Principle
To offer clinicians a formal pathology consultation of their patients with anemia, in order to further define the cause of anemia. This utilizes an organized protocol, including reflex testing, based on the red blood cell indices.

Collection and Submission:

Note:  Confirm the specimen requirements below with the requirements for your in-house or referral laboratory.
Collect:

• one 4ml EDTA whole blood, refrigerated (CBC, Retic, peripheral smears)
• 3ml of serum refrigerated (Sol Ser Transf, Iron/TIBC, B12, Ferritin, Folate)
• 3ml of FROZEN serum, separated from cells within two hours (MMA) 

Perform CBC

Perform or refer reflex testing based on the anemia algorithm

Send to Dahl-Chase Pathology in a red interoffice envelope labeled ANEMIA PANEL, via Uniship:

• a completed Clinical Pathology Requisition
• CBC data and differential results
• include patient demographics and clinical history
• include one stained and one unstained peripheral smear
• include results of all reflex or referral tests based on the algorithm

Interpretation
A written report will be received including results of all additional laboratory data, with an interpretive comment, along with suggestions for additional testing if recommended.  See the flow chart following to determine the reflex testing that may be done based on interpretation of results.