Specimen Requirements

Preparation of Patient: 

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

Container Type: 

Green Top 5mL Lithium Heparin Separator Tube

Or

Gold Top 6mL SST Gel & Clot Activator Tube

Specimen Type:

Plasma or Serum

Specimen Volume: 

2.5 mL Plasma or Serum minimum .5 mL

Specimen Handling/Transport:

Separate plasma or serum from cells within 2 hours of collection.

Transport ambient room temperature.

Specimen Stability/Storage:

5 days refrigerated 2-8°C