Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Direct ion selective electrode (ISE), Radiometer ABL 90 FLEX Plus

Reported

Stat 15 min, Routine 30 min

Synonyms

  • iCa
  • Ca
  • Ca++
  • Free calcium
  • Calcium, free
  • Ionized calcium
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV
  • NLYTE
  • Electrolytes
  • Blood gas
  • ABG

Sample Type

Heparinized whole blood (Blood gas syringe only)

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the “butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or “butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Deliver samples immediately to lab for testing.  Samples delivered to the lab >30 minutes after collection may yield erroneous results.
 

Stability (from collection to initiation)

10 min.

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume

Test Code

CAIB

LAB4449: Arterial source

LAB4450: Venous source

LAB4452: Mixed venous source

LAB4451: Central venous source

LAB4453: Capillary source

Test Group

Calcium

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume

Stability (from collection to initiation)

10 min.

Units

mmol/L

Reference Interval

Arterial and capillary:

< 6 months: 0.93 - 1.48 mmol/L
≥ 6 months: 1.13 - 1.27 mmol/L

Arterial reference range adopted from the UCSF reference range previously used with the ABL 835 blood gas analyzers and adjusted based on the results of method comparison studies with the ABL 90 Flex Plus.


Venous, mixed venous, central venous:

1.12 – 1.26 nmol/L

Critical Values

< 0.80 mmol/L or > 1.55 mmol/L

CPT Codes

82330

Available Stat

Yes

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Test Code

CAIB

LAB4449: Arterial source

LAB4450: Venous source

LAB4452: Mixed venous source

LAB4451: Central venous source

LAB4453: Capillary source

Test Group

Calcium

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Direct ion selective electrode (ISE), Radiometer ABL 90 FLEX Plus

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the “butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or “butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Deliver samples immediately to lab for testing.  Samples delivered to the lab >30 minutes after collection may yield erroneous results.
 

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Sample Type

Heparinized whole blood (Blood gas syringe only)

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume

Units

mmol/L

Reference Interval

Arterial and capillary:

< 6 months: 0.93 - 1.48 mmol/L
≥ 6 months: 1.13 - 1.27 mmol/L

Arterial reference range adopted from the UCSF reference range previously used with the ABL 835 blood gas analyzers and adjusted based on the results of method comparison studies with the ABL 90 Flex Plus.


Venous, mixed venous, central venous:

1.12 – 1.26 nmol/L

Critical Values

< 0.80 mmol/L or > 1.55 mmol/L

Synonyms

  • iCa
  • Ca
  • Ca++
  • Free calcium
  • Calcium, free
  • Ionized calcium
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV
  • NLYTE
  • Electrolytes
  • Blood gas
  • ABG

Stability (from collection to initiation)

10 min.

Reported

Stat 15 min, Routine 30 min

CPT Codes

82330
Ordering

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Direct ion selective electrode (ISE), Radiometer ABL 90 FLEX Plus

Reported

Stat 15 min, Routine 30 min

Synonyms

  • iCa
  • Ca
  • Ca++
  • Free calcium
  • Calcium, free
  • Ionized calcium
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV
  • NLYTE
  • Electrolytes
  • Blood gas
  • ABG
Collection

Sample Type

Heparinized whole blood (Blood gas syringe only)

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the “butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or “butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Deliver samples immediately to lab for testing.  Samples delivered to the lab >30 minutes after collection may yield erroneous results.
 

Stability (from collection to initiation)

10 min.

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume
Processing

Test Code

CAIB

LAB4449: Arterial source

LAB4450: Venous source

LAB4452: Mixed venous source

LAB4451: Central venous source

LAB4453: Capillary source

Test Group

Calcium

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume

Stability (from collection to initiation)

10 min.
Result Interpretation

Units

mmol/L

Reference Interval

Arterial and capillary:

< 6 months: 0.93 - 1.48 mmol/L
≥ 6 months: 1.13 - 1.27 mmol/L

Arterial reference range adopted from the UCSF reference range previously used with the ABL 835 blood gas analyzers and adjusted based on the results of method comparison studies with the ABL 90 Flex Plus.


Venous, mixed venous, central venous:

1.12 – 1.26 nmol/L

Critical Values

< 0.80 mmol/L or > 1.55 mmol/L
Administrative

CPT Codes

82330
Complete View

Available Stat

Yes

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Test Code

CAIB

LAB4449: Arterial source

LAB4450: Venous source

LAB4452: Mixed venous source

LAB4451: Central venous source

LAB4453: Capillary source

Test Group

Calcium

Performing Lab

Parnassus, Mission Bay and Mt. Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Direct ion selective electrode (ISE), Radiometer ABL 90 FLEX Plus

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the “butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or “butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Deliver samples immediately to lab for testing.  Samples delivered to the lab >30 minutes after collection may yield erroneous results.
 

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Sample Type

Heparinized whole blood (Blood gas syringe only)

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 60 min. after collection. Samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume

Units

mmol/L

Reference Interval

Arterial and capillary:

< 6 months: 0.93 - 1.48 mmol/L
≥ 6 months: 1.13 - 1.27 mmol/L

Arterial reference range adopted from the UCSF reference range previously used with the ABL 835 blood gas analyzers and adjusted based on the results of method comparison studies with the ABL 90 Flex Plus.


Venous, mixed venous, central venous:

1.12 – 1.26 nmol/L

Critical Values

< 0.80 mmol/L or > 1.55 mmol/L

Synonyms

  • iCa
  • Ca
  • Ca++
  • Free calcium
  • Calcium, free
  • Ionized calcium
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV
  • NLYTE
  • Electrolytes
  • Blood gas
  • ABG

Stability (from collection to initiation)

10 min.

Reported

Stat 15 min, Routine 30 min

CPT Codes

82330

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