Ictotest Procedure
Document #17/version #2
Effective Date: 11/01/13
ICTOTEST
Principle
Ictotest tablets are used to confirm the presence of bilirubin in
urine. The tablet is much more sensitive than dipstick tests. The
reaction is based on the coupling of a unique solid diazonium salt
with bilirubin in an acid medium to give the blue or purple
reaction.
Sample
It is important to use a fresh urine specimen when testing for
bilirubin. Bilirubin is rapidly decomposed once excreted,
particularly in the presence of light or heat. If immediate testing is
not possible, the specimen may be refrigerated immediately and
tested as soon as possible.
Materials
Equipment
 NA
Reagents
 Ictotest reagent
tablets
 Positive and
negative quality
control material
Supplies
 Absorbent test mats
(provided with
ictotest tablets)
 Plastic transfer
pipette
 water
 PPE
Quality
Control
Step
1
Action
Remove the control materials from the refrigerator and
allow to reach room temperature (at least 15 minutes).
2
Invert the control materials at least 20 times to assure
homogeneity.
3
Follow procedure used for the patient sample.
4
Compare the quality control test results with expected
values. If the results are outside acceptable range,
repeat quality control analysis. If results are still out
of range, consider system variables. Call
manufacturer if necessary.
5
Record quality control results on Ictotest QC logsheet.
Perform weekly and when a new bottle of ictotest reagent tablets is
opened.
Test
Procedure
Step
1
2
Action
Place a square of the absorbent test mat supplied onto
a paper towel.
Using a plastic transfer pipette, place 10 drops of urine
Columbus County Health Department Laboratory, Whiteville, NC 28472
1
Ictotest Procedure
Document #17/version #2
Effective Date: 11/01/13
onto the center of the test mat.
Shake one ictotest reagent tablet into the bottle cap
and transfer the tablet to the center of the moistened
mat. Do not handle the tablet with the fingers. Recap
the bottle promptly.
Place one drop of water onto the tablet. Wait 5
seconds, then place a second drop of water onto the
tablet so that the water runs off the tablet onto the mat.
Observe the color of the mat around the tablet at 60
seconds.
3
4
5
Interpretation
Positive
blue or purple color develops on the mat
within 60 seconds
Negative
no blue or purple color develops on the mat
within 60 seconds
Pink or red color should be ignored.
Result
Reporting
Procedure
Notes
If results are positive, the bilirubin test in the urinalysis results is
reported as positive. If results are negative, the bilirubin test in the
urinalysis results is reported as negative, even though the dipstick
results were positive. Results are also documented on the ictotest
logsheet.
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References
Related Documents

Metabolites of Pyridium give bright red-orange colors which
may mask the reaction of small amounts of bilirubin.
Elevated concentrations of urobilinogen do not mask the
reaction of small amounts of bilirubin, but atypical orange
colors are produced.
Chlorpromazine in large amounts may give a false positive
result and metabolites of Lodine may cause false positive or
atypical results.

Graff, Sister Laurine, A Handbook of Routine Urinalysis,
J.B.Lippincott Co, 1983.
Manufacturer’s package insert for Ictotest Reagent Tablets.


Document #11. Urinalysis Procedure.
Policy #2, Specimen Rejection Policy.
Author
Karen H. Wall, BSMT (ASCP), Technical Consultant
Approval
Signature
_____________________________
Name
Columbus County Health Department Laboratory, Whiteville, NC 28472
_____________
Date
2