laboratory

instrumentation

Lecture 1

1
• General instrument: ( Microscope ,centrifuge , Heating instrument
(oven ,incubator ,water bath, distiller and autoclave) Analytical
balance ,Rotor ,shaker and vortex )
• Chemistry Instrumentation: ( Colorimeter, Spectrophotometer,
Flame photometer, Ion selective electrode ,Hormonal autoanalyzer
,Auto Chemistry analyzer)
• Hematology instrumentation : Hematology analyzer (blood counter
) ,Coagulation, Electrophoresis, Hemoglobin meter) Virology : (Elisa
reader, Elisa washer)
• Analyzes patient specimens (e.g. blood, bone marrow, urine, or
tissue samples) in order to provide information to aid in the
diagnosis of disease and evaluate the effectiveness of therapy.
 Clinical laboratory

Analyzes patient specimens (e.g. blood, bone •

marrow, urine, or tissue samples) in order to
provide information to aid in the diagnosis of
disease and evaluate the effectiveness of
therapy.
 Hematology laboratory instrument

Determine the numbers and characteristics of •

elements in the blood (RBC, WBC, platelets,
etc) and test the blood clotting.
Biochemistry laboratory instrument

Analyze blood, urine, and other fluids to •

determine how much clinically important
substances is present.

Glucose level Indication

( nmol
/ L)

3.5—5.5 Normal
5.6—6.9 Pre-diabetes
>7 Diabetes

Sp ectro
p hotomete
r
 Molecular diagnostic instrument •
Detect the formation, structure, and •
function of DNA, RNA, and proteins.
 Microbiology laboratory instrument •
Test various fluids and tissue culture for •
presence of pathological microorganisms
(E. coli, fungi, parasites, etc).
 Histology laboratory instrument •
Study the microscopic anatomy of tissue to •
analyze disease states at a cellular level by
light or electron microscopy.
• Definition :
laboratory medicine : is the branch of medicine
which provide physicians and other healthcare
professionals with information to :
1- detect disease or predisposition of a disease .
2- confirm or reject a diagnosis .
3- establish prognosis .
4- guide patient management .
5- monitor efficacy therapy .
6- direct prevention of disease and health care
planning .

11
 • Blood Bank ( transfusion medicine ) :
is a multidisciplinary specialty encompassing all
aspects of blood donation , blood component
preparation , serology ( antibody screening ) ,
and blood transfusion therapy .

12
• Sections/branches : they are different among
hospitals
1- blood bank : offering cross match, antibody
detection, donor screening , providing blood &
blood component
2- clinical biochemistry : offering a wide range of
chemistry parameters including :
• enzymology, toxicology and endocrinology.
3- histopathology & cytopathology : giving the
service of cytology & biopsy report for all the
tissue .

13
4- hematology : offering routine CBC , coagulation
profile and bone marrow aspirate .
5- microbiology : offering the gram’s stain , culture
& sensitivity . In some hospitals it is offering Z.N
stain .
6- parasitology : routine exam of stool & urine .
7- serology & virology : screening of hepatitis , HIV,
and other serology test .
8- receiving section : receives the samples from all
wards

14
• Lab equipments :
1- Autoclave :
is an instrument used to
sterilize equipment and
supplies by subjecting
them to high pressure
saturated steam at 121 °C
for around 15–20 minutes
depending on the size of the
load and the contents

15
2- Incubator :
is a device used to grow
and maintain
microbiological cultures
or cell cultures.
The incubator maintains
optimal temperature,
humidity and other
conditions such as the
(CO2) and O2 content of
the atmosphere
inside.

16
3- Centrifuge
The centrifuge works using
the sedimentation principle,
where the centripetal acceleration
causes more dense substances to
separate out along the bottom of the tube
& lighter objects will tend to
move to the top of the tube .

17
4- Biosafety cabinet
is an enclosed, ventilated
Laboratory workspace for safely
working with materials
contaminated with
pathogens requiring
a defined biosafety level.

18
5- Pipette (micro pipette)
is a laboratory tool used to transport a
measured volume of liquid.

19
6- Petri dish
is a shallow glass or plastic cylindrical
lidded dish .
• Agar plate : is a Petri dish partially filled with
growth medium Usually warm liquid
containing agar and a mixture of specific
ingredients . After the agar cools and solidifies,
the dish is ready to receive a microbe-laden
sample in a process known as inoculation
or "plating".

20
 7- water bath 8- mouth pipette 9- plastic pipette

10- mixer 11- microscope 12- Cuvette

21
 Safety rules
• DEFINITION:
• Safety is the control of recognized hazards to
achieve an acceptable level of risk.
• This can take the form of being protected from
the event or from exposure to something that
causes health or economical losses. It can
include protection of people or of
possessions.

22
 Safety rules
➢ Always behave responsibly
– General Safety Procedures
1- All department employees report defective equipment, unsafe
conditions, acts or safety hazards to supervisor.
2- Keep electrical cords clear of passageways.
3- All equipment and supplies must be properly stored. Heavy
items not stored on top shelves.
4- Scissors, knives, pins, razor blades and other sharp
instruments safely stored and used.

23
 Safety rules
5- All electric machines with heat producing elements turned off
when not in use.
6- Minor spills, i.e., water, cleaned by the employee who
discovers the spill. Major spills cleaned by Environmental
Services Department.
7- Obey warning signs.

24
 Ionizing Radiation General Caution High Voltage

Flammable Toxic ( Poison ) Laser Radiation

Biohazard Irritant Non-ionizing Radiation

25
 Explosion risk Hot Surface Low Temperature

Environmental Hazard Oxidizer Corrosive

26
27
28
 Safety rules
8- Wear suitable clothing
9- Keep hands away from
sample needles and probes
in the instrument chambers.

29
 Safety rules
10- Equipments not left standing in traffic lanes.
11- Do not obstruct fire equipment. Know location of firefighting
equipment and how to use it. Know evacuation routes and
what to do in case of fire.
12- All Clinical Laboratory materials, bottles, specimens, etc.,
shall be plainly labeled.
13- Mouth pipetting is prohibited.
14- Disposable gloves must be worn as indicated.
15- Any working area that becomes contaminated, cleaned
immediately with a disinfecting solution.
16- Any specimen of blood, urine, sputum, saliva, other body
fluid or tissue must be regarded as potentially infectious.

30
 Safety rules
• Rules of obtaining the Specimen
1- Always use Standard Precautions.
2- Avoid contact of open skin lesions with blood.
3- Hands are to be washed if they become contaminated with
blood while taking specimens.
4- Do not bend needles after use. Do not reinsert used needles
in their original containers. Place used needles in the
puncture-resistant container provided for disposal needles.
5- Gloves and lab coats are to be worn while obtaining all
specimens.
6- After removing gloves and lab coat wash hands thoroughly.

31
 General feature of the test forms
• Every form should include the following :
1- general information : related to the patient & the
ward
2- hospital name
3- form’s type
4- clinical diagnosis
5- Processing type
6- date , time & name of the sender
7- tests to be done
8- analyzer information
32
 Test requisition
• Criteria for filling the forms :
1- patient’s name, age, sex, nationality & hospital ( file )
number.
2- relevant ward details .
3- name of ( consultant / specialist )
4- highlight the tests to be done .
5- request must be signed and stamped by the requesting
physician .
6- the staff nurse collecting the sample must ensure
labeling of the sample & fill the request form including
time & date .

33
 Test requisition
• The requesting physician must check following
before ordering :
1- availability of test in the lab .
2- inform the patient about the test procedure
and any precaution to be taken .
3- instruct the staff nurse about any precautions
to be taken during collection .

34
 HAEMTOLOGY FORM
• Consist of these tests :
1- CBC
2- Differential count
3- RBC morphology

35
 CHEMISTRY FORM
• Consist of these tests :
1- U/E test ( urea & electrolyte )
2- LFT ( liver function test )
3- RFT or KFT ( renal function test )

36
 SEROLOGY FORM ABB.
• ASO: Antistreptolysin O Titer(streptococcal
infection)
• VDRL : Venereal disease research laboratory
(syphilis caused by Treponema pallidum )
• TPHA : Treponema Pallidum
Haemagglutination Assay (syphilis caused
by Treponema pallidum )

37
 HORMONES FORM
• T3 : Triiodothyronine
• T4 : Thyroxine
• TSH : Thyroid-stimulating Hormone

38
 STOOL ANALYSIS FORM ABB.

• E.histo .veg. : Entamoeba histolytica

vegetative(trophozoite)
• E. histo. Cyst : Entamoeba histolytica cyst
• E. coli veg. : Entamoeba coli vegetative

39
 Specimen collection
• Specimen collection is the first step in
proficiency surveillance. For issuing accurate
and precise results, it is the job of the nurse or
phlebotomist to make sure that the
enumerated conditions are met and
implemented in order to deliver a suitable
sample for analysis so that an accurate and
precise result will be issued.

40
 Procedure of specimen collection

• Pre-collection check :
1- review the request and identify the patient by
asking the name, seeing his ID and compare it with
the request form.
2- Is there any special instruction / preparation
needed for the patient. If so advice the patient
accordingly
e.g. fasting or after meals and sample collection .
container may be given if needed e.g. 24 hour urine
collection or sputum collection.

41
 Procedure of specimen collection
3- Read all the tests and select the
tubes/containers as needed for the tests.
4- Arrange the tubes in order of filling.

42
 Procedure of specimen collection
• Post collection :
1- Label all the tubes and specimen bottles as
per the guideline.
2- NEVER write the name before extraction and
NEVER ask any other person to write for the
same.
3- Finish the job before patient leaves the chair .

43
44
 COMMUNICATION
• Most patients have had a blood extraction
before.
• To them the phlebotomist's statement of
intending to perform a blood test is usually
sufficient to understand what is about occur.
• To a patient who has never had a blood test, a
more detailed explanation may be necessary.
• Special procedures may require additional
information.
45
 COMMUNICATION
• The phlebotomist must always inform the patient
of the procedure and determine that the patient
understands what is about to take place before
proceeding.
– If a patient does not speak or understand your
language, the phlebotomist may have to use sign
language or other nonverbal means to demonstrate
what is to occur, or an interpreter must be located.
– Speaking slowly and distinctly, using sign language or
writing down information may be necessary for
patients with hearing problems.

46
 COMMUNICATION
• Most patients understand that the blood tests
are needed in the course of their treatment.
• Reminding the patient that the test was
ordered by the doctor as part of their care will
sometimes convince the patient to cooperate.

47
 Remember
• The patient has the right to refuse the test .
• When it has been determined that the patient
truly refuses to cooperate, the phlebotomist
should write on the requisition that the
patient has refused to have blood drawn.

48
 Recommendations
• Receive the patient with pleasant smile.
• Gain the patient trust and confidence.
• The phlebotomist should have a pleasant appearance
and behave in a professional manner to convey
confidence with the patient when taking blood.
• In handling difficult and irritable patients, the
phlebotomist should remain calm and treat the patient
in a caring manner under all circumstances.
• Thanking the patient for their cooperation makes them
feel traumatic-free and positive about the laboratory.

49