Specimen Requirements

Patient Preparation

Outpatients: Draw performed in Outpatient Infusion Clinic by IV Therapists. Injection given by IV Therapy. Appointments are preferred but not required.

1. IV Therapist verifies the following information is provided:

A. Face sheet

B. Physician orders or laboratory request form

C. Progress notes

D. Charge slip

2. Obtain 1 vial 0.25 mg Cosyntropin® from pharmacy.

3. Identify patient and explain procedure.

4. Question patient to verify proper preparation.

5. Place patient in supine position, apply tourniquet, palpate and locate vein, cleanse site with alcohol, and start INT lock.

6. Draw pre-injection blood specimen for baseline cortisol level (minimum volume:  3 mL), and label as such with collection time.

7. IV Therapy gives 0.25 mg Cosyntropin® intramuscular injection. Write injection time on laboratory request form.

8. Draw blood specimens for cortisol level at 30 and 60 minutes post-injection. Label each specimen accordingly.

9. Send specimens and laboratory request form to main laboratory.

10. Remove INT lock.

11. Chart in progress notes/computer.

12. Place chart in file drawer.

Inpatients: Collection performed in patient’s room by phlebotomist. Injection is given by patient’s nurse.

1. Floor staff obtains 1 vial 0.25 mg Cosyntropin® from pharmacy

2. Phlebotomist calls patient's nurse to verify Cosyntropin® has been ordered and arranges draw time.

3. Patient's nurse:

    A. Contacts phlebotomist when Cosyntropin®  is available and ready to proceed.

    B. Verifies proper patient preparation protocol has been followed.

    C. Identifies patient and explains procedure.

4. Phlebotomist verifies patient identification.

5. Phlebotomist draws and labels pre-injection specimen in presence of nurse.

6. Patient's nurse gives 0.25 mg Cosyntropin® intramuscular injection.

7. Phlebotomist notes injection time and begins timing for subsequent samples.

8. Phlebotomist draws blood specimens for cortisol levels at 30 and 60 minutes post injection, labeling accordingly.

Note: Adverse reactions other than rare hypersensitivity are not reported.

Submit only 1 of the following specimens:

Plasma

Container/Tube: Green-top (heparin) gel tube. 

Microcontainer with heparin and plasma gel separator is also acceptable.

Specimen Volume: 0.5 mL of heparinized plasma

Transport Temperature: Refrigerate

Collection Instructions: Draw baseline, 30 minutes, and 60 minutes post dose.

Note: 1. Indicate time of draw and plasma.

2. Label specimen appropriately (time of draw and plasma).

Serum

Container/Tube: Gold-top serum gel tube. 

Microcontainer with serum gel separator is also acceptable.

Specimen Volume: 0.5 mL of serum

Transport Temperature: Refrigerate

Collection Instructions: Draw baseline, 30 minutes, and 60 minutes post dose.

Note: 1. Indicate time of draw and serum.

2. Label specimen appropriately (time of draw and serum).