Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
SlideShare a Scribd company logo

Specimen collection dr manar-nursing

•
•

This document discusses key considerations for proper specimen collection including differential diagnosis, appropriate tests, collection methods, transport medium, labeling, and timing. It emphasizes the importance of advance planning, collecting adequate and appropriate specimens, sufficient documentation, biosafety, correct packaging, rapid transport, and communication of results. Specific guidelines are provided for collecting and transporting various specimen types including urine, stool, respiratory, blood, and cerebrospinal fluid.

1 of 19
Download to read offline
Specimen collection DR. MANAR AKAS MICROBIOLOGY & IMMUNOLOGY 11/feb/2015 DR. MANAR 1
Specimen collection: key issues What is your differential diagnosis? What test(s) you should conduct? How to collect appropriate samples ? 11/feb/2015 DR. MANAR 2
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 11/feb/2015 DR. MANAR 3
Transport medium Allows organisms (pathogens and contaminants) to survive Non-nutritive - does not allow organisms to proliferate For bacteria – i.e., Cary Blair For viruses - virus transport media (VTM) 11/feb/2015 DR. MANAR 4
specimens type ◦ Urine ◦ Stool ◦ Sputum ◦ Wound drainage/puss ◦ Blood 11/feb/2015 DR. MANAR 5
Why a urine specimen ? Urinary Tract Infection (UTI) ◦ Frequency ◦ Urgency(An immediate unstoppable urge to urinate) ◦ Dysuria (painful urination) ◦ Hematuria(blood in urine) ◦ Flank pain ◦ Fever Culture = ? Bacteria growing Sensitivity = which antibiotics are effective Midstream Urine Sterile Catheter Specimen (never from bag) Random Clean Female ? Menstrual details Tested for: ◦ Specific gravity ◦ pH ◦ Albumin ◦ Glucose ◦ Microscopic exam To lab 15-20min post collection 11/feb/2015 DR. MANAR 6
Stool Specimen Analysis of fecal material can detect pathological conditions i.e: infection, hemorrhage, tumors. Tests ◦ Occult Blood ◦ Bacteria ◦ Ova & Parasites Note the: 1-Color ◦ Melena (black stools) 2-Odor 3-Consistency Medical aseptic technique To lab on time Labelling /Documentation 11/feb/2015 DR. MANAR 7
Stool samples for bacteria Timing ◦ during active phase Method ◦ Cary-Blair medium ◦ For Ag detection/PCR – no transport medium Storage ◦ refrigerate at 4oC if testing within 48 hours, store at -15oC for Ag detection and PCR Transport ◦ 4oC (do not freeze); dry ice for Ag, PCR detection 11/feb/2015 DR. MANAR 8
Stool samples for parasites Timing ◦ as soon as possible after onset Sample amount and size ◦ at least 3 x 5-10 ml fresh stool from patients and controls Storage ◦ refrigerate at 4oC; store at -15oC for Ag detection and PCR Transport ◦ 4oC (do not freeze); dry ice for antigen detection and PCR 11/feb/2015 DR. MANAR 9
Respiratory Tract Tests to determine infection ◦ Throat cultures ◦ Sputum specimens Upper respiratory/ throat infections Throat swabs ◦ before meal or 1 hr after meal ◦ Wash hands, glove ◦ Tilt head backward ◦ “ah” ( if pharynx not visualized, tongue depressor, anterior 1/3 of tongue) ◦ Don’t contaminate 11/feb/2015 DR. MANAR 10
Nose & Throat cultures Nose, Oropharynx & tonsillar Sterile swab Insert swab into pharyngeal region Take swab from reddened areas/ exudate Culture determines pathogenic microorganisms Sensitivity determines the antibiotics to which the microorganisms are sensitive or resistant 11/feb/2015 DR. MANAR 11
Sputum collection Ordered to identify organisms growing in sputum Culture & Sensitivity AFB (acid fast bacilli) 3samples in 3 consecutive days, early morning ◦ Cough effectively,avoid postnasal discharge and saliva ◦ 1 ml minimum volume Record ◦ Color ◦ Consistency (thickness) ◦ Amount ◦ Odor ◦ Document date & time sent to lab. 11/feb/2015 DR. MANAR 12
Blood for smears Collection Capillary blood from finger prick ◦ make smear ◦ fix with methanol Handling and transport Transport slides within 24 hours Do not refrigerate (can alter cell morphology) 11/feb/2015 DR. MANAR 13
Blood for cultures Collection Requires aseptic technique Venous blood ◦ infants: 0.5 – 2 ml ◦ children: 2 – 5 ml ◦ adults: 5 – 10 ml Collect within 10 minutes of fever ◦ if suspect bacterial endocarditis: 3 sets of blood culture 11/feb/2015 DR. MANAR 14
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 can’t reach laboratory in 24h 11/feb/2015 DR. MANAR 15
Cerebrospinal fluid (CSF) Collection Trained person Aseptic conditions Lumbar puncture Sterile tubes 11/feb/2015 DR. MANAR 16
CSF Handling and transportation Bacteria ◦ Medium pre-warmed to 25-37°C before inoculation OR ◦ transport at ambient temperature (relevant pathogens do not survive at low temperatures) Viruses ◦ transport at 4-8oC (if up to 48hrs or -70oC for longer duration) 11/feb/2015 DR. MANAR 17
Labeling specimens Patient’s name Clinical specimen Unique ID number Specimen type Date, time and place of collection Name/ initials of collector
Thank you Questions? DR. MANAR AKAS 19

More Related Content

Specimen collection dr manar-nursing

  • 1. Specimen collection DR. MANAR AKAS MICROBIOLOGY & IMMUNOLOGY 11/feb/2015 DR. MANAR 1
  • 2. Specimen collection: key issues What is your differential diagnosis? What test(s) you should conduct? How to collect appropriate samples ? 11/feb/2015 DR. MANAR 2
  • 3. 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 11/feb/2015 DR. MANAR 3
  • 4. Transport medium Allows organisms (pathogens and contaminants) to survive Non-nutritive - does not allow organisms to proliferate For bacteria – i.e., Cary Blair For viruses - virus transport media (VTM) 11/feb/2015 DR. MANAR 4
  • 5. specimens type ◦ Urine ◦ Stool ◦ Sputum ◦ Wound drainage/puss ◦ Blood 11/feb/2015 DR. MANAR 5
  • 6. Why a urine specimen ? Urinary Tract Infection (UTI) ◦ Frequency ◦ Urgency(An immediate unstoppable urge to urinate) ◦ Dysuria (painful urination) ◦ Hematuria(blood in urine) ◦ Flank pain ◦ Fever Culture = ? Bacteria growing Sensitivity = which antibiotics are effective Midstream Urine Sterile Catheter Specimen (never from bag) Random Clean Female ? Menstrual details Tested for: ◦ Specific gravity ◦ pH ◦ Albumin ◦ Glucose ◦ Microscopic exam To lab 15-20min post collection 11/feb/2015 DR. MANAR 6
  • 7. Stool Specimen Analysis of fecal material can detect pathological conditions i.e: infection, hemorrhage, tumors. Tests ◦ Occult Blood ◦ Bacteria ◦ Ova & Parasites Note the: 1-Color ◦ Melena (black stools) 2-Odor 3-Consistency Medical aseptic technique To lab on time Labelling /Documentation 11/feb/2015 DR. MANAR 7
  • 8. Stool samples for bacteria Timing ◦ during active phase Method ◦ Cary-Blair medium ◦ For Ag detection/PCR – no transport medium Storage ◦ refrigerate at 4oC if testing within 48 hours, store at -15oC for Ag detection and PCR Transport ◦ 4oC (do not freeze); dry ice for Ag, PCR detection 11/feb/2015 DR. MANAR 8
  • 9. Stool samples for parasites Timing ◦ as soon as possible after onset Sample amount and size ◦ at least 3 x 5-10 ml fresh stool from patients and controls Storage ◦ refrigerate at 4oC; store at -15oC for Ag detection and PCR Transport ◦ 4oC (do not freeze); dry ice for antigen detection and PCR 11/feb/2015 DR. MANAR 9
  • 10. Respiratory Tract Tests to determine infection ◦ Throat cultures ◦ Sputum specimens Upper respiratory/ throat infections Throat swabs ◦ before meal or 1 hr after meal ◦ Wash hands, glove ◦ Tilt head backward ◦ “ah” ( if pharynx not visualized, tongue depressor, anterior 1/3 of tongue) ◦ Don’t contaminate 11/feb/2015 DR. MANAR 10
  • 11. Nose & Throat cultures Nose, Oropharynx & tonsillar Sterile swab Insert swab into pharyngeal region Take swab from reddened areas/ exudate Culture determines pathogenic microorganisms Sensitivity determines the antibiotics to which the microorganisms are sensitive or resistant 11/feb/2015 DR. MANAR 11
  • 12. Sputum collection Ordered to identify organisms growing in sputum Culture & Sensitivity AFB (acid fast bacilli) 3samples in 3 consecutive days, early morning ◦ Cough effectively,avoid postnasal discharge and saliva ◦ 1 ml minimum volume Record ◦ Color ◦ Consistency (thickness) ◦ Amount ◦ Odor ◦ Document date & time sent to lab. 11/feb/2015 DR. MANAR 12
  • 13. Blood for smears Collection Capillary blood from finger prick ◦ make smear ◦ fix with methanol Handling and transport Transport slides within 24 hours Do not refrigerate (can alter cell morphology) 11/feb/2015 DR. MANAR 13
  • 14. Blood for cultures Collection Requires aseptic technique Venous blood ◦ infants: 0.5 – 2 ml ◦ children: 2 – 5 ml ◦ adults: 5 – 10 ml Collect within 10 minutes of fever ◦ if suspect bacterial endocarditis: 3 sets of blood culture 11/feb/2015 DR. MANAR 14
  • 15. 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 can’t reach laboratory in 24h 11/feb/2015 DR. MANAR 15
  • 16. Cerebrospinal fluid (CSF) Collection Trained person Aseptic conditions Lumbar puncture Sterile tubes 11/feb/2015 DR. MANAR 16
  • 17. CSF Handling and transportation Bacteria ◦ Medium pre-warmed to 25-37°C before inoculation OR ◦ transport at ambient temperature (relevant pathogens do not survive at low temperatures) Viruses ◦ transport at 4-8oC (if up to 48hrs or -70oC for longer duration) 11/feb/2015 DR. MANAR 17
  • 18. Labeling specimens Patient’s name Clinical specimen Unique ID number Specimen type Date, time and place of collection Name/ initials of collector