Bronchio Alveolar Lavage for Cytology

Test Name	Bronchio Alveolar Lavage
Alternate Name(s)	BAL
Laboratory Module	Cytology
Ordering Mnemonic	Meditech Order Entry- Category: Cyto Mneumonic: BAL - NO CELL COUNT IS REQUIRED. or Mneumonic BALCC - CELL COUNT WILL BE DONE All additional mandatory fields must be satisfied in order to complete the requisition
Specimen Type	Bronchio Alveolar Lavage
Collection Container	BALCC -( BAL with cell count requested) Collect in a sterile container and send fresh specimen immediately to the laboratory BAL- ( BAL for routine cytology) Collect in a container with cytolyt fixative solution
Container Information	BALCC -( BAL with cell count requested) Collect in a sterile container and send fresh specimen immediately to the laboratory BAL- ( BAL for routine cytology) Collect in a container with cytolyt fixative solution
Collection Information	Bronchio Alveolar Lavage specimens are collected by installing aliquots of balanced saline solution through a bronchoscope and re-aspirating the material into a sterile container. The instilled volume should be at least 100 ml. If a cell count is requested, submit the fresh pooled saline lavage specimen in a sterile container and send immediately to the lab. Do NOT add fixative. If only routine cytology is requested, submit the specimen in cytolyt cytology fixative. Different sites may be sampled. Each specimen from a different area requires a separate requisition. For example if there was a right BAL and a left BAL, each sample would require a separate requisition. Fresh specimens (BAL's with cell count requests) should be received in the lab before 2:00 pm and should not be collected Friday afternoons. I.1.All labelled specimens must be accompanied by a completed manual or Meditech generated cyto-pathology non-gynecological requisition. All mandatory fields must be satisfied in order to complete the request. In the case of computer downtime use the standard cytopathology non-gynecological requisition. The following information is required on the requisition (a) Patient identifiers (addressographs may be used) (i) patient's first and last name (ii) hospital unique number (iii) date of birth (iv) Ontario Health Insurance Number with version code. (b) Submitting area identifiers: Hospital site and the submitting department (Emergency, Ambulatory Care etc.). (c) Submitting physician's name. (d) Date of specimen collection (e) Pre- and post-operative presumptive diagnosis. (f) A brief clinical history, relevant pathological and radiological findings. (g) Specimen information (i) specimen type/source (ii) specimen site I.2. If received, the specimen container must be labeled. Addressograph labels are preferred, otherwise the following information must be provided, clearly written in ink: (a) Patient identifiers - (i) patient's full name (ii) hospital unique number (iii) and at least one other unique additional identifier (ie. date of birth, OHIN). (b) Date of specimen collection. (c) Specimen type and site, as it is written on the Cytology Requisition form. This information must be recorded on the side of the specimen container and not the lid. If a specimen is known or suspected to contain unique or extreme biohazard (e.g. CJD) the container shall be so marked. I.3. Place specimen container in a biohazard bag (if applicable). The requisition should be placed in the outer pouch of the biohazard bag. Send all additional meditech generated labels in the biohazard bag. I.4. Transport specimen to the Triage area of the laboratory immediately following collection I.5. Inform the triage staff that you have delivered a specimen.
Test Schedule	Monday to Friday
Routine Turnaround Time	1 week
Stat Turnaround Time	3 days
Reference Interval	(Information Unavailable)
Critical Values	(Information Unavailable)
Lab Process Notes	Specimens are to be stored refrigerated in the laboratory triage area. (Fresh if there is a cell count request) Notify Pathology staff immediately upon arrival of a BAL specimen with a Cell count request.
Storage and Transport	Specimens should be stored in the refrigerator
Test Referred To	Referred off site. BAL specimens with cell count requests are sent to Grand River. Bal specimens for routine cytology will be sent to Dynacare.

updated 26/07/21