Lo2:Prepare to collect samples

Learning out comes (objectives): At the end of this module the trainee will be able to:-

• Know the purpose, priority and scopes of sampling request

• Identify Site hazards and reviewing safety procedures

• Confirm type of sample, site of collection , time of collection and collection methods

• Assemble all specified sampling equipment, safety equipment, materials and containers

• Check pre-use and cleanliness of all items

• Check All items against given inventory and packed to ensure safe transport

• Confirm Handling sequence and any permit requirements

• Check Vehicle and communication devices are in working order

• Check Required transport containers and materials

2.1.The purpose, priority and scopes of sampling request

2.1.1. Purpose of specimen

• In the laboratory, patient disease condition can't be identified and confirmed

without reliably analyzing specimen.

• Because of without the result of the specimen analysis, the treatment of patient
relies on empirical treatment alone.

• Indeed, early detection and treatment of cases ensured by the help of analyzing
appropriate specimen.

• Therefore, analysis of specimen in the laboratory by competent laboratory

professionals helps:
• To make a diagnosis of pathogen for the patients likely to receive the best possible care

• To identify source of disease correctly/confirm a clinical impressions

• To check epidemics and spread of major communicable diseases reliably/to screen for
disease

• To rule out (R/o)a disease and diagnosis

• To provide prognostic information.

• Use properly valuable financial and human resource

• To identify patterns of emerging drug resistance /to reduce spread of resistance to essential
drugs

• Drugs can be used more selectively.

• Side effects and progress are monitored.

• Stage of the disease at which the specimen is collected

Enteric pathogens are present in great numbers during the acute or

diarrheal stage of intestinal infection.

• Health and Safety Precautions

Use universal precautions when handling specimens containing blood

or other potentially infectious material.

Work areas contaminated with blood or serum must be disinfected

immediately with 10% bleach (hypochlorite at 0.5% final
concentration) or other approved disinfectant.
 • Patient preparation

• Many tests require that the patient be prepared in some specific way to
ensure useful results.

• The best analytical techniques provide results that are only as meaningful
as the quality of the specimen that has been submitted for analysis.

• Our goal is to provide you with the most useful diagnostic information
possible.
 • Fasting requirements

• For the majority of tests performed on serum, plasma or whole blood,

a fasting specimen is preferred.

• Non-fasting specimens often contain fat particles that can interfere

with many analytical procedures.
 Patient age

• Age of the patient has a limiting factor to obtain enough volume of

sample! specimen required for analysis.

• Besides, It is helpful to indicate patient age and blood type so that

appropriate reference ranges can be assigned for reporting purposes.

• On occasion, patient age will assist the technologists in choosing the

appropriate initial sample dilution for the assay.
 Pediatric Specimens:

• Special small conical tubes with screw caps with a holding capacity of

up to 1.5 ml specimen should provided to prevent evaporation of

small volume samples, better if Pediatric color-coded Vacutainer test

tubes are provided to facilitate special handling.

• These tubes will hold up to 1.5 ml of specimen.

• Standard specimen transfer tubes should be used for larger volume

samples.

• For urine specimens, use urine vials should also be used.

• We generally request 1 tube per test to avoid delays in processing

and to expedite turnaround time.
• To minimize specimen volume requirements for small children,
however, only one tube is required even when multiple tests are
ordered.

• Bright orange, self-adhesive "Pediatric Sample" labels are provided.

Please place one of these labels in a blank area of the Test Request
Form.

• The Test Request Form, properly filled out and labeled, should be
folded and inserted in the pediatric specimen bag.
 Provocation tests

• Some tests require the patient to ingest a substance.

• The most common are the Glucose Tolerance Tests where the patient drinks a
solution containing glucose, and blood specimens are obtained before and at
various times after the drink, to measure the concentration of glucose in
plasma or serum.

• In the standard Glucose Tolerance Tests, adults ingest 75 g (10 ounces) of a

glucose solution.

• Children ingest an amount of glucose proportional to their body weight (1.75

grams of glucose per kilogram of body weight, up to 75 g of glucose).
Answer the Following Questions (2 point each)

1. Analysis of specimen in the laboratory by competent laboratory professionals helps:-

A. To rule out (R/o)a disease and diagnosis

B. To provide prognostic information.

C. Use properly valuable financial and human resource

D. None;;E.;All

2. Before sample collection Priority of sample request given to the following condition

except

A. Patient preparation B. Pediatric patients

C. Time of collection. D. Height of patient

2.2. Identifying Site hazards and reviewing safety procedures

2.2.1. Approaches to avoid contamination:

• Careful patient education - There are occasions when patients

participate actively in specimen collection (e.g. sputum, urine). -

• Therefore, they must be given full instructions & cooperation by the

care giver
Educating by the clinicians

• How to collect & transport specimens through written document & make

available at every patient care unit.

• Obtaining a specimen involves the collection of tissue or fluids for

laboratory analysis or near-patient testing, and may be the first step in

determining a diagnosis and treatment.

• The procedure used to collect a specimen must minimize the risk of

introducing error and protect the health and safety of both the patient and

the staff who handle the sample.

• Specimens are an important part of a holistic assessment and can help to:

 Build a clinical picture of the patient;

 Confirm a diagnosis;

Inform a treatment plan.

• Laboratory personnel frequently collect specimens including urine, stool

and sputum.

• They may also perform vein puncture to collect blood samples and support
patients through complex procedures to collect specimens, such as
biopsies.
• An accurate specimen collection technique is essential to reduce the
risk of contamination, which can lead to inaccurate results and
inappropriate treatment and can result in a longer length of hospital
stay.

• Specimens must be collected at the right time, using the correct

technique and equipment, and be delivered to the laboratory as quickly
as possible.
Specimen collection: good-practice principles

• The specimen must be:

Appropriate to the patient's clinical presentation

Collected at the right time

 Collected in a way that minimizes contamination

 Collected in a way that reduces health and safety risk to all staff handling the
specimen (including laboratory staff)

 Collected using the correct equipment

 Documented clearly using appropriate forms

 Stored/transported appropriately
• The collection of any tissue/fluid carries a risk to staff from splash or

inoculation injury, so standard infection prevention and control precautions

should be followed.

• These include adhering to:

 Hospital environmental hygiene principles

 Hand hygiene principles

 Use of personal protective equipment

 Safe use and disposal of sharps

Criteria for Specimen rejection include:

Specimen collected in the wrong tube, container, preservative, or media.

Specimen inappropriately handled with respect to temperature, timing, or storage

requirements.

 Quantity not sufficient - QNS.

 Lipemic or grossly hemolyzed specimens may be rejected depending on test

requested. e) Specimens with

IV fluid or other peripheral line contamination.

 Specimen collection device past expiry dates.

Answer the Following Questions (2 point each):

1. Which of the following is fare good practice of Specimen collection?

A. Collected at the right time

B. Collected in a way that minimizes contamination

C. Collected using the correct equipment

D. Documented clearly using appropriate forms E. All

2. Write Criteria for Specimen rejection.

2.3. Confirming type of sample, site of collection, time of collection
and collection methods

2.3.1. Introduction to anatomy and physiology of digestive system

• Two groups of organs compose the digestive system: the

gastrointestinal (GI) tract and the accessory digestive organs.
• The gastrointestinal (GI) tract, or alimentary canal (alimentary
nourishment), is a continuous tube that extends from the mouth to
the anus through the thoracic and abdomen pelvic cavities. -
Organs of the gastrointestinal tract include the mouth, most of the
pharynx, esophagus, stomach, small intestine, and large intestine.

• The length of the GI tract is about 5-7 meters (16.5-23 ft) in human
being.

• The accessory digestive organs include the teeth, tongue, salivary

glands, liver, gallbladder, and pancreas;
• Teeth aid in the physical breakdown of food, and the

• Tongue assists in chewing and swallowing

• Salivary glands, liver, gallbladder, and pancreas do not have direct

contact with food but produce or store secretions that flow into the GI
tract through ducts; the secretions aid in the chemical breakdown of food
(dear trainee, read this accessory digestive organs function in relation to
food digestion)
• The GI tract contains food from the time it is eaten until it is digested
and absorbed or eliminated.
• Muscular contractions in the wall of the GI tract physically break
down the food by churning it and propel the food along the tract, from
the esophagus to the anus.

• The contractions also help to dissolve foods by mixing them with

fluids secreted into the tract.

• Enzymes secreted by accessory digestive organs and cells that line the
tract break down the food chemically. Functions gastrointestinal tract:
Ingestion: taking food into the mouth.

 Secretion: release of water, acid, buffers, and enzymes into the lumen
of the GI tract.

 Mixing and propulsion: churning and propulsion of food through the GI

tract.

Digestion: mechanical and chemical breakdown of food.

Absorption: passage of digested products from the GI tract into the

blood and lymph.

Defecation: the elimination of feces from the GI tract

2.3.3. Stool specimen collection and materials

• Patients usually collect this sample themselves during toileting,

following instructions to prevent the sample from becoming
contaminated from other material in the toilet bowl.

• Patients may also be told to avoid certain foods during the test
period.

• Depending on the test, patients may be instructed to collect the

sample in a container, scoop a small portion into a vial, or smear a
small amount on special test paper.
• Wash your hands well after handling the sample.

• Stool specimens are collected aseptically and submitted to the

laboratory for the diagnosis of intestinal problem - intestinal bleeding
(occult blood), parasitic infection, bacterial dysentery (shigellosis),
enteric fever (Salmonellosis), diarrhea, GIT problem or abnormalities
in the function of pancreas.

• Stool containers- Various containers are used in collecting stool

• A waxed cardboard box

• An empty tin with a lid

• A light plastic box

• Match boxes

• Collection of sufficient quantity is important to permit detection of parasites and to

prevent rapid drying. The stool specimen should contain at least 4 ml.

• Once the specimen collected; If possible, process:

• Liquid stool: < 3O minutes of passage at Room Temperature.

• Semi-formed stool: < 1 hour of passage at Room Temperature.

• Formed stool: < 24 hours of passage, 4 OC.

If delay is unavoidable, place in suitable preservative or transport medium

Macroscopic Examination

Stool specimen is examined with the naked eye for:

 Presence of worms: - may have adult helminthes or segments Example:

Ascaris, Taenia species, E.vermicularis and gravid Taenia species.

 Consistency (degree of moisture)

in varies in diet but certain clinical conditions associated with parasite

presence may be suggested by particular consistencies.
• It will be described as hard, formed, semi-formed and diarrheic
(watery).

 Color: - any abnormal color e.g., pale yellowish passed in

steatorrhoeac conditions such as giardiasis, dark or black stools
occur when iron or bismuth is taken or when there is intestinal
hemorrhage

 Pathologic odor Offensive, non-offensive

Abnormal features seen (composition): mucus, blood or fat globules.

Microscopic Examination preparation

The detection and identification of species of parasites require

microscopic examination of specimens

1. Direct Microscopic Examination of stool Specimen with

Physiological Saline and Dobell's Iodine Solutions.

• Routine microscopic examination of stool specimen with

physiological saline and Dobell's iodine solution helps to detect and

identify the stages of some parasitic organisms.

 • Material and Methods

• Wooden applicator sticks Microscopic slides

• Cover slips

• Dropping bottles containing physiological saline (O.85%w/v) and

Dobell's Iodine solutions Microscope Pasture pipette

Procedure

1. Place a drop of physiological saline (O.85%w/v) in the center of the left half of

the slide and place a drop of Dodell's Iodine solution in the center of the right half

of the slide.

2. With an applicator stick, pick up a small portion of the feces (Approximately

2mg which is about the size of a match head) and put on the drop of saline. Add a
similar portion of stool sample to the drop of iodine.

3. Mix the feces with the drops to form homogeneous suspensions.

4. Cover each drop with a cover slip by holding the cover slip at an angle
of 300, touching the edge of the drop, and gently lowering the cover slip
onto the slide so that air bubbles are not produced.

5. Examine the saline preparations using the 10X objective for motile
forms, cyst and oocyte of intestinal protozoa and for any ova or larva of
helminthes.

6. Examine the iodine solution preparation using 40X objective to identify

the cyst stages of protozoa. The iodine will stain the nuclei and the
glycogen mass of the cyst
2.3.4. Collection of urine sample

Anatomy and physiology of urinary system

The kidneys do the major work of the urinary system.

The other parts of the system are mainly passageways and storage

areas.

Nephrons are the functional units of the kidneys.

Each nephron consists of two parts: a renal corpuscle (tiny body),

where blood plasma is filtered, and a renal tubule into which the

filtered fluid passes.

To produce urine, nephrons and collecting ducts perform three basic

processes

Glomerular filtration: - the first step of urine production,

water and most solutes in blood plasma filtered and move across the

wall of glomerular capillaries into the glomerular capsule

Tubular re-absorption; - the filtered fluid flows along the renal tubule

through the collecting duct, tubule cells reabsorb about 99% of the

filtered water and many useful solutes

The water and solutes return to the blood as it flows through

Tubular secretion: - the collecting duct, the tubule and duct cells secrete

other materials, such as wastes, drugs, and excess ions into the fluid.
Urine sample collection and necessary materials

A urine specimen is collected and submitted to the lab in case of possible

renal problems or metabolic disorders of the body.

A volume of urine specimen required for routine urinalysis is 15to 33 ml.

The urine specimen can be referred to urinalysis, clinical chemistry, and

Bacteriology and Parasitology labs

• Most urine specimens are collected by having the patient urinate into a
container or receptacle.

• To keep the sample from becoming contaminated by materials outside

the urinary tract, patients are given instructions on how to clean the
genital area and void a bit of urine before collecting the specimen into
the container. (If a urinary catheter is required, a health practitioner is
usually responsible for insertion.)
• Collecting the urine specimen is awkward but not in itself
uncomfortable (An infection, however, can create a burning sensation
during urination.).

• For certain tests, 24- hour urine samples are collected at home and
must be refrigerated during the collection process.

• Remember to wash hands well after collecting the specimen

For urine collected in the laboratory use a:

Clean conical urine jar

Any clean glass container or bottle

Container should be clean, dry, leak-proof and free from disinfectants .

Collection of urine specimen

When urine sample is received with request to find urinary parasites and urine
sediment, the method to use is described below. This will concentrate most of the
parasite and urinary materials.

1. Collect random urine sample, preferably at midday, into a clean container.

2. Centrifuge 10ml of urine at 1500RPM for 2 min. to deposit the ova of the
parasite and sediments

3. Decant the supernatant and Place a drop of deposit onto a microscope slide
and cover with a cover slip. Make ready for microscopic examination
Urine preservative methods, advantages and disadvantages
 2.3.5. Blood sample collection

• Blood samples can be collected from blood vessels (capillaries, veins,

and sometimes arteries) by trained phlebotomists or medical personnel.

• The sample is obtained by needle puncture and withdrawn by suction

through the needle into a special collection tube.

• Some specimens may be obtained by a finger puncture that produces a

drop of blood, such as that used for glucose testing.

• The procedure usually takes just a few minutes and hurts just a bit,
typically when the needle is inserted or from the puncture of a lancet.
Introduction to Cardiovascular system
• Cardiovascular system consists of three interrelated components:
blood, the heart, and blood vessels.
• Blood contributes to homeostasis by transporting oxygen, carbon
dioxide, nutrients, and hormones to and from your body‘s cells.
• It helps regulate body pH and temperature, and provides protection
against disease through phagocytosis and the production of antibodies.
• Blood constitutes about 20% of extracellular fluid, amounting to 8% of
the total body mass.
• The blood volume is 5-6 liters (1.5gal) in an average-sized adult male
and 4-5liters (1.2 gal) in an average sized adult female.

• The difference in volume is due to differences in body size.

• Blood vessels: The three main types of blood vessels are arteries,
capillaries and veins.
Arteries- carry blood away from the heart to other organs

Capillaries- branched and numerous tiny vessels which allow the

exchange of substances between the blood and body tissues.

Veins- are the blood vessels that convey blood from the tissues back to
the heart
Blood collection site

Blood samples for laboratory testing may be obtained in several ways.

The most common procedures are vein puncture, capillary finger or

heel prick and arterial puncture.

Vein puncture - withdrawal of blood from a vein using a needle and

collecting tube which contains various additives.
A tourniquet is wrapped around the arm above the vein puncture site,
which causes blood to accumulate in the vein

This increased blood volume makes the vein stand out.

Opening and closing the fist further causes it to stand out, making the
vein puncture more successful.

A common site for vein puncture is the median cubital vein anterior to
the elbow
 Capillary finger or heel prick- this collection is used when small blood is required

It is often used for drawing blood from infants and children.

• Arterial puncture- blood is withdrawn from an artery

this test is used to determine the level of oxygen in oxygenated blood

Blood collection materials and procedure

• Vein puncture

The volume of blood obtained by vein puncture is sufficient to carry out multiple tests.

Vein puncture can be done either by the syringe method or vacuum tube method .

the latter is disposable and is not popular in developing countries because of the high cost.
• Anticoagulants: - Anticoagulants are chemical substances that

are added to blood to prevent coagulation.

• A number of different anticoagulants are available which have

different function but EDTA and citrate are mostly useful.

• The venous blood can be collected either in anticoagulant or

without anticoagulant test tube based on the need of the blood

collected.
Blood collection Procedure by syringe method:

1. Assemble all the things required during blood

2. Read carefully the patients form, identify the patient and decide patient

and decide the total amount of blood needed for the entire test.

3. Select the blood collection container and label them with the patients‘

identification number.
4. Introduce yourself to the patient.

Ask the patient to sit alongside the table used for taking blood.

 Lay his arm on the table, palm upwards.

For indoor patients lying in bed, lay patients arm in an outstretched

position.

The procedure of blood collection should be explained by the vein-

puncturist to the patient to minimize apprehension.

• Never draw blood from standing patient or patient sitting on a high stool.

5. Select the puncture site carefully after inspecting both arms.

If necessary apply the tourniquet to select the puncture site and then

release the tourniquet to proceed with the next step.

6. Re- apply the tourniquet as described earlier before drawing blood.

The tourniquet should not be left in place unless the technician is ready to

proceed immediately with the vein puncture.

7. using the index figure of your left hand, feel for the vein where you will introduce

the needle.

8. Disinfect the sin with a swab dipped in methanol or 70% alcohol. Rub the vein

puncture site thoroughly.

9. Remove the syringe from the protective warp or test tube used during sterilization

and the needle from the sterilized vial, assemble them and see the needle is fixed

tightly.

Do not touch the tip of the needle or wall of the position.

10. With the patient cooperation, grasp the elbow with your left hand and hold the arm

fully extended.
11. Tae the syringe in the right hand holding your index finger against the base of the
needle. Position the needle with the bevel uppermost and push the needle firmly and
steadily, without hesitation, in to the center of the vein. Try to enter the sin first and then
the vein at a 30 to 40o angle

12. As the needle enters the vein there is a sudden loss of resistance. Push the needle
along the line of the vein to a depth of 1 to 1.5 cm.

13. With your left hand slightly pull back the position. Blood should appear in the barrel.

Continue with draw the position and fill the syringe with the request amount of blood.

14. Release the tourniquet by pooling on the looped end.

Ideally this should be released once the needle has been inserted in to the skin
but it can also be released after the blood is drawn.

15. Place a swab of cotton wool over the hidden point of the needle.

With draw the needle in one rapid movement from under the swab.

16. Ask the patient to firm on the cotton wool swab for 3 to 5 minutes. This
stops bleeding from the wound. Do not bend the arm, this may cause hematoma.

17. Remove the needle from the syringe and gently expel the blood in to
appropriate container.
18. Mix the blood immediately and thoroughly but gently with the anti-coagulant.
Label the bottle clearly with the name of the patient, date, sex and registration number.

19. Immediately rinse the syringe and the needle with cold water. This will prevent
clotting of blood in to the syringe or lumen of the needle. The syringe and the needle
are left in the water with a mild detergent and later washed thoroughly prior to
sterilization.

20. Before the patient leaves, re inspect the vein puncture site to ascertain that the
bleeding has stopped. If the bleeding has stopped, apply an adhesive tape over the
cotton wool swab on the wound; otherwise continue to apply pressure until the
bleeding stops.

Do not leave the patient until the bleeding stops

Capillary pucture materials and procedure

The capillary blood is obtained by skin puncture and anticoagulant is not

required.

It provides only small quantities of blood specimen for making a blood
smear (differential count), cell count or Hematocrit determination.

Skin puncture specimen is preferred over vein puncture specimen for the
study of blood smear and differential count. Procedure:
1. Assemble the necessary materials: lancet, alcohol pad, dry surgical gauze,
capillary tube, microscope, slide and other supplies (glass, marking pencil,
lead pencil, etc.).

2. Be sure that the patient is seated comfortably.

3. Find a spot on the middle or ring finger of the left hand. The spot is located
on the side of the figure, which is less sensitive than the tip.

4. Clean the site with a sterile cotton wool swab dipped in 70% alcohol, and
then removes the alcohol with a dry sterile cotton wool swab. These remove
dirt, and epithelial debris. Warm up the part chosen for pricking, increase the
blood circulation and leave the area relatively sterile.
5. Grasp the figure firmly and make a quick, firm puncture with a sterile
lancet (sharp pointed blade). The puncture should be 2-3 millimeter
deep at the pre-located spot on the side of the figure in line with the
figure print striations. If a good puncture has been made, the blood will
flow freely. If it does not, use gentle pressure to make the blood form a
round drop. Excessive squeezing will cause dilution of blood with tissue
fluid. Discard the lancet in the appropriate disposal container. Used
lancets should never be left lying on the work area.
6. Wipe away the first drop of blood with sterile cotton wool. The first
drop of blood is contaminated with tissue fluid and will interfere with
the laboratory result if used. The succeeding drops are used for test.

7. Collect the specimen by holding a capillary tube to the blood drop

(for Hematocrit determination), or for blood count, or by touching the
drop to the glass slide for preparing blood smear.
• Blood film: Microscopic examination of the peripheral blood and hematological
parasite are most often done by preparing, staining, and examining a thin film
(smear) thick film of blood on glass slide. A great deal of information can be
obtained from the examination of a blood film. Blood film preparation

 A small drop of blood (2µl) is placed in the center line of a slide about 1-2cm
from one end. Another slide, the spreading slide placed in front of the drop of
blood at an angle of 30O- 45Oto the slide and then is moved back to make contact
with the drop. The drop will spread out quickly along the line of contact of the
spreader with the slide.
Once the blood has spread completely, the spreader is moved forward
smoothly and with a moderate speed. The drop should be of such size that the
film is 3-4cm in length (approx. 3/4th of the length of the slide). It is essential
that the slide used as a spreader have a smooth edge and should be narrower in
breadth than the slide on which the film is prepared so that the edges of the
film can be readily examined.

 Once the slide is dry, the name of the patient and date or a reference number
is written on the head of the film using a lead pencil or graphite. If these are no
 2.3.6. Collection of Sputum
• Anatomy and physiology of respiratory system The respiratory system
consists of the nose, pharynx (throat), larynx (voice box), trachea (windpipe),
bronchi, and lungs. Its parts can be classified according to either structure or
function. Structurally, the respiratory system consists of two parts:

(1) The upper respiratory system includes the nose, pharynx, and
associated structures

(2) The lower respiratory system includes the larynx, trachea, bronchi,
and lungs
Functionally, the respiratory system also consists of two parts:

(1) The conducting zone consists of a series of interconnecting cavities and

tubes both outside and within the lung include the nose, pharynx, larynx,
trachea, bronchi, bronchioles and terminal bronchioles; their function is to filter,
warm, and moisten air and conduct it into the lungs.

(2) The respiratory zone consists of tissues within the lungs where gas exchange
occurs include the respiratory bronchioles, alveolar ducts, alveolar sacs, and
alveoli; they are the main sites of gas exchange between air and blood To
diagnose the respiratory system impairment, sputum sample is an appropriate
Sputum collection and necessary materials

Patients are instructed to cough up sputum from as far down in the

lungs as possible. (A health practitioner may assist the patient in some
situations.)

This is best accomplished first thing in the morning before eating or

drinking, by taking several deep breaths before expectorating into the
collection cup.
Sputum should be relatively thick and not as watery as seen when
producing saliva.

Sputum is usually examined to determine the presence of disease of

the lungs or of the upper respiratory tract. Careful! sputum to be
collected should not be saliva.

Saliva: - is secreted by the salivary glands and is limited in the oral

region.

Sputum: - is the material coughed up from the throat and lungs.

Collection Method

Provide the patient with a sterile wide- mouthed glass bottle of about 50 ml
capacities with a screw top. Two samples required :Spot–Spot WHO
Recommendation • 1 stSpot -initial visit to the clinic

• 2 nd Spot-after 30`-1hr of 1st spot collection on the same day.

The laboratory technician or the nurse should be present when the sample is
taken. First, the patient should be standing, if possible.
Then, he/she should take a very deep breath, filling his/her lungs. She/he
should empty his/her lungs in one breath, coughing as hand and deeply as
she/he can. She/he should spit what he brings up into the jar. After Collection:
Check that a sufficient amount of sputum has been produced. The sputum of
an infected person usually contains:

 Thick mucus with air bubbles

 Threads of fibrin

 Patches of pus

 Occasional brownish streaks of blood

• N.B- The first sputum coughed out in the early morning is the most desirable
specimen for the laboratory investigation. - Liquid frothy saliva and secretions
from the nose and pharynx are not acceptable expectations. Have the patient
produce another specimen. Blood sputum is also not accepted for Gene X-pert
technique
 2.3.7. Collection of body fluids and discharges

• A sample of cerebrospinal fluid is obtained by lumbar puncture, often called a

spinal tap.

• It is a special but relatively routine procedure.

• It is performed while the person is lying on their side in a curled up, fetal
position or sometimes in a sitting position.
• The back is cleaned with an antiseptic and a local anesthetic is injected
under the skin.

• A special needle is inserted through the skin, between two vertebrae,

and into the spinal canal.

• The health practitioner collects a small amount of CSF in multiple

sterile vials; the needle is withdrawn and a sterile dressing and
pressure are applied to the puncture site.
• The patient will then be asked to lie quietly in a flat position, without
lifting their head, for one or more hours to avoid a potential post-test
spinal headache.

• The lumbar puncture procedure usually takes less than half an hour.

• Discomfort levels can vary greatly.

• The most common sensation is a feeling of pressure when the needle is

introduced.

• Let your healthcare provider know if you experience a headache or any

abnormal sensations, such as pain, numbness, or tingling in your legs, or
 Formation and Physiology

Cerebrospinal fluid (CSF) is a major fluid of the body.

CSF provides a physiologic system to supply nutrients to the nervous tissue,

remove metabolic wastes, and produce a mechanical barrier to cushion the
brain and spinal cord against trauma.

The brain and spinal cord are lined by the meninges, which consists of three
layers:

The dura mater, arachnoid, and pia mater.

The outer layer is the dura mater that lines the skull and vertebral canal.
The arachnoid is a filamentous (spiderlike) inner membrane.

 The pia mater is a thin membrane lining the surfaces of the brain and
spinal cord.

Cerebrospinal fluid is produced in the choroid plexuses of the two

lumbar ventricles and the third and fourth ventricles.

In adults, approximately 20 ml of fluid is produced every hour.

The fluid flows through the subarachnoid space located between the
arachnoid and pia mater
• To maintain a volume of 90 to 150 ml in adults and 10 to 60 ml in
neonates, the circulating fluid is reabsorbed back into the blood
capillaries in the arachnoid granulations/villae at a rate equal to its
production.

• The cells of the arachnoid granulations act as one-way valves that

respond to pressure within the central nervous system (CNS) and prevent
reflux of the fluid.
CSF Collected in three sequentially labeled tubes:

Tube 1 .Chemical and immunologic tests

Tube 2 .Microbiology

Tube 3. Hematology (gross examination, total white blood cell

&differential)

This is the list likely to contain cells introduced by the puncture

procedure
• Synovial fluid, often referred to as ―joint fluid,‖ is a viscous liquid found in
the cavities of the movable joints (diarthroses) or synovial joints.

• The bones in the synovial joints are lined with smooth articular cartilage and
separated by a cavity containing the synovial fluid.

• The joint is enclosed in a fibrous joint capsule lined by the synovial

membrane.
• The synovial membrane contains specialized cells called synoviocytes.

• The smooth articular cartilage and synovial fluid reduce friction

between the bones during joint movement.

• In addition to providing lubrication in the joints, synovial fluid

provides nutrients to the articular cartilage and lessens the shock of
joint compression that occurs during activities such as walking and
jogging.
• Sample collection: Joint fluid aspiration (arthrocentesis) should be
confined to patients with an undiagnosed effusion.

• It should be performed by an experienced operator using good sterile

technique.

• Large joints (knee) normally contain< 4.0 ml of synovial small sample

size is common unless effusion is present.

 Uro-genital and semen samples collection

Uro-genital collection
• The organs of the female reproductive system include the ovaries , the
uterine (fallopian) tubes or oviducts , the uterus, the vagina and the
external organs.

• Uro-genital specimens should be collected by a medical officer or an

experienced nurse.

• Amies medium is the most efficient medium for transporting urethral,

cervical and vaginal swabs. Specimen should be transported in a cool
box.
Semen collection
• Male patients ejaculate into a specimen container, avoiding lubricants,
condoms, or any other potentially contaminating materials.

• Usually, men need to refrain from ejaculating for at least 2 days prior
but less than 7 days before collecting the specimen.

• The specimen must not be refrigerated but kept as close to body

temperature as possible by placing the container in a pocket and
delivering it to the laboratory within 60 minutes
• The testes or testicles are paired oval glands in the scrotum measuring
about 5 cm (2 in.) long and 2.5 cm (1 in.) in diameter.

• Each testis (singular) has a mass of 10–15 grams.

• The testes develop near the kidneys, in the posterior portion of the
abdomen, and they usually begin their descent into the scrotum
through the inguinal canals (passageways in the anterior abdominal
wall during the latter half of the seventh month of fetal development.
Functions of the Male Reproductive System:
1. The testes produce sperm and the male sex hormone testosterone.

2. The ducts transport, store, and assist in maturation of sperm.

3. The accessory sex glands secrete most of the liquid portion of

semen.

4. The penis contains the urethra, a passageway for ejaculation of

semen and excretion of urine.
 Semen analysis:

• Used in the evaluation of reproductive dysfunction (infertility) in the

mal

• Used to select donors for therapeutic insemination

• Is a cost-effective and relatively simple procedure.

• Consists of microscopic and macroscopic components

 Collection and transport of semen

• Give the person a clean, dry, leak-proof container

• request him to collect a specimen of semen at home following 3 days

of sexual abstinence

• Condom is used to collect the fluid; this must be well-washed to

remove the powder which coats the rubber.

• It must be dried completely before being used

 How to Collect a Semen Sample for Your Lab Test

Before You Collect a Sample

 You should not have sexual activity for 2 to 5 days before collecting a semen sample.

It should be more than 2 days from your last ejaculation but not more than 7 to 10 days.

If you are collecting the sample at home, please pick up a clean container at the lab.

You will need to make an appointment to return the sample. Call the scheduling line for
the location at which you wish to return the sample.

 The sample must be collected within 1 hour of your appointment for your test results to
be correct.
How to Collect Your Sample
 Clean the head of your penis with wet, soapy to welettes or cotton balls.

 If you are not circumcised, pull back your foreskin and cleanse.

 Rinse the cleansed area with a new towelette or cotton ball that is wet with
plain water.

Dry your penis well before you collect the sample.

 Remove the lid from the collection container.

 Make sure the container is clean and dry.

The sample should be collected by masturbation into the container

Lubricants or condoms should not be used while collecting the sample.

They can kill the sperm and affect your test results.

 If you need to collect the sample with intercourse — You can buy a nontoxic condom (one
that won‘t kill your sperm) from the lab.

After you are finished, seal the condom with the twist tie and put it in a clean container. —
make sure intercourse is not interrupted.

This may harm the first part of the ejaculate and affect your test results.

 If a pubic hair or thread from your clothing falls into the container, do not take it out. The
lab will take it out using a clean tool.

 Put the lid back on the container.

 Make sure it is closed tightly

After Collecting Your Sample
Write the following information on the container with a pen or marker
that will not run if the ink gets wet:

-Full name

-Date of birth

-Date and time of collection.

 Wrap the container in a dry towel and place it in a paper sack.

Keep it at room temperature.

 Other body Fluid

• Other body fluids such as synovial fluid, peritoneal fluid, pleural fluid,
and pericardial fluid are collected using procedures similar to that used
for CSF in that they require aspiration of a sample of the fluid through
a needle into a collection vessel.

• These are generally more complex type of collections and often

require some patient preparation, use of a local anesthetic, and a
resting period following sample collection.
 2.3.8. Collection of skin sample
Anatomy and physiology of integumentary system

• The skin (also known as the cutaneous membrane or integument) covers the external
surface of the body and it is the largest organ of the body in both surface area and
weight.

• In adults, the skin covers an area of about 2 square meters (22 square feet) and weighs
4.5–5 kg (10–11 lb), about 16% of total body weight.

• It ranges in thickness from 0.5 mm (0.02 in.) on the eyelids to 4.0mm (0.16 in.) on the
heels.

• However, over most of the body it is 1–2 mm (0.04– 0.08 in.) thick.
- Epidermis- superficial and thinner portion

- composed of epithelial tissue,

- Dermis- deeper and thicker connective tissue portion of the skin. Functions of
the skin:

• Regulates body temperature.

• Stores blood.

• Protects body from external environment.

• Detects cutaneous sensations.

• Excretes and absorbs substances.

• Synthesizes vitamin D
 Collection of ulcer and skin Specimens
• Most skin specimens should be collected by a medical officer or an experienced nurse.

 Ulcer: Using a sterile dry cotton wool swab Collect a sample of discharge from the infected
tissue.

If there is no discharge use a swab moistened with sterile physiological saline to collect a
specimen.

Insert the swab in a sterile tube. - If the tissue is deeply ulcerated, aspirate a sample of infected
material from the sidewall of the ulcer using a sterile needle and syringe - Collect a drop of the
exudates directly on a clean cover glass and invert on clean slide.

Deliver immediately the specimen to the laboratory for examination by dark-field microscope
 Collection of skin and hair specimen

a- cleanse the affected area with 70% v/v ethanol

b- Collection skin scales, crusts, pieces of nail or hairs

Skin scales: - collect by scraping the surface of the margin of the

lesion using a sterile scalpel blade.

Crust: - collect by removing part of the crust nearest to healthy skin

using sterile scissors and sweezers
Nail pieces: - collect by taking snippiness of the infected part of the
nail using sterile scissors &sweezer

Hairs: - collected by removing dull broken hairs from the margin of

the lesion using sterile tweezers After collecting the specimens fold
the paper to form a flat packet, label the patients name and number
source of material, and the date collected.

Skin snip collection: - The skin snip materials are surgical blade,
swap, adhesive plaster, lancet and PPE - The collection procedures are
as below pictures
Answer the Following Questions (2 point each):

1. Blood sample for diagnosis of malaria parasite is best if collected ___

. A. when the body temperature rises B. when the body temperature falls C. when the patient is at
convalescence period D. when the patient is at recovery period

2. The suitable site/s for venous blood collection site for adults is/are________

A. The femoral veins B. the veins of the legs C. The jugular vein D. The veins of the forearm

3. The most concentrated and bladder incubated urine specimen used for most urinalysis test
procedures ____________ A. random urine sample B. 24 urine sample C. postprandial urine specimen
D. Early morning urine

4. The recommended sputum specimen for AFB detection is ____

A. Morning-Morning-Morning B. Spot-Spot C. Spot-Spot-Morning D. Morning-Spot-Spot

 2.4. Assembling all specified sampling equipment,
safety equipment, materials and containers
2.4.1. LABORATORY SAFETY RELATED TO SPECIMEN
COLLECTION, PREPARATION AND STORAGE

All staff involved in handling of laboratory specimens should receive

specimen management training and be covered by appropriate vaccinations.

 Use personnel protective equipment when processing biological specimens.

 Take precautions to prevent injuries caused by needles, scalpels, and other

sharp instruments.
 Do not recap, bend or break needles by hand or remove needles from
disposable syringes.

 Discard all sharp instruments in puncture-resistant sharp containers

located close to the work area.

 Secure lids immediately to avoid spillage and contamination during

transport.

 Place all liquid specimens in containers that will prevent leakage

during transport.
 Preferably use vacutainer tube with needle rather than ordinary
(syringe with needle) Do not overfill specimen containers, as they can
explode‘ upon opening.

 If hands or other skin surfaces become contaminated with blood or

other body fluids, wash them immediately and thoroughly with soap
and water.

 Remove gloves and wash hands with soap and water upon completion
of processing after contact with each patient.
Use a biological safety cabinet for procedures that have a high potential
for generating droplets.
 Use mechanical pipette devices to manipulate all liquids in the
laboratory.
 Decontaminate laboratory work surface area daily and after any spill of
potentially dangerous materials with a freshly prepared household
bleach (0.5% NaHCl).
 Disinfect refrigerators and centrifuge component primary by 1:10
dilution of household bleach then clean with water finally wipe with
70% ethanol. Autoclave or soak racks in 1:10 dilution of household
bleach for Ten minutes and then rinse thoroughly with water.
• Dispose biological waste& disinfect all non disposable components
with 1:10 dilution bleach and wipe with 70% ethanol

• Allow disinfectant to remain in contact with surfaces for at least ten

minutes at an ambient temperature for optimal effectiveness against
dried blood or serum.
 If equipment needs maintenance, clean and decontaminate them in the
laboratory before transporting to repair/maintenance.

• Incinerate or autoclave all waste before disposal in a sanitary landfill.

Solutions containing bleach may corrode the autoclave; therefore,
these solutions may be poured down a drain connected to a sanitary
sewer.

• After decontaminating, carefully pour down a drain connected to a

sanitary sewer bulk blood, suctioned fluids, excretions, and secretions.
2.4.2. STANDARD PRECAUTIONS
Universal Precautions

Rules of universal precautions

Consider ALL patients potentially infectious.

 Assume ALL blood and body fluids and tissue to be potentially

infectious.

Assume ALL unsterile needles and other sharps to be similarly

contaminated.
 Standard Precautions
These precautions should be followed in all patient care situations.

• All staff should be informed of the need to report exposure to blood or

potentially infectious body fluids to the duty doctor without any delay.

• Certain standard precautions should be taken in all healthcare settings

as given below
Standard Precautions
1. Proper hand hygiene: Wash hands thoroughly with soap and water
before and after handling specimens.

If soap and water are not available, use an alcohol-based hand sanitizer.

2. Personal protective equipment (PPE): Wear gloves, a lab coat or

gown, and appropriate eye protection (goggles or face shield) to protect
against potential exposure to hazardous materials.
3. Proper specimen handling: Follow the specific guidelines for each
type of specimen being collected, including proper labeling, packaging,
and transportation.

4. Contamination prevention: Keep work areas clean and free of

clutter. Use disinfectants to clean surfaces and equipment regularly.

5. Proper disposal: Dispose of all contaminated materials, including

sharps, in designated biohazard waste containers.
6. Vaccinations: Ensure that laboratory personnel are up to date on
necessary vaccinations, such as hepatitis B, to protect against potential
infections.

7. Training and education: Provide ongoing training and education to

laboratory staff on proper specimen collection techniques, infection
control practices, and safety protocols.

8. Emergency preparedness: Have emergency response plans in place

and ensure that staff are trained on how to respond to accidents or
incidents involving hazardous materials.
9. Regular maintenance of equipment: Regularly inspect and maintain
laboratory equipment to ensure it is functioning properly and does not
pose a risk of contamination or other hazards.

10. Communication: Establish clear lines of communication between

laboratory staff, healthcare providers, and other relevant personnel to
ensure that all necessary precautions are taken and that any potential
hazards or concerns are addressed promptly.
Laboratory work area and equipment should make free of contamination
to minimize hazards of

1. Cross-contamination: Contamination of samples or equipment with other

samples, chemicals, or biological materials can lead to inaccurate results and
potential hazards.

2. Biohazard exposure: Improper handling of biohazardous materials can

result in exposure to infectious agents, leading to potential infections or
illnesses.

3. Chemical exposure: Spills or leaks of hazardous chemicals can pose health

risks to laboratory personnel and can also contaminate samples or equipment.
4. Physical hazards: Cluttered work areas, improperly stored equipment, or
malfunctioning machinery can increase the risk of accidents and injuries in the
laboratory.

5. Environmental hazards: Improper disposal of hazardous waste or chemicals

can have negative impacts on the environment and pose risks to human health.

6. Quality control issues: Contamination in the laboratory can lead to errors in

testing and analysis, affecting the accuracy and reliability of results.

7. Regulatory compliance: Failure to maintain a clean and contamination-free

work area can result in violations of regulatory standards and guidelines, leading
to potential legal consequences or sanctions.
Answer the Following Questions (2 point each).

1. List personnel protective equipment in specimen collection.

2. What are the standard precautions should be taken in Laboratory

specimen collection

3. Laboratory work area and equipment should make free of

contamination to minimize hazards of:
 2.5. Cleaning of work area pre-use of all items
• 2.5.1. Cleaning and disinfecting work area and equipment after use

• Laboratory work area and equipment should make free of contamination to

minimize hazards of:

• Handling

• Collecting,

• Transporting

• Disposing of left over samples and unnecessary other biological materials

• Minimize hazard effect to the environment.

• All left over samples and unnecessary other biological materials shall be
discarded in a containers specifically designed, planned and marked for
disposal of hazard wastes.

• Biological waste containers should not fill beyond their designed

capacity. Sharps including needle, lancets, scalpels, glass and metals
discarded directly to the puncture resistance containers.

• Rubbish and other laboratory wastes shall not allow accumulate.

• Filled containers shall be removed on a regular base from work area.

• They shall be held in a designated secure place, normally with in the

laboratory area, prior to decontamination or disposal
 2.6. Packaging Specimens for Transportation
2.6.1. Triple Packaging System

Referral testing requires proper packaging and shipping of patient specimens to preserve

their integrity and suitability and to protect all persons involved in their transportation.

• Proper specimen packaging and shipping is important to ensure quality results and the

safety of laboratory and courier personnel.

• The three factors necessary for specimen packaging and shipping are:

The right packaging

The right temperature

The right timeframe

• Regardless of the sophistication of the packaging materials, it is possible to properly
package and ship specimens for referral testing.

• A well-collected, properly labeled, and properly stored specimen, with a matching

test requisition form, must be forwarded to a referral testing site in a timely manner
to ensure the viability of specimens for testing.

• Some specimens are of critical importance to patient health and the late arrival of
specimens at the testing site, and failure to package and ship them intact or at the
appropriate temperature may result in the need for another specimen to be drawn and
an unnecessary (and perhaps costly) delay in the patient‘s treatment.

• Drivers and couriers must be trained in the biosafety practices relevant to their job.
The training should be documented and included in the personnel file.
• Laboratory specimens must be tracked. The sending site should retain a copy of the
requisition. The specimen referral log should be kept current and reviewed weekly to follow-
up on any outstanding results. Link this to the activity, tracking a Referral Specimen.

• A communicative process between the sending and referral laboratory should be established.
Areas that should be addressed are critical result notification, specimen rejection notification,
specimen receipt verification, adding additional test confirmation, and result report
transmission.

• The referral testing laboratory should provide a laboratory handbook as part of its customer
service for the sending laboratory. The handbook should include instructions and guidelines
that address such areas as: specimen collection and processing by test, available testing
menu, expected turn-around-times, and required specimen identification and test information.
Specimen Collection and Processing:

Packaging Specimens for Shipment Primary Receptacles

• Contains the specimen

• Must be watertight and leak proof

• Must be appropriately labeled as to content.

• Wrapped in enough absorbent material to absorb all fluid in case of

breakage or leakage.
 Secondary Packaging

Encloses and protects the primary receptacle

 Must be watertight and leak proof

 Several wrapped primary receptacles may be placed in a single secondary

packaging. Outer Packaging (Tertiary)

 Protects secondary packaging from physical damage while in transit

 Contains specimen data forms, letters, and other types of information that
identify or describe the specimen and identify the shipper and receiver, and any
other documentation required.

Must be a sturdy container with a latch or able to be taped shut

 Specimen Packaging and Shipping
 Utilize PPE when packaging specimens.

 Ensure specimens are in the appropriate transport media (primary containers)

for the specimen collected and the test requested (primary containers). Ensure
that primary containers will not leak

 Determine the requirements temperature (ambient temperature vs

refrigerated) and the referral timeframe (i.e., 6 hours) for the specimen collect
and the test requested.

 Consult the driver/courier schedule to ensure that the sample will reach the
referral center within the necessary referral timeframe.
• Place cool packs on the bottom of a secure leak-proof secondary container to properly
preserve the specimens during shipping (specimens shipped at ambient temperature
may not require cool packs, although it is often still advisable in warm climates.)

• Place the primary container(s) in the secondary container with sufficient absorbent
material

—paper towels, cotton balls, commercial product

—to absorb the entire contents of the primary containers.

– Ambient temperature specimens can be transported in the same secondary packaging

as refrigerated specimens, but should be packed as far away from the cool pack as
possible and be insulated by at least one layer of absorbent material.
• Ensure secondary container(s) is labeled properly with a biohazard sticker or stamp.

• Place secondary container(s) in an outer shipping container that can be secured with a screw
top, latch mechanism or sealed with tape.

• Place test requisition forms in a plastic sheath (if possible) inside the outer shipping container
with specimen tracking form.

• Confirm that the contact information for the laboratory is clearly marked on the outer shipping
packaging and/or in paperwork inside the outer packaging

• Note the date and time of pick-up on the specimen tracking form and/or the driver/courier
logbook.

• Ensure that the drivers/couriers have received basic safety training in the transportation of
specimens.

• Disinfect the bench where the specimens were packaged

2.7. Requirements permitted for handling specimen

2.7.1. HANDLERS‘ INSTRUCTIONS

• Improper collection, transport, storage and handling of specimens between the

laboratories carry a risk of infection to the personnel involved and the environment.

• As a result, it is important to strictly follow the rules of general laboratory safety:

• Ensure that containers are leak-proof with a screw cap so that no material remains
on the outside of the container. To avoid cracking or bending this container, never
use mechanical devices to tighten the cap.

• Avoid spills and splashes during the opening and closing of tubes by using
appropriate materials such as paper towel (absorbent pad), gauze, etc.
• When applicable, ensure that the outer part of triple package is large enough to
hold the containers.

• Label containers to facilitate identification; do not wrap request or specification

forms around the containers.

• To avoid accidental leakage or spillage, use secondary metal or plastic containers

fitted with racks so that the containers remain upright.

• The secondary containers should be autoclavable or resistant to the action of

• chemical disinfectants and should be regularly decontaminated.

• For laboratories that receive large numbers of specimens, designate a particular

room or area for this purpose.
• Shipping cartons or carriers must be immediately unpacked in a
designated area equipped with a discard container (infectious, non
infectious and sharps), alcohol swabs and paper towels.

• Use a Class II biosafety cabinet to limit exposure of laboratory staff to

potential pathogens.

• If a biosafety cabinet is not available, use a clean workbench that can

be easily disinfected using common laboratory disinfectants; this
should be located away from areas used for other laboratory activities.
• Open the package safely and record and maintain all related documents:

• If there is linkage, broken container and contaminated paper manage it

according to universal safety precaution.

• For blood specimen, ensure that appropriate safety measures are

adopted to prevent laboratory infections; the handling of patient‘s blood
and arthropods is particularly hazardous because the specimens are
suspected to contain infectious agents.
 2.8. Make available Vehicle and communication devices are in working order

2.8.1.laboratory specimen couriers

• Transport the specimen(s) properly and safely from referring to

referral laboratories and return results back to referring laboratories in
a timely manner(per established TAT)

• Ensure the quality and/or safety of the specimen, environment and all
parties involved in the process including keeping bio-security.
• Ensure that the required documentation is available and maintained

• Maintain Communicate with referring and referral laboratories

• Follow the memorandum of understanding and SOP.

• Must report any incident based on the incident report form

2.8.2. REFERRAL/RECEIVING LABORATORIES

• Check for integrity and safety of specimen.

• Ensure that all the formats are properly filled, that complete
documentation is provided to the appropriate authorities and that all
information is appropriate and adequate

• Inspect the packaging and transportation process as per the SOP

• Perform the requested test analysis using the referred specimens and
provide timely results back to referring laboratories

• Establish and communicate TAT to referring laboratories

• Dispose of leftover specimen(s) appropriately

• Maintain proper reporting documentation

• Maintain early notification and proper communication with referring

laboratories and couriers.
 2.9. Identifying Required transport containers and
materials
Referral testing requires proper packaging and shaping of patient sediment to preserve
their integrity and suitability and to protect all persons involved in their transportation.

• Primary receptacle

• Paper towel

• Secondary receptacle (packaging)

• Absorbent

• Outer receptacle (packaging)

• Biohazard marker
Special Safety Precautions

- Use universal precaution (PPE) when packaging specimen or

infectious materials

- Disinfect the bench where the specimens were packaged.

- Wash hands after packaging specimens.

Procedural Notes

1. Make sure that the lab request & specimen forms are filled properly.

2. Note the date and time of pick-up on the specimen referral log form.

3. Make certain that the test-tube labeled properly and clearly

4. Determine the requirements temperature (ambient temperature vs.

refrigerated) and the referral timeframe (i.e., 6 hours) for the specimen collect
and the test requested.

5. Ambient temperature specimens can be transported in the same secondary

packaging as refrigerated specimens, but should be packed as far away from the
cool pack as possible and be insulated by at least one layer of absorbent material.
6. Ensure that the outside of the specimen container is clean and uncontaminated

7. Check if the test tube /container/ closed tightly so that its contents do not leak
during transportation.

8. Place test tube into test tube rack aseptically in appropriate manner.

9. Check if vaccine carrier cool box is large enough to hold sufficient specimen
container.

10. Each test tube rack must be individually protected by absorbent materials
(absorptive paper, cotton or cloth/ to reduce cotton or cloth/ to reduce shake or
prevent breakage.
11. Place test-tube rack in to cold box or sample packaging box.

12.Place the dry ice packs at the bottom of the box and along the sides, place specimen in the center,
and then place more ice packs on top in order to keep the temp at 2-8 C. N.B. Specimens shipped at
ambient temperature may not require cool packs, although it is often still advisable in warm climates

13. Close the cold box tightly.

14. If the external temp is high, the samples should be shipped cool (not frozen) packs.

15.Ensure that the drivers/couriers have received basic safety training in the transportation of
specimens.

16. Arrange for immediate transport of the sample to testing laboratory.

17. Disinfect the bench where the specimens were packaged.

18. Wash hands after sample handling and Packaging.

1. When transporting specimen what is the currier should check

A. Ensure that the required documentation is available and maintained

B. Maintain Communicate with referring and referral laboratories

C. Follow the memorandum of understanding and SOP.

D. Must report any incident based on the incident report form

E. All

2. What are the conditions of specimen Referral/receiving laboratories should check.

3.What are general laboratory safety rule that are followed by the laboratory Personnel?

4. What is Special Safety Precautions should be taken in specimen packing for transportation?

5.what are the 5 common pre-analytical errors in the laboratory?