PRINCIPLES OF MEDICAL TECHNOLOGY It is a facility that performs chemical and microscopic
PRACTICE 1 examinations of various body fluids (e.g. blood
tissues). OVERVIEW OF THE MEDICAL Inside the Clinical Laboratory TECHNOLOGY/MEDICAL LABORATORY - Pathologist SCIENCE PROFESSION - Medical Technologist - Medical Technician OUTLINE Historical Perspective Medical Technology/Medical Laboratory Science Practices Medical Technologist acts as… Medical Technology Education MEDICAL DETECTIVES LEARNING OUTCOMES Trace the history of Medical Technology Globally and in the Philippines. Roles of Medical Technologist Enumerate the scope of Medical Technology Practices. Observe, identify, and analyze organisms Discuss the scope of medical technology curriculum and different job opportunities. and cells causing infection and disease. Perform blood tests. MEDICAL TECHNOLOGY Measure substance in blood and other body is also known as: fluids. Clinical Laboratory Science Operate complex apparatus, instruments and Medical Laboratory Science machines. Use standards and controls to improve What is Medical Technology (according to) ? reliability of results. Work under pressure with accuracy and Ruth Heinemann precision. -is the application of natural, physical and biological Adhere to high ethical standards of sciences to the performance of laboratory procedures performance. which aid in the diagnosis and treatment of disease. HISTORY OF MEDICAL TECHNOLOGY Anne Fagelson GLOBAL AND LOCAL -is the branch of medicine concerned with the performance of laboratory determinations and EARLY BEGINNINGS analyses used in the diagnosis and treatment of the disease and maintenance of health. 400 B.C. - Hippocrates (Father of Medicine) described Walters the “four humors” in man; BLOOD, -is the health profession concerned with performing PHLEGM, YELLOW BILE and BLACK laboratory analyses in view of obtaining information BILE necessary in the diagnosis and treatment of disease - Urine was regarded as composite of these as well as in the maintenance of good health. humors.
RA 5527 (The Philippine Medical Technology Act 600 B.C.
of 1969) - Hindu physicians recorded the sweet taste of -is an auxiliary branch of laboratory medicine which diabetic urine as well as polyuria in diabetes. deals with the examination of tissues, secretion and excretion of human body and body fluids by various 1500 B.C. chemical, microscopic, bacteriologic and other - Vivian Herrick identified Taenia and medical laboratory procedures of technic which will Ascaris. aid the physician in the diagnosis strictly and - “Ebers Papyrus” was discovered. treatment of disease and in the promotion of health in - “Ebers Papyrus” – the oldest preserved general. Egyptian compilation of medical texts.
What is common among them? 1632
- Performing laboratory procedures - Anton Van Leeuwenhoek invented the (samples) compound microscope. - Analysis (results) - He was the first to describe the red blood - Diagnosis and treatment (disease) cells, protozoa, and to classify bacteria according to shape. CLINICAL LABORATORY 1628-1694 - Automated equipment. - Marcelo Malphigi (Founder of Pathology) - Quality control programs. - Greatest of the early microscopists. - Contributed to Embryology and Anatomy. IN THE PHILIPPINES
1847 Jan. 9, 1945
- Rudolph Virchow - First Clinical Laboratory in Phil. at - Founder of the “Archives of Pathology” in Quiricada St., Sta. Cruz, Manila ws Berlin. established and is known as Public Health Laboratory. 1848 - Herman Fehling Oct. 1, 1945 - Performed the first quantitative test for - Dr. Pio de Roda and Dr. Mariano Icasiano urine sugar. reopened Manila Public Health Laboratory.
15th Century 1947
- Discovery of dyes (aniline dyes) made - Dr. Pio de Roda and Dr. Prudencia Sta. possible the staining and study of Ana offered a training for highschool and microorganisms such as bacteria. paramedical graduates.
IN THE UNITED STATES 1954
- 6-month laboratory training was offered. 1878 - Formal education of Medical Technology - Dr. William H. Welch began. - Established a laboratory at Bellevue Hospital Medical College. HISTORY OF MEDICAL TECHNOLOGY - Became the first professor of Pathology at EDUCATION IN THE PHILIPPINES John Hopkins University (1885). MRS. WILLA HILGERT HEDRICK 1896 Founder of Medical Technology Education in the - Dr. William Osler opened the first clinical Philippines laboratory at John Hopkins Hospital. - William Pepper Laboratory was also 1954 opened at the University of Pennsylvania. - Philippine Union College of Baesa - First to offer BS Medtech. 1908 - Dr. Jesse Umali was its first graduate after 2 - Dr. James C. Todd wrote “A Manual of years. Clinical Diagnosis” which became the standard reference for laboratories. 1957-1959 - Dr. Antonio Gabriel and Dr. Gustavo 1921 Reyes of UST offered MT as an elective to - Denver Society of Clinical Pathologists was pharmacy students. Due to its popularity, it organized. was decided to be offered as a course. - American Board of Pathology was organized in 1936. 1960 - CEU offered MT course World War I - First batch graduated in 1962. - Produced a great demand for technicians. - University of Minessota is one of the first 1662-1662 schools to establish trainings for workers in - Dr. Horacio Ylagan and Dr. Serafin 1922 and first to offer degree program in Juliano applied for the offering of BSMT 1923. courses in FEU which was approved in 1662. - First batch graduated in 1663. World War II - “Closed system” of blood collection was U.P – offers the same course but the degree is adopted. conferred to as B.S. Public Health. - Advanced instrumentation. Professional Organizations of Medical Technology in the Philippines: Program Curriculum -The Philippine Association of Schools of Medical The Course shall be at least four years, including a 12- -Technology and Public Health, Inc. (PASMETH) month long internship in accredited laboratories and The Philippine Association of Medical Technologists shall include the following subjects: (PAMET) GENERAL EDUCATION CORE COURSES MEDICAL TECHNOLOGY EDUCATION IN PROFESSIONAL COURSES THE PHILIPPINES Scope of Licensure Examination Nature of the Field of Study The given examination covers the following subjects Program course shall be called as: with its specific percentage: -Bachelor of Science in Medical Technology or Clinical Chemistry 20% -Bachelor of Science in Medical Laboratory Science Microbiology and Parasitology 20% - It is a four year program consisting of a one Hematology 20% year internship with rotational duties in Blood Banking and Serology 20% different sections during the 4th level in a Clinical Microscopy 10% CHED-accredited training laboratory. Histopathologic Techniques and MT Laws10% - A licensure examination is given to all applicants for registration as Medical Technologist. Employment Opportunities of Medical Technology Graduates Program Goals The program aims for the graduates to: Medical technologist (generalist/specialist) - Develop knowledge, skills, professional Clinical laboratory supervisors attitude and values in the performance of Chief medical technologist laboratory procedures. Laboratory owners - Acquire critical thinking skills. Sales and public relations representative - Engage in research and community-related Educational representatives (company/health activities. program) - Participate in activities promoting the Researcher (industrial/medical) profession and engage in the life-long Teachers/Instructors (secondary/tertiary learning undertakings. levels) - Develop collaborative and leadership qualities. Employment abroad
Expected Performance Outcomes of Graduates (Medical Technologist Specialist, Phlebotomist,
The graduates must be able to: Industrial/Medical Researcher, Medical Doctors, - Demonstrate technical competence in the Medical Sales Representatives) performance of clinical laboratory tests. - Demonstrate analytical and critical thinking skills in the workplace. - Engage in the proper collection, analysis and projection of health information. - Demonstrate inter-personal skills, leadership qualities and ethical practice of the profession. - Apply research skills in relevance to areas to areas of Medical Technology/Laboratory Science practice. - Participate in community oriented activities. - Engage in life-ling learning activities. - Demonstrate effective teaching and communication skills. C. Based on Institutional Character 1. Institution-based 2. Freestanding
UNIT 2 D. Based on Service Capability
CLINICAL LABORATORY 1. General Clinic Laboratory 2. Special Laboratory OUTLINE General overview General Clinical Laboratory Classification of medical laboratories a. Primary Category Organization of the laboratory 1. Routine hematology (CBC) Laboratory Sections Information flow in the clinical laboratory 2. Qualitative platelet determination Three phases of the laboratory testing 3. Routine urinalysis and fecalysis Laboratory policies 4. Blood typing – for hospital-based LEARNING OUTCOMES Identify and differentiate the classification of clinical laboratory settings. b. Secondary Category Construct an organizational chart/architectural plan. 1. Routine clinical chemistry Explain the roles, functions and services offered by the different sections 2. Quantitative platelet determination of the laboratories. Justify and explain various information on a laboratory requisition. 3. Cross matching Identify the different phases of laboratory testing. 4. Gram staining 5. KOH staining for fungal disease CLINICAL LABORATORY c. Tertiary Category Facility 1. All secondary lab services Specimens (whole blood, serum, plasma, 2. Special chemistry (Cardiac markers) urine, stool, etc.) from the human body 3. Special hematology (coagulation tests) Collected, processed, examined or analyzed 4. Immunology/Serology (HIV, hepa profile, Prevention, diagnosis, and treatment tumor markers) 5. Microbiology – culture of sensitivity CLASSIFICATION OF CLINICAL d. Limited Service Capability LABORATORY Special Clinical Laboratory DEPARTMENT OF HEALTH a. Assisted reproduction technology laboratory Administrative Order no. 20017-0027 b. Molecular and cellular technology c. Molecular pathology, Forensic pathology, and A. Based on ownership Anatomic laboratory 1. Government 2. Private E. National Reference Laboratory 1. Confirmatory testing B. Based on Function 2. Surveillance 1. Clinical Pathology 3. Resolution of conflicting results 2. Anatomical Pathology 4. Training and research Clinical Pathology: 5. Evaluation of diagnostic kits and reagents 1. Clinical Chemistry 2. Hematology F. Satellite Testing Sites 3. Microbiology Testing site owned by a licensed laboratory 4. Clinical Microscopy but situated in a location some distance from 5. Immunology the main laboratory. 6. Molecular Biology 7. Immunohematology G. Mobile Clinical Laboratories 8. Cytogenetics 9. Endocrinology Laboratory testing unit 10. Toxicology Moves form one testing site to another testing 11. Therapeutic drug monitoring site Anatomical Pathology: Has a temporary testing location 1. Surgical Pathology Shall have a base laboratory 2. Immunohistopathology Permitted to collect specimen only 3. Cytology Operate within a 100-km radius from its main 4. Autopsy lab 5. Forensic Pathology 6. Molecular Pathology ORGANIZATION OF THE LABORATORY ……. LABORATORY REPORTS to transmit test results Reference rangers Date and time of the specimen collection LABORATORY SECTIONS Name, address of the laboratory Name and identification number of patient A. SPECIMEN PROCESSING Source of specimen B. HEMATOLOGY SECTION Date and time the report was generated C. COAGULATION SECTION D. CLINICAL MICROSCOPY THREE PHASES OF LABORATORY TESTING E. PARASITOLOGY F. CLINICAL CHEMISTRY A. PREANALYTICAL PHASE G. CLINICAL MICROBIOLOGY occurs first in the laboratory process H. IMMUNOLOGY/SEROLOGY SECTION Patient preparation SEROLOGY TESTS Paper work and data entry Pregnancy test – detects B-HCG Specimen collection, processing, storage, Dengue Test and transportation HbsAg – for hepatits Responsible Personnel Bacterial Agglutination test ***Phlebotomist, laboratory technician a. Widal test –typhoid fever b. Weil-Felix – nonspecific test for B. PREANALYTICAL PHASE typhus fever Considered the “actual” laboratory testing or I. IMMUNOHEMATOLOGY/BLOOD the diagnostic procedures, processes and BANK products J. HISTOPATHOLOGY/ Proper instrument maintenance CYTOPATHOLOGY Reagent supplies Quality control Why is Laboratory Testing Performed? Responsible Personnel 1. To assign a diagnosis ***Medical Technologist or Medical Lab **confirm clinical diagnosis Scientist **to establish an appropriate plan of action Ensure accuracy, precision, reliability of 2. Prevention by early detection of diseases the test procedure through screening tests. Validates the following: 3. Ongoing assessment of the patient’s progress Test reagents/kits and treatment. Testing process Training of the lab personnel INFORMATION FLOW IN THE CLINICAL performing the test LABORATORY C. POST-ANALYTIC PHASE Laboratory requisition Includes the following: A form used by physician to document the Review and analysis of results tests that are to be performed on patients. Recording and reporting of test results Contains the following Storage and disposal of specimen Patient’s demographic data, name data, Releasing of results address, birth data Responsible Personnel Test selection – should be marked clearly ***Medical Technologist, Section Date and time of collection Supervisor, Chief Medical Technologist, Identification of the person who performed office clerk or staff the collection, name of ordering physician Additional comments LABORATORY POLICIES Laboratory Directory Stability of the specimen A. Laboratory hour and emergency work Minimum volume Definite working hours Test schedule Outside regular working hours organize a Specimen processing system for testing urgent specimens. Method B. Range of tests to be performed and those to be referred to higher level Range of tests to be performed 1. The number of staff available 2. The availability of material resources 3. The types of health institutions (hospital or health center) Referral of specimens (when necessary) Example specimens for HIV detection and water samples for bacteriological analysis.
C. Collection of laboratory specimen
1. The specimen containers should be clearly labeled with the patient’s name, identification number, date of collection and time of collection 2. A fully completed, request form should accompany each specimen with the detail mentioned above.
D. Workload capacity of a laboratory
- Should match to the number of staff - Their level of training - Size of the laboratory - The availability of laboratory facilities