Clinical chemistry and toxicology

PACI pathologists oversee and work directly in the clinical chemistry laboratory. The laboratories we serve perform millions of determinations each year. 60% of this volume is from outside smaller hospitals and physician’s clinics.  This laboratory operates 24 hours/day 7 days/week. It is the responsibility of the pathologists to determine the accuracy, precision and appropriateness of testing and to work closely with the technologists to streamline all testing activity. In addition, it is the responsibility of the pathologist to determine the timeliness of all testing (including determination of critical tests and their values) and to determine the population normal ranges of all analytes. If clinical problems occur with testing as detected by ordering physicians, the pathologist determines what the problem is and corrects the problem.

Pathologists also oversee pre-analytical phases of testing and communicate to physicians and staff what problems exist and how they need to be eliminated. Also all peripheral testing (i.e.: point of care testing) is overseen by pathologists and, like in the laboratory, appropriateness and accuracy of this testing is determined and also compared to similar testing in the main clinical laboratory. Pathologists also actively participate with the clinical laboratory technologists in the determination and “best fit” for laboratory testing equipment.

Pathologists are responsible for final evaluation and/or interpretation of specific tests including protein electrophoresis, immunofixation electrophoresis, parathyroid-calcium comparisons, final toxicology reports (see below), and second trimester trisomy and neural tube defects.

Automated urinalysis is also a part of clinical chemistry and is overseen by pathologists. Pathologists interpret unusual urinary sediment findings.

A specialized area of the clinical chemistry laboratory of MMC is toxicology. Sophisticated instrumentation is utilized to confirm positive screening tests. Extensive digitized computer banks are available for exact identification. This laboratory is unusual for a hospital based clinical laboratory, but exists as a result of the extensive forensic testing preformed on coroner's cases autopsied at Memorial Medical Center. Clinical volatile identifications and quantitation (e.g., ethylene glycol) on patients hospitalized at other institutions in Central Illinois are performed in this laboratory.