Handling & Processing

of Blood Specimens for

laboratory testing
Prepared by:
Patricia Nicole
D. Fernandez, RMT
collection
procedures,
storage,
processing, and
transporting
protocol
approximately
48% to 68%
mishandling or
error
Routine Handling
Mixing tubes by inversion
usually between 3 to 10
stopper:
transported with the
1)avoid contact between
contents and the stopper
2)minimize agitation
3)aid clot formation
SPECIAL HANDLING
1. Body temperature
 transported at near body temperature
which is 37˚C.
 pre-warmed at 37˚C
PORTABLE HEAT BLOCKS
hold the temperature for 15 minutes from
removal from the incubator.
 HEEL WARMER
specimen that can withstand a
temperature slightly higher than 37˚C
1. Body temperature

█Cold agglutinin
█Cyrofibrinogen
█Cyroglobulins
2. Chilled specimens
 CHILLING
slows the metabolic process

 SUBMERGED IN
CRUSHED ICE AND
WATER SLURRY
immediately tested or refrigerated if
needed
2. Chilled specimens
█ Gastrin
█ Adrenocorticotropic
█ Glucagon
hormone ACTH
█ Homocysteine
█ Acetone
█ Lactic acid
█ Angiotensin-
converting enzyme █ Parathyroid
ACE Hormone PTH
█ Ammonia █ pH/blood gas
(if indicated)
█ Catecholamines
█ Pyruvate
█ Free Fatty Acids
█ Renin
3. Light-sensitive specimens
 exposure to light could affect the result of
a specimen BILIRUBIN

 wrap the tube with

ALUMINUM FOIL or use
LIGHT-BLOCKING
AMBER-COLORED
CONTAINER
3. Light-sensitive specimens
█ Bilirubin
█ Carotene
█ Red Cell Folate
█ Serum Folate
█ Vitamin B2
█ Vitamin B6
█ Vitamin B12
█ Vitamin C
█ Urine Porphyrins
█ Urine Porphobilinogen
CRITERIA FOR
SPECIMEN REJECTION
 Specimen
identified
SPECIMEN HANDLING

logged or accessioned
sorted by department and
type of processing
evaluated for specimen
suitability which is
necessary for accurate
reasons
SPECIMEN HANDLING
 REJECT Specimen
SPECIMEN HANDLING

not identified properly

inadequate volume
hemolysis
wrong tube
SPECIMEN HANDLING
SPECIMEN HANDLING
 REJECT Specimen
SPECIMEN HANDLING

outdated tube
improper
handling/mixing
contaminated specimen
insufficient specimen or
"quality not sufficient" QNS
 REJECT Specimen
SPECIMEN HANDLING

incorrect collection time

exposure to light
did not follow testing time
limits
delay or error in
processing
TIME CONSTRAINTS AND
EXCEPTIONS
for delivery and processing of specimens
DELIVERY TIME LIMITS
 transported to the
laboratory IMMEDIATELY
after collection
within 45 minutes
Centrifugation - 1 hour

Hematology specimen EDTA

lavender or purple stopper
should not be centrifuged
TIME LIMIT EXCEPTIONS

"STAT" or
"emergency”
priority in terms of
transportation, processing
and testing
TIME LIMIT EXCEPTIONS
BLOOD SMEAR
from EDTA specimen

1 hour from the TOC

TIME LIMIT EXCEPTIONS
COMPLETE BLOOD COUNT
from EDTA specimen

6 hours from the TOC

STABLE: 24 hours ROOM TEMP
TIME LIMIT EXCEPTIONS
ERYTHROCYTE SEDIMENTATION RATE
from EDTA specimen

4 hours from the TOC

STABLE: 12 hours REF TEMP
TIME LIMIT EXCEPTIONS
RETICULOCYTE COUNT
from EDTA specimen

6 hours from the TOC

STABLE: 72 hours REF TEMP
TIME LIMIT EXCEPTIONS

GLUCOSE TEST
Sodium flouride

24 hours from the TOC

STABLE: 48 hours REF TEMP
2 to 8 degrees Celsius
TIME LIMIT EXCEPTIONS

PROTHROMBIN TIME
Sodium citrate

24 hours from the TOC

TIME LIMIT EXCEPTIONS
PARTIAL THROMBOPLASTIN TIME
Sodium citrate

4 hours from the TOC

 CENTRIFUGE
CENTRIFUGATION

apparatus that separates

cells, plasma or serum of
blood specimen
centrifugal force
STOPPERS
avoid contamination,
evaporation, aerosol
formation, and pH changes
CENTRIFUGATION
CENTRIFUGATION
CENTRIFUGATION CENTRIFUGE
  tubes should be BALANCED
same size and volume of specimen
CENTRIFUGATION

PLASMA SPECIMEN
anticoagulants
centrifuged immediately

SERUM SPECIMEN
completely clotted
30 to 60 minutes at room temp
CENTRIFUGATION
 GAUZE or
CENTRIFUGATION

TISSUE
cover the stopper to
catch drops of blood that
may leak or to catch
aerosol
ALIQUOT PREPARATION

ALIQUOT
portion of a sample specimen
taken for chemical analysis
or testing
MULTIPLE TESTS
ordered on a single specimen
 tubes that are labeled with the
ALIQUOT PREPARATION
same information as the
original specimen tube
disposable transfer pipettes

NOTE:
 do not put specimen with
different anticoagulants in
the same aliquot tube
 cover the tube as soon as it
is filled
OSHA-REQUIRED
protective equipment worn when
processing specimen
PROTECTIVE EQUIPMENT
health worker is exposed to blood
and other potentially infectious
materials
OCCUPATIONAL SAFETY AND
HEALTH ADMINISTRATION OSHA
 gloves
 laboratory gown
 laboratory coats
 masks
PROTECTIVE EQUIPMENT

RA 11058
An Act Strengthening
Compliance with
Occupational
Safety and Health Standards
 Handling & Processing
of Blood Specimens for
laboratory testing

END OF PRESENTATION