How to Order the Cosyntropin Stimulation Test
I was unable to locate specific evidence about ordering a "Costim test" in the provided guidelines and research. However, I can clarify that you are likely referring to the cosyntropin (ACTH) stimulation test, which is a standard diagnostic procedure in endocrinology.
General Test Ordering Principles from Clinical Guidelines
Based on established clinical practice standards for diagnostic testing:
Who Can Order the Test
- Members of the patient's medical team, including primary care physicians, endocrinologists, and other specialists, may initiate diagnostic test orders in accordance with institutionally accepted practices 1
- The ordering clinician should possess appropriate expertise in interpreting the results or have access to specialist consultation 1
When to Order
- Testing should be initiated in a timely fashion based upon the clinical scenario and in accordance with institutionally accepted practices 1
- Test ordering can occur on a case-by-case basis or by policies established by the medical staff 1
Required Documentation in the Order
Based on chemotherapy and diagnostic testing standards that apply broadly to medical orders:
- Patient's full name and a second patient identifier (e.g., medical record number, date of birth) 1
- Date of order 1
- Clinical indication/diagnosis (e.g., suspected adrenal insufficiency, Addison's disease) 1
- Specific test requested with full name (avoid abbreviations) 1
- Any relevant allergies or contraindications 1
- Appropriate criteria to perform the test based on relevant clinical findings 1
Pre-Test Considerations
- The ordering clinician should provide a consultation question that the test can be structured to answer 1
- Assessment of patient comprehension regarding the test procedure 1
- Documentation of informed consent when appropriate 1
Turnaround Time Expectations
- Laboratories should provide clinically appropriate turnaround times 1
- For send-out tests, a benchmark of 90% of specimens should be sent within 3 working days 1
- Results should be available within 10 working days from receipt in the laboratory when feasible 1
Common Pitfalls to Avoid
- Do not use verbal orders except to hold or stop a procedure; new orders must be made in writing (fax and email are considered written orders) 1
- Ensure the ordering clinician has the expertise to interpret results or arranges for appropriate specialist input 1
- Verify that the test will result in a change in patient management in the near term to justify its performance 1
Note: The specific procedural details for cosyntropin stimulation testing (dosing, timing of blood draws, patient preparation) would typically be found in endocrinology-specific guidelines or institutional protocols, which were not included in the provided evidence.