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Specimen Collection

Presented by: N/C Faiza Saleem N/C Hifza Bano Faculty: Maj. Shagufta
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Objectives
Definition of specimen collection
Purposes Types of diagnostic test

Types of sample bottles

Procedures, Preparation, Processing and

transportation

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Successful laboratory investigations

Advance planning
Collection of adequate and appropriate specimens Sufficient documentation

Biosafety and decontamination

Correct packaging Rapid transport

Choice of a laboratory that can accurately perform the tests

Timely communication of results
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DEFINITION
Specimen Any kind of body tissue or fluid for laboratory investigation is called specimen Specimen collection It is the procedure in which collect any kind of body tissues or fluid for laboratory investigation

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Purposes
Diagnostic purpose
Screening purpose Baseline before treatment.

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Types Of Specimen
Blood specimen
Hematology (CP,PT,PTTK,INR,ESR,CRP) Chemistry (Ca++,Mg++,Na+,K+,PO4-) Pathology (LFT'S, RFT'S,PCR) Serology (antigen, antibodies)

Urine Specimen
Urine R/E (Routine Examination) Urine C/S (Cultural sensitivity)
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Stool Specimen
Stool R/E Stool C/S Rectal swabs

Respiratory System
Sputum for culture Throat swab for culture Nasal swab for culture

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Phlebotomy Techniques General steps

Call lab for clarification of orders

Organize equipment
Patient assessment Proper identification Position patient Use universal precaution

Assemble equipment: proper equipment

Select best site Be aware of complications Proper preparation of site Perform the venipuncture/ release tourniquet

Control bleeding
Properly lable specimens at bedside/phlebotomy chair Care of puncture site Transport specimens to lab

Maintain aseptic techniques.

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Equipment:
Tourniquet Alchohol swabs Specimen bottles Gloves Dry cotton Kidney tray Sterile syringes

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Procedure

Explain procedure Select the venipuncture site Apply tourniquet (15 to 20 cm above venipuncture site Dilate the vein Clean the venipuncture site with alchohol swab from inward to outward in cicular motion. Insert the needle Draw blood sample Release the tourniquet Controle bleeding.
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Processing
Complete lab. Form
Place the specimen in appropriate place for pick up Documentation.

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Transportation
Double bagging Recheck Identification

Sample+ Requisition=Proper handing

Communicate to lab

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Contraindications
An arteriovenous fistula in the extremity Mastectomy on the same side of arm

Presence of phlebitis
Infiltration Seclerosis

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Blood for cultures

Collection Venous blood

infants: 0.5 2 ml children: 2 5 ml adults: 5 10 ml

Requires aseptic technique Collect within 10 minutes of fever

if suspect bacterial endocarditis: 3 sets of blood culture

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Blood for cultures

Handling and Transport

Collect into bottles with infusion broth

Change needle to inoculate the broth

Transport upright with cushion

Prevents hemolysis
Wrap tubes with absorbent cotton Travel at ambient temperature Store at 4oC if cant reach laboratory in 24h

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Obtaining Urine Specimen

Indications
Diagnosis of urinary tract infection (UTI) Detection of possible diabetes mellitus Detection of possible renal disease Screening test during general physical examination

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Equipments:

Sterile urine container Lab form Kidney tray Sterile syringe

Forcep
Gloves Foleys catheter

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Mid Stream
Wash hands
Clean meatus, female front to back Start stream, then stop, collect specimen Aseptic techniques Bedpan

To lab 15-20min post collection

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Indewelling catheter
Strict aseptic technique
Only from bag if brand new Sampling port

Clamp 30 min. prior

Wash hands and gloves Cleanse port with alcohol swabs

Sterile needle

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PROCEDURE for 24hr. URINE

Large collection container with preservative in

basin of ice Usually begin at 0600 with 1st void discarded.The next void goes into container with the correct date and time written on the label. The collection is stopped 24hrs. following the initial date and time and to lab immed. Start:Feb.10/04,0600 Stop:Feb.11/o4,0600

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Obtaining Sputum Specimen

Indications: Acid-fast Bacilli(AFB) If TB suspected-3 sputum specs tested over 3 separate days for Mycobacterium tuberculosis Early morning spec as this produces the most organism-concentrated sample Sputum for Culture & Sensitivity Diagnose microorganisms causing resp. infection Identify appropriate antimicrobial sensitive to the pathogens
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Obtaining Sputum specimen

Equipments:
Sterile specimen container Sputum cup Tissue paper Suction catheter Suction apparatus Gloves

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Collection
Instruct patient to take a deep breath and cough up sputum directly into a wide-mouth sterile container. Avoid saliva or postnasal discharge. 1ml minimum volume should be

Special consideration:
It is preferable to collect an early morning sputum specimen before brushing/rinsing the mouth.
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Obtaining Throat Swab For Culture

Equipments:
1. 2. 3. 4. 5.

Tongue depressor Cotton tipped applicators in sterile packed test tube Disposable gloves Clean gauze pieces Lab form

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Collection
Hold tongue away with tongue depressor Locate areas of inflammation and exudate in posterior pharynx, tonsillar region of throat behind uvula

Avoid swabbing soft palate; do not touch tongue

Rub area back and forth with cotton or Dacron swab

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Nasopharyngeal swab
Tilt head backwards
Insert flexible fine-shafted polyester swab into nostril

and back to nasopharynx Leave in place a few seconds Withdraw slowly; rotating motion

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Obtaining Stool Specimen

Indications:
Diarrhea of unknown etiology Evaluation of fat in the stool

Diagnosis of inflammatory bowel disease

Fecal occult blood Presence of parasites

Feaces pH to determine the lactulose tolerance

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Equipments:
Sterile container Sterile spatula Bedpan Gloves & tissue Lab form

Collection: Freshly passed stool samples

avoid specimens from a bed pan do not clean with disinfectant

Use sterile or clean container

During an outbreak - collect from 10-20 patients

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Rectal swabs
Advantage
convenient adapted to small children, debilitated patients and other

situations where voided stool sample not feasible

Drawbacks
no macroscopic assessment possible less material available

not recommended for viruses

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Virologic Investigations

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Specimen Collection Criteria

Leaking Specimen
Unlabeled/Mislabelled Specimen Incorrect collection container type

Sputum not expectorated

To old for culture Hemolysis: result from poor techniques or exposure to

extreme heat or cold Clotting: results from insufficient inverting Under filling or overfilling of specimen container
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Biosafety: Protect the patient

Use single use equipment Disinfect Work in a clean, dedicated area Use personal protective equipment: disposable gloves laboratory coats / gown mask protective eyewear / face shields if procedure is likely to generate aerosols If no sharps container: collect sharps immediately to prevent needle-stick injury Have first aid kit readily accessible Do not reuse contaminated equipment
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Biosafety: Protect others, the environment

Package samples appropriately for transport Decontaminate spills - 10% bleach after wiping the

surface clean Disinfect working areas for future use - 1% household bleach daily Soak contaminated non-disposable equipment/material in 1% household bleach

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Reference:
Guidelines for the collection of clinical specimens during

field investigation of outbreaks, WHO, 2000 The role of laboratories and blood banks in disaster situations, WHO publication, 2001 Sampling during avian influenza investigations (2006) IDSR guidelines for specimen collection (2003) Laboratory Needs for Emergency Situations (2003) Overview of Laboratory Structure and Operational Needs for the Iraqi Crisis (2003) Costing for sampling materials and diagnostic reagents for the Iraq crisis (2003)
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