MODULE 11: SPECIMEN HANDLING AND PROCESSING 

4. Specimen Suitability 
 Specimens are rejected for: 
Pre-Analytical Phase – accessioning (name, age, gender,  Hemolysis (if serology, it’s okay)
date, etc.; request form), specimen collection  Insufficient amount of specimen
Analytical Phase – test, experimentation  Clotting 
Post-Analytical Phase – record, release results  Inadequate, inaccurate, or missing
specimen ID 
Specimen Handling  Wrong or outdated tube 
Pre-analytical Phase  Improper handling 
 All the steps taken before the actual testing of  Wrong collection time 
the sample   Exposure to light 
 Estimated that 46% to 68% of all laboratory  Delay in testing 
errors occur prior to analysis   Delay or error in processing 
 Specimen handling is a critical part of this phase
 The specimen we collect must be ‘fit to use’
5. Centrifugation 
 Centrifuge: a machine that spins blood tubes at
1. Routine Handling  high rpm 
Mixing tubes by inversion   Centrifugal force separates cells & plasma or
 Additive tubes require 3-10 gentle serum 
inversions  Tubes awaiting centrifugation 
 Stoppers should remain on to prevent
Transporting specimens  inaccurate results, evaporation, &
 Stopper should be up  contamination 
 Should be in plastic bags with biohazard  Centrifuge operation 
logo, liquid-tight closure, & a slip pocket  Tubes must be balanced (equal-size
for paperwork  tubes w. equal volumes of specimen
must be placed opposite one another) 
Delivery time limits   Centrifuging plasma specimens 
 Routine blood specimens should arrive  Plasma specimens may be centrifuged
at lab within 45 min.  without delay 
 Centrifugation, if required, should occur  Centrifuging serum specimens 
within 1hr of arrival (less than 1hr)  Serum specimens must be completely
clotted before centrifugation 
 Complete clotting takes 30 to 60 min. at
2.  Specimen Handling  room temp. (red top)
Body temperature specimens 
 Should be collected in a pre-warmed
tube  6. Stopper removal 
 Should be transported at or near  Some testing machines sample specimens
normal body temp. of 37˚C  directly through stopper 
 Use portable heat blocks to maintain  Most require stopper removal 
temp. during transport   Stopper may be removed by removal devices or
robotics 
Chilled specimens   If removed manually: 
 Should be immersed in a slurry of  Face shield or splash shield should be
crushed ice & water  used 
 Should be tested immediately or  Gauze or tissue should cover stopper 
refrigerated  Stoppers should be pulled straight up &
off  
Light-sensitive specimens 
 Wrap in aluminum foil or use light-
blocking amber-colored container 7. Aliquot preparation 
 to prevent light penetrating the bottle  Aliquot ‘mini me’: a portion of specimen used
and avoid oxidation for testing 
o in bilirubin testing, you should protect it  Uses 
from light  Multiple tests are ordered 
 Tests are performed on different
instruments or in different areas 
3. Specimen processing   Prepared by transferring a portion of
 Central processing area in large labs  specimen into one or more tubes
 Here, specimens are:  labeled w. same ID info. as specimen
 Identified  tube 
 Logged/accessioned   Each aliquot tube should be covered or capped
 Sorted by department & type of as soon as it is filled
processing required 
 Evaluated for suitability for testing