
Very interesting topic, though!
I cannot speak for the central/clinical lab on what they mask/convert but for POCT 'what you see is what you report'.
The manufacturer does not assign "Abnormal" flagging to any positive detectable level. That is left to the performing institution to decide what they want to call abnormal.
Our proposal would be to report out the Trace result with a footnote indicating that the result should be interpreted in the clinical context of the patient setting. (not the proposed verbiage but you get the jist).
What we are seeing is that we need to perform education with our clinicians since many are demonstrating they do not understand that myoglobin can result in a positive dip stick result at the trace-lysed level.
Trace, in my opinion, is still a result the physician needs to see.