ACTIVITY

NO. 5
 SAMPLE
PREPARATION,
TREATMENT AND
TRANSPORTATION
OCT.01,2022

Prepared by: REZZY MAE PANADERO-ORA, RMT

 Introduction 01
The collection of appropriate and optimum
samples is the responsibility of the laboratory,
even though the actual collection process is
often carried out by persons who are not part
of the laboratory staff. The sample may be
collected at the bedside by a nurse if the
patient is being managed in a hospital. The
health care provider may collect a sample in a
clinic setting.
 Introduction
The laboratory can help to ensure good
samples by providing collection information to
health care personnel at the collection site,
making sure that appropriate containers and
collection supplies are available, defining a
good labelling system and checking all
samples carefully when they arrive in the
laboratory.
 Introduction
Frequently, samples are collected outside the
laboratory and must be transported for
subsequent processing and testing. Transport
may be for a short distance, but sometimes a
distant clinic or collection site requires the
use of vehicles or aero planes. In addition, it
may be necessary for the laboratory to ship
samples to referral laboratories.
 Introduction
In all cases, transport must be managed
carefully in order to maintain integrity of the
sample, giving attention to temperature,
preservation needs, special transport
containers and time limitations. It is also
important to ensure the safety of those
handling the material before, during and after
transport.
02 OBJECTIVES
At the end of this activity, the students must
be able to:

01 02 03
Ensure the adequacy and Apply sampling
condition of the sample Define sampling protocol during
or specimen received for protocol in the lab. sample collection.
examination.
 03
PROCEDURE
“ SERUM

”
 Serum is the liquid fraction of whole blood that is collected after
the blood is allowed to clot.
 Normally clear, pale yellow fluid
 Non fasting serum can be cloudy (chylous) due to lipids
 Separated from clotted blood by CENTRIFUGATION
 Routine and special chemistry tests are performed on serum
 Serum Preparation

The most common serum preparation considerations:

1) Separate serum from red cells within two hours of venipuncture.
2) Mix specimen immediately after collection.
3) Allow specimens collected in a clot tube (eg, red-top or gel-barrier
tube) to clot before centrifugation.
4) Centrifuge sample at 2000 RPM for 10 minutes.
5) It is important to immediately transfer the serum
into another tube.
 Serum Preparation

The most common serum preparation considerations:

6) The sample should be maintained at 2-8 degree Celsius.
7) Avoid hemolysis: red blood cells broken down and components
spilled into serum.
8) Avoid lipemia: cloudy or milky serum
sometimes due to the patient's diet.
PREPARATION OF
SERUM
PREPARATION OF
SERUM
 Causes of Hemolysis
(Hemolyzed specimen)
4. Forcing the blood from
1. Using needle that is too a syringe into an
small. evacuated tube.

2. Pulling a syringe 5. Shaking or mixing the

plunger back too fast. tubes vigorously.

6. Performing blood
3. Expelling the blood collection before the alcohol
vigorously into the tube. has dried up at the collection
site.
“ PLASMA

”
 Normally clear, to slightly hazy, pale yellow fluid
 Separates from the cells when blood in an anticoagulant tube is
centrifuged
 Plasma contains FIBRINOGEN; serum DOES NOT because it was
used in clot formation
 Many chemistry tests can be perform in either serum or plasma
 Plasma Preparation

The most common considerations in the preparation of plasma:

1) Collect specimen in additive indicated in the test
requirements.
2) Mix specimen with additive immediately after collection by
inverting 5-10 times.
3) Avoid hemolysis or red blood cell breakdown.
 Plasma Preparation

The most common considerations in the preparation of plasma:

4) Fill the tube completely, thereby avoiding a dilution factor
excessive for total specimen volume (QNS).
5) Separate plasma from cells within two hours of venipuncture
when indicated in the test requirements.
6) Label transport tubes as “plasma”.
7) Indicate type of anticoagulant (ex. “EDTA,” “citrate”, etc).
PREPARATION OF
PLASMA
 URINE COLLECTION

 Collection and preservation of urine for analytic testing must

follow a carefully prescribed procedure to ensure valid results.
 Several kinds of collection are used for urine specimens:
RANDOM, CLEAN-CATCH, TIMED, 24 HOURS and
CATHETERIZED.
 Random specimens may be collected at any time, but a first
morning-voided aliquot is optimal for constituent
concentration, as it is usually the most concentrated and has a
lower ph caused by decreased respiration during sleep.
 Urine Collection

The most common urine collection considerations:

1) Obtain a clean-catch, midstream specimen.
2) Store unpreserved specimens refrigerated or in a cool
place until ready for transport.
3) Provide patients with instructions for 24-hour urine
collection.
4) Add the preservative (as specified in the test requirements)
to the urine collection container prior to collection of the
specimen.
 Urine Collection

The most common urine collection considerations:

5) Provide sufficient quantity of sample to meet the minimum
fill line on preservative transport container.
6) Provide the proper mixing of specimen with urine
preservative as specified in the test requirements.
7) Use the collection container as specified in the test
requirements, and refrigerate the specimen when
bacteriological examination of the specimen is required.
 Urine Collection

The most common urine collection considerations:

8) Carefully tighten specimen container lids to avoid leakage
of specimen.
9) Divide specimen into separate containers for tests with
such requirements.
10) Provide a complete 24-hour collection/aliquot or other
timed specimen.
11) Provide a 24-hour urine volume when an aliquot from the
24-hour collection is submitted.
 Urine Collection

The most common urine collection considerations:

12) Preservatives vary for each test; refer to test information
for the required preservative.
 24 HOUR URINE COLLECTION

 Most difficult to obtain and require patient cooperation

 For 24 hour urine collection, the first morning specimen should be
discarded, record the time, and collect the succeeding voiding for the next
24 hours --- overcollection occurs if the first morning specimen is included
in this routine.
 Pediatric collections require special attention to avoid stool contamination.
 CONTAINER – unbreakable, measures 4L (approximately|), is plastic, is
chemically clean, with correct preservatives added.
 Total volume collected is measured and recorded on the request form.
 The entire 24 hour specimen is thoroughly mixed, and a 40 ml aliquot is
submitted for analysis.
 24 HOUR URINE
COLLECTION PRESERVATIVES
PRESERVATIVE TESTS
Amino acids, amylase, calcium, citrate, chloride, copper, creatinine, delta ALA, glucose, 5-
HIAA, heavy metals, histamine, immunoelectrophoresis, lysozyme, magnesium,
NONE (Refrigerate) methylmalonic acid, microalbumin,mucopolysaccharides, phosphorous, porphobilinogen,
porphyrins, potassium, protein, protein electrophoresis, sodium, urea, uric acid, xylose
intolerant

10 g boric acid Aldosterone, cortisol

Cathecolamines, cystine, homovalinic acid, hydroxyproline, metanephrines, oxalate and

10 ml 6N HCl VMA

0.5 g sodium flouride Glucose

If processing delayed longer than

24 hours : equal amounts of 50% Cytologic examination
alcohol, Saccomano’s fixative and
SurePath or Preserve PT
 Reason for specimen rejection
1) Hemolysis/Lipemia
2) Clots in an anticoagualant tube
3) Nonfasting specimen (if required)
4) Wrong blood collection tube
5) Short draws
6) Improper transport (temperature)
7) Discrepancies between requisition and
special label
8) Unlabeled or mislabeled specimen
9) Contaminated specimen/leaking container
 TEN COMMON ERRORS IN
SPECIMEN REJECTION
1) Misidentification of patient
2) Mislabeling of specimen
3) Short draws/wrong anticoagulant/blood ratio
4) Mixing problems/clots
5) Wrong tubes/wrong anticoagulant
6) Hemolysis/lipemia
7) Hemoconcentration from prolonged tourniquet time
8) Exposure to light/extreme temperatures
9) Improperly timed specimens/delayed delivery to laboratory
10)Processing errors: Incomplete centrifugation, incorrect log-in, improper
storage
 STORAGE AND TRANSPORT
OF SPECIMENS

 During storage (ambient temperature, refrigeration or freezing), the

concentration of a blood constituent in the specimen may change as a
result of various processes, including adsorption to glass or plastic
tubes, protein denaturation, evaporation of volatile compounds, water
movement into cells resulting in hemoconcentration of serum and
plasma, and continuing metabolic activities of leukocytes and
erythrocytes.
 STORAGE AND TRANSPORT
OF SPECIMENS

 The ice crystals formed during storage cause disruptive effects to

molecular structure particularly to large protein molecules.
 Serum or plasma must be stored at 4 °C to 6 °C if analysis is to be
delayed for longer than 4 hours.
 LDH 4 and 5 isoenzymes (decreased) and alkaline phosphatase
(increase) are affected by low temperature storage prior to testing.
 SPECIMEN CONSIDERATIONS

 Specimens that require chilling (4°C) during transport and

storage of specimens: ammonia, blood gases,
catecholamines, gastrin, lactic acid, renin, PTH and
pyruvate.
 Photosensitive analytes: bilirubin, beta-carotene, folate,
porphyrins and Vitamin A and B6.
TRIPLE PACKAGING SYSTEM
 TRIPLE PACKAGING SYSTEM

 PRIMARY SAMPLE CONTAINER

(ex.., Lavender top and red top/yellow top tube) wrapped with absorbent
material (ex.., cotton or gauze) and place in resealable plastic bags
 SECONDARY RECEPTACLE (watertight, leak-proof
container)
 AN OUTER SHIPMENT BOX
END.
THANK YOU.