Lead

Last Modified: 4/12/2019 10:17:09 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation: Patients should refrain from seafood, antacids, vitamins with mineral supplements, and herbal preparations at least 3 days prior to specimen collection.
Specimen Requirements: 3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions: Collect pediatric samples in lead-free microtubes following manufacturer's instructions

1. For contamination control during blood collection, use powderless gloves, and wash the draw site with soap and water, then dry with a clean, low lint towel. If water is unavailable, the skin may be cleansed using foaming soaps or using alcohol prop pads.
2. Follow universal precautions during blood collection.
3. For venous sample, follow the standard venipuncture procedure. Collect whole blood in a lead-free tube.
*4. Follow the guidelines below for collection of capillary blood
A. Heel stick should be performed for children under the age of 12 months.
B. Please note that the high potential for lead contamination of capillary during collection is well known (CDC, 1985) and that special precautions must be followed to minimize the Lead contamination which may be present on the skin:
*thoroughly wash the hand/foot with soap and water and dry with a clean, low-lint towel
*if water is not available, the skin may be cleansed with foaming soaps or using alcohol prep pads.
* the finger/heel to be punctured must be free of any visible infection or wound(s) and the area should be massaged to increase the circulation prior to collection
* do not allow the cleansed area to touch any articles of clothing or non-cleansed skin areas prior to sample collection
* lance the skin area using routine capillary collection techniques and remove the first droplet of blood using gauze pad or other sterile blotting material - DO NOT WIPE.
* blood which runs down the finger or around the fingernail is not suitable for collection 
* draw the blood into the capillary container maintaining a continuous flow of blood. Cap or seal the container and agitate gently (20-30 sec) to mix the blood with the anticoagulant. Check the tube identification Stop the bleeding and cover the draw site with sterile gauze. If bleeding is slow to stop, apply pressure to the puncture site with sterile gauze. If bleeding continues after 3-5 min, consult a physician. If multiple tubes are drawn for chemistry, hematology, etc., the draw for trace elements should be done last. 

Be sure to gently mix the blood specimen immediately after collection. 

To Avoid trace element contamination observe the following precautions:
1. Use powderless gloves.
2. Do not aliquot the specimen
Minimum Volume: 0.5mL Whole Blood
Neonatal Volume: 0.2 lavendar microtainer or for Capillary draw
Transport & Storage: Temperature/Stability: 5 days Ambient
14 days Refrigerated (preferred)
60 year Frozen
Reference Range:

Birth to 6 years: < 5 mcg/dL*

> 6 years: < 10 mcg/dL

Blood lead levels in the range of 5-9 mcg/dL have been associated with adverse health effects in children aged 6 years and younger. For this age group, case management varies by CDC Blood Lead Level range. Refer to current guidelines for recommended interventions.

CDC Class I: < 10 mcg/dL
CDC Class IIA: 10 - 14 mcg/dL
CDC Class IIB: 15 - 19 mcg/dL
CDC Class III: 20 - 44 mcg/dL
CDC Class IV: 45 - 69 mcg/dL
CDC Class V:  > 69 mcg/dL 

Critical Ranges:  
Test Comments: Refer to current CDC Guidelines for comments and interventions recommended for each class. OSHA references 40 mcg/dL or less Guidelines dated June 3, 1993, were published in the Federal Register, Volume 58, No. 84, pp 26627-26649, May 4, 1993.
Methodology: Atomic Spectroscopy
Clinical Significance: Children are especially susceptible to neurologic damage from lead and acute neurologic toxicity may develop without previous symptoms
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 2 to 5 days
Days Performed: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Quest - Chantilly
PHL Test Code: LEAD
EPIC Test Code: LAB98
Send Out Test Code: 599
Included Tests:  
CPT Coding: 83655

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