SPECIMEN CARE

Overview

Involves specimen collection techniques Involves specimen processing techniques especially centrifugation Involves specimen transportation techniques Involves specimen storage techniques.

Brief explanation of specimen collections in the elderly.

Pre-analytical control of variation in Laboratory Results.

Insight in the study/screening for Ca prostate and our procedure.

Biological specimen that are analyzed in Clinical Laboratories are:

Whole blood Serum Plasma Urine Faeces Saliva Spinal fluid Synovial fluid Amniotic fluid Pleural fluid Pericardial fluid Ascitic fluid Solid tissues

Blood: for analysis from arteries, vein, capillaries.

Venous blood by venopuncture

Capillary blood by skin puncture from children, point of care.

Arterial puncture for blood gases analyzers.

VENOPUNCTURE:
All the steps involved in obtaining an appropriate identified blood specimen from a patients vein. PRELIMINARY STEPS: Be properly dressed, gloved, etc. Confirm patients identity to tally with bottle, form, case note etc. Name, D.O.B., Sex, Medical Records Number, Location, Address of Patient. Patient seated comfortably for at least 20 minutes.

 Choose appropriate arm No drip, No Haematoma, No Recent Marks/Scar.

Note blood volume needed Note tube/type of Blood/Serum/Plasma. Location Antecubital fossal/crook of the elbow, e.t.c. Preparation of site

Use alcohol swab, If collecting blood for alcohol determination clean Benzalkonium Chloride Solution (Zephiran Chloride Solution 1:750).

 Timing very important (corticosteroids, iron diurnal variations drug monitoring toxicology testosterone infertility drugs. Veno occlusion For not more than 3 minutes beyond which total protein, iron, total lipid, cholesterol, CK, AST, Bilirubin are , Potassium Decreased. Pumping of fist before venopuncture increase K+, Ca++, PO4, Lactate, decreases pH. Stress increase cortisol, growth hormones, AST, LD.

COLLECTION WITH EVACUATED BLOOD TUBES

Serum separator tubes Gel separator tubes polymer gel/silica activator. Serum tube (nonaddictive) coated interior/ non coated. Serum tubes with additive thrombin, particulate, clot activate. White blood/plasma tubes K2EDTA, citrate (coagulated) sodium fluoride, heparin, and lithium iodoacetate.

OTHER BLOOD COLLECTION INTO TUBES

Blood cultures.

Nonadditive tubes (Red Stopper)

Coagulation or citrate-containing tube (Blue Stopper)

Serum separator tube containing gel (Red stopper with black flecks)
Heparin-containing tubes (Green Stopper)

EDTA - containing tube (Lavender Stopper)

Oxalate fluoride containing tubes (Grey stopper)

BLOOD COLLECTION WITH SYRINGES

Syringe and needle aligned with the vein at an angle to the
skin of approximately 15. When there is an initial resistance of the vein wall. Pull back gently. Gently pull back the plunger of the syringes.

 Should a syringe be necessary

Put a gauze pad under the hub of the needle to absorb the spill, the first syringe is then quickly disconnected and a second one put in place to continue the draw. When transferred into the bottle mix by 5-10 inversion.

COMPLETION OF COLLECTION

The needle goes into the sharp container Syringe into the hazardous waste Gloves in the hazardous waste

Skin puncture especially for point of care testing. Drop may be transferred or collected into a capillary blood tubes, collected on filter paper especially for neonatal screening or molecular genetics.

ARTERIAL PUNCTURE
Arterialized Capillary Blood
ANTICOAGULANTS & BLOOD PRESERVATIVES

Concentration of analytes may vary in serum and plasma.

Plasma Value > Serum

Calcium Chloride Lactate dehydrogenase Total protein

No difference between serum and plasma values

Bilirubin Cholesterol Creatinine

Plasma value less than serum values

Albumin, ALP, AST, Bicarbonate, creatinine kinase, Glucose, phosphorus, potassium, Sodium, urea, uric acid.

Whole blood or plasma is needed for some assay systems, then anticoagulant must be added during collection Types

1. Heparin causes least interference with test except for tests performed using PCR. It is mucoitin polysulfuric acid as lithium, NH4,
DISADVANTAGES:

High cost Temporary action Inhibits ACP Affects binding of T3 & T4 to carrier protein Produces coagulation.

2. EDTA

3. Sodium fluoride

4. citrate

5. Oxalate. Especially potassium do not shrink RBC.

6. Iodoacetate

HAEMOLYSIS
MAINTENANCE OF SPECIMEN IDENTIFICATION

Minimum information include;

NAME, Location, Identification number, Date Of Collection, Time Of Collection
Treat all specimen as if they are potentially dangerous

PRESERVATION IN TRANSIT

In coolers, e.t.c

SEPARATION & STORAGE Separation of serum or plasma must be within 2 hours.

CENTRIFUGATION.