PMLS FINALS

SPECIMEN HANDLING AND PROCESSING

CRITERIA FOR RE-COLLECTION OR REJECTION OF SAMPLE
 Labels must have the patient’s complete name/ hospital number/ unique identifier
 Sample must have on the label the name of the test to be performed
 Sample must be collected within the time limits requested
 Urine samples must have the label on the container, not on the lid
 Appropriate anticoagulant
 Tubes may not be used beyond the expiration date
 Certain sample may not be exposed to light
 Delays in centrifuging or processing a sample will invalidate the results
 Anticoagulated blood samples must be free from clots
 Blood samples drawn above an IV line are unacceptable
 Sample must be re-collected if the results are not consistent with previous results on
the patient

WHOLE BLOOD
 Maintain the specimen at room temperature
 Do not place whole blood specimens in direct contact with cool packs / ice
 Do not centrifuge if the sample requirement is whole blood
 STORAGE: Ref Temp (48 hours)
 TEST: CBC, Reticulocyte Count, ESR

PLASMA / SERUM
 Allow the sample to clot in an upright position within 15-30 minutes
 Centrifuge for at least 15 minutes at 2200 – 2500 RPM
 Separate the plasma / serum using a pipette
 STORAGE: Ref temperature: 48 hours
Frozen temperature: 1 year
 TEST: Crossmatching, coagulation Tests, Chemistry tests, Serology Tests

NON- BLOOD SAMPLES

 BODILY FLUIDS
-Cerebrospinal Fluid (CSF)
-Peritoneal Fluid
-Pericardial Fluid
-Pleural Fluid
 URINE
 STOOL SPUTUM
 SEMEN
 OROPHARYNGEAL (OP) AND NASOPHARYNGEAL (NP) SWAB
 NASOPHARYNGEAL WASH / ASPIRATE
 TISSUES
 BODILY FLUID CSF PLEURAL PERITONEAL PERICARDIAL
SOURCE Spinal Space Lungs Abdominal Area Surrounding the
Heart
COLLECTION Lumbar Thoracentesis Paracentesis Pericardiocentesis
Puncture
VOLUME >0.5 ml (Clear)
Minimum of 50 Minimum of 50 Minimum of 10
mL mL mL
CONTAINER Glass and Sterile Glass and Sterile Glass and Sterile Glass and Sterile
CENTRIFUGATION 15 minutes at 15 minutes at 15 minutes at 15 minutes at
2200 – 2500 2200 – 2500 2200 – 2500 2200 – 2500 RPM
RPM RPM RPM
STORAGE Room Room Room Room
temperature (7 temperature (7 temperature (7 temperature (7
days), days), days), days),
Refrigerated (7 Refrigerated (7 Refrigerated (7 Refrigerated (7
days), Frozen days), Frozen days), Frozen days), Frozen (28
(28 days) (28 days) (28 days) days)
ROUTINE TEST Glucose, Total Glucose, Total Glucose, Total Glucose, Total
Protein, WBC Protein, WBC Protein, WBC Protein, WBC and
and RBC Count, and RBC Count, and RBC Count, RBC Count,
Differential Differential Differential Differential Count
Count Count Count

URINE
 COLLECTION: Mid- stream, clean- catch
 VOLUME: 30- 60 mL
 CONTAINER: Screwcap Lid
 PROCESSING: Within 2 hours
-Physical Examination (Color and Clarity)
-Chemical Examination (SG, pH, Glucose, and Protein)
-Microscopic Examination (WBC, RBC, Bacteria, Epithelial Cells)
STOOL
 COLLECTION: Freshly Collected
 VOLUME: 0.5 to 1.0 or pea- sized
 PROCESSING: Within 2 hours
-Physical Examination (Color and Consistency)
-Microscopic Examination (WBCs, RBCs, Parasite, Yeast)

SPUTUM
  COLLECTION: Deep respiratory secretions, not saliva
 VOLUME: about 1 teaspoon (5 milliliters)
 PROCESSING: Immediately
-Gram Stain
-Sputum Culture
-AFB

SEMEN
 COLLECTION: collected on -site
 CONTAINER: Sterile, Wide- mouth container
 TEMPERATURE: Must not be refrigerated but kept as close to body temperature
 PROCESSING: Within 2 hours
-Volume
-Sperm count, movement and shape
-White blood cells

OROPHARYNGEAL (OP) AND NASOPHARYNGEAL (NP) SWABS

 OPTIMAL TIMING:
Within 3 days and no later than 7 days
 SWAB TYPE:
Sterile Dacron or rayon swabs with plastic shafts
 OP COLLECTION:
Posterior pharynx and tonsillar areas
 NP COLLECTION:
Nares parallel to the palate
 SPECIMEN HANDLING:
Immediately into a sterile vial with 2 ml of viral transport media w/o antibiotics

NASOPHARYNGEAL WASH / ASPIRATE

 OPTIMAL TIMING:
Withing 3 days and not later than 7 days
 SPECIMEN COLLECTION:
Insert tubing into the nostril parallel to the palate
 SPECIMEN HANDLING:
Sterile vials @ 4 degrees Celsius
LIST OR RECOMMENDED CLINICAL SPECIMENS TO COLLECT FROM OUTPATIENTS, INPATIENTS,
AND FATAL CASES IN THE SETTING OF AN UNEXPLAINED RESPIRATORY DISEASE

OUTPTIENTS
 Upper Respiratory
-Nasopharyngeal (NP) and Oropharyngeal (OP)
-Nasopharyngeal wash / aspirate
 Lower Respiratory
-Sputum
 Blood
-Serum: Acute (at onset) and convalescent (3-6 weeks post onset)
-Blood (plasma)
 Urine
 Stool

INPATIENTS
 Lower Respiratory
-Brachoalveolar lavage, Tracheal Aspirate, Pleural Fluid
-Sputum
 Upper Respiratory
-Nasopharyngeal (NP) and Oropharyngeal (OP) swabs
-Nasopharyngeal wash / aspirate
 Blood
-Serum: Acute (at onset) and Convalescent (3 – 6 weeks post onset)
-Whole Blood (plasma)
 Tissue
 Urine
 Stool

FATAL CASES
 All available premortem specimens
 Tissue
-Fixed tissue from all major organs (lung, heart, spleen, liver, brain, kidney, adrenals)
-Non- fixed tissue from lung and upper airways (trachea, bronchus)
 Lower Respiratory
-Bronchoalveolar lavage, Tracheal aspirate, Pleural fluid
-Sputum
 Blood
-Serum
-Blood (plasma)
 Deep lung swab for bacterial culture
 PMLS LAB

HANDLING OF BLOOD AND NON- BLOOD SPECIMENS