Samples are delivered to NSO Monday – Saturday by courier. Samples should be received no later than 10:00 am.
All specimens received are assessed for blood quality/quantity and barcoded for subsequent entry into the NSO database. At the barcoding stage, each requisition/blood sample is reviewed for sample quality and quantity. Those samples that are of satisfactory quality/quantity are then barcoded in duplicate. Any samples that are possibly unsatisfactory during sample review are set aside for evaluation by the laboratory head or resource/senior technologist.
Blood cards suitable for analysis are bundled into groups of 50 and passed on to the technicians in charge of punching on the multi-puncher.
Procedure in the NSO lab for blood spot punching:
A “punch” is an excised circle of blood which is subsequently used for sample analysis. Each and every sample received is tracked at all times. All samples are punched into barcoded Microplates that are designated for a specific method/procedure. The minimum number of punches required for a collection to be of sufficient quantity is currently 10. This may increase as the newborn screening panel expands. NSO uses 3.2 mm punches, which are taken from the blood spot collection card.
Re-punched samples:
Specimens may be deemed unsuitable for reporting for several reasons:
- Machine malfunction
- QC issues
- Instrumental flags
- Equivocal results of unknown reason upon review by laboratory head or designate.
In these situations, the sample will typically be re-punched singly and processed for the specific method in question:
- Specimens flagged as an initial positive are re-punched in duplicate for confirmation and are processed overnight and reported out the following day.
Exceptions where an abnormal result will be re-evaluated for confirmation on the same day of initial analysis include very provocative results for disorders where the delay in diagnosis may have catastrophic consequences such as:
- Citrullinemia
- MSUD