ACTIVITY 11: QUESTIONS FOR RESEARCH:

1. What are the different ways in handling a clinical chemistry laboratory? (PILI KA NA LOL KAHIT 10 LANG)

 Know locations of laboratory safety showers, eyewashstations, and fire extinguishers. The safety equipment may
be located in the hallway near the laboratory entrance.
 Know emergency exit routes.
 Avoid skin and eye contact with all chemicals.
 Minimize all chemical exposures.
 Assume that all chemicals of unknown toxicity are highly toxic.
 Post warning signs when unusual hazards, hazardous materials, hazardous equipment, or other special
conditions are present.
 Combine reagents in their appropriate order, such as adding acid to water.
 Avoid adding solids to hot liquids.
 All laboratory personnel should place emphasis on safety and chemical hygiene at all times.
 Never leave containersof chemicals open.
 All containersmust have appropriate labels. Unlabeled chemicals should never be used.
 Do not taste or intentionally sniff chemicals.
 Wash exposed areas of the skin prior to leaving the laboratory.
 No contact lenses should be worn around hazardous chemicals – even when wearing safety glasses.
 Laboratory safety glasses or goggles should be worn in any area where chemicals are used or stored. They
should also be worn any time there is a chance of splashes or particulates to enter the eye. Closed toe shoes will
be worn at all times in the laboratory. Perforated shoes or sandals are not appropriate.
 Determine the potential hazards and appropriate safety precautions before beginning any work.
 Procedures should be developed that minimize the formation and dispersion of aerosols.
 If an unknown chemical is produced in the laboratory, the material should be considered hazardous.
 Do not pour chemicals down drains. Do NOT utilize the sewer for chemical waste disposal.
 Keep all sink traps (including cup sink traps and floor drains) filled with water by running water down the drain
at least monthly.
 Do not utilize fume hoods for evaporations and disposal of volatile solvents.
 Perform work with hazardous chemicals in a properly working fume hood to reduce potential exposures
 Clothing made of synthetic fibers should not be worn while working with flammable liquids or when a fire
hazard is present as these materials tend to melt and stick to exposed skin.
 Laboratory coats should not be stored in offices or break rooms as this spread contaminates to other areas.
 Computers and instrumentation should be labeled to indicate whether gloves should be worn or not.
Inconsistent glove use around keyboards/keypads is a source of potential contamination.

General Laboratory Safety Rules | Environmental Health and Safety | Oklahoma State University. (n.d.). Environmental
Health and Safety. Retrieved December 13, 2022, from https://ehs.okstate.edu/general-laboratory-safety-rules.html

2. What are the different analytes that has a special transporting method in a clinical chemistry laboratory, explain why
and discuss how it is done. (PILI KA NA LATTAN, TSAKA DI KO SURE TOH ANTAGAL KO SINEARCH KALOKA YAN TALAGA
LUMALABAS)

 Plasma: Plasma: Draw a sufficient amount of blood with the indicated anticoagulant to yield the necessary
plasma volume. Gently mix the blood collection tube by inverting 8-10 times immediately after collection. The
majority of samples require separation of plasma from cells within two hours of collection. However, there are
few tests that require separation within 15-30 minutes. Please refer to our laboratory test directory for
additional information. All specimens must be delivered to the laboratory within 4 hours of collection.
 Serum: Draw a sufficient amount of blood to yield the necessary serum volume. Invert tube 5-10 times to
activate clotting. Allow blood to clot at room temperature for 30 minutes. NOTE: Avoid hemolysis.
 Whole Blood: Draw a sufficient amount of blood with the indicated anticoagulant. Gently mix the blood
collection tube by inverting 8-10 times immediately after collection. NOTE: Tubes intended for whole blood
analyses are not to be centrifuged and separated.
 All patient specimens must be place in biohazard bags for transport to the laboratory.
 Gold-top serum separator tube (SST)
This tube contains a clot activator and serum gel separator – used for various chemistry, serology, and
immunology tests. If the specimen requirement for a test is red-top tube(s), do not use gold-top/SST tube(s).
NOTE: Invert the tube to activate the clotting; let stand for 20-30 minutes before centrifuging for 10 minutes. If
frozen serum is required, pour off serum into plastic vial and freeze. Do not freeze Vacutainer® tubes.
 Red-top tube, plastic
This tube is a plastic Vacutainer containing a clot activator but no anticoagulants, preservatives, or separator
material. It is used for collection of serum for selected laboratory tests as indicated. If the specimen
requirement for a test is red-top tube(s), do not use gold-top/SST® tube(s), as the gel separator may interfere
with analysis.
 Red-top tube, glass
This tube is a plain glass Vacutainer® containing no clot activators, anticoagulants, preservatives or separator
material. These tubes can be used for Blood Bank tests.
 Pink-top tube (EDTA)
This tube contains EDTA as an anticoagulant. These tubes are preferred for blood bank tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Light green-top tube (lithium heparin)
This tube contains lithium heparin and gel separator used for the collection of heparinized plasma for routine
chemistry tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Dark green-top tube (sodium heparin)
This tube contains sodium heparin used for the collection of heparinized plasma or whole blood for special tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Grey-top tube (potassium oxalate/sodium fluoride)
This tube contains potassium oxalate as an anticoagulant and sodium fluoride as a preservative – used to
preserve glucose in whole blood and for some special chemistry tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Lavender-top tube (EDTA)
This tube contains EDTA as an anticoagulant - used for most hematological procedures. These tubes are
preferred for molecular tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.To avoid RBC shrinkage due to excess EDTA (with resulting changes in
HCT and RBC indices values) and possible dilutional effect, the tubes should be filled with the proper amount of
blood for the size of tube used. Tubes with various draw volumes are available (2.0 mL, 3.0 mL, 5.0 mL and 0.75
mL microvettes); to assure proper ratio of EDTA to blood, it is recommended that the tubes contain no less than
one-half of the stated volume.
 Royal blue-top tube
 There are two types of royal blue-top Monoject® tubes – one with the anticoagulant EDTA and the other plain.
These are used in the collection of whole blood or serum for trace element analysis. Refer to the individual
metals in the individual test listing to determine the tube type necessary.
 Yellow-top tube (ACD)
This tube contains ACD, which is used for the collection of whole blood for special tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Pearl white-top tube plasma preparation tube (PPT)
This tube contains EDTA and a special polyester material - used for the collection of plasma for molecular (PCR)
tests.
NOTE: After the tube has been filled with blood, immediately invert the tube 8-10 times to mix and ensure
adequate anticoagulation of the specimen.
 Special Collection Tubes: Some tests require specific tubes for proper analysis. Please contact the laboratory
prior to patient draw to obtain the correct tubes for metal analysis or other tests as identified in the individual
test listing.
Specimen Requirements/Containers | Department of Pathology | School of Medicine | University of California,
Irvine. (n.d.). University of California, Irvine. Retrieved December 13, 2022, from
https://www.pathology.uci.edu/services/specimen-containers.asp

3. What are the advantage and disadvantages in transporting a specimen from a laboratory to another?

a. ADVANTAGE:
 Efficiency: POCT uses efficient work flow process, as the testing is performed at the bedside or in close proximity
to the location of patient care. The testing is performed within the clinical management setting. Determination
of need for testing is made at the bedside with the testing being implemented within a short time frame.
 Speed of diagnosis and treatment: Rapid test results with the potential to expedite medical decision-making.
The POCT is conducted and medical care can be promptly implemented. In addition to rapid implementation of
treatment, the process is more efficient for the physician, as there is not a need to refamiliarize with the case
after test results are returned from a central laboratory.
 Expanded testing capabilities: Provision of laboratory testing in a wide variety of sites both within and outside of
the health care facility. Possible non-traditional testing locations or circumstances include, but are not limited to,
underserved populations, rural areas, and locations with limited infrastructure or personnel (eg, disaster,
accident, or military sites).
 Specimen stability and ease of handling: Unprocessed samples, such as whole blood, that do not require
centrifugation or processing.
 Lean process: Leaner because fewer steps are necessary to produce the result, including the elimination of
processing and aliquoting, the need to transport the specimen to the core laboratory, and communicating
results back to the clinical staff.
 Portable devices:
- Diminished space requirements for operation and storage.
- Wide menu of analytes.
- Allows testing to be performed in a variety of locations.
- Flexibility to meet the diversity of medical needs.
 Improved patient outcomes: The immediately availability of test results can be linked to patient management to
facilitate movement of individual patients through the system faster or to allow for handling of more patients in
a diminished time frame.

b. DISADVANTAGE:
  Slow and if emergency samples are carried by hand the time spent with sample transportation is time lost to
perform other tasks.
 The tendency to gather samples at the wards in order to send them in batches to the laboratory. This perhaps
saves transportation labor, but the first sample collected may have been waiting for hours at the ward before it
is transported to the laboratory.
 If samples are received batch-wise, it is not possible to maintain a “first-in-first-out” (FIFO) process, as the
laboratory does not know in which order the samples were collected.

Advantages of POCT. (n.d.). LabCE. Retrieved December 13, 2022, from

https://www.labce.com/spg1033982_advantages_of_poct.aspx

4. Who are the authorize personnel to transport a specimen?

 The authorized individuals are: lab personnel designated in their zone/program, clinical chemist whose
responsible for the proceeding process of the specimen and the laboratory worker who designed to do the work
in different aspect in the laboratory.

Transportation of Lab Specimens. (n.d.). Alberta Health Services. Retrieved December 13, 2022, from
https://www.albertahealthservices.ca/assets/wf/lab/wf-lab-transporting-lab-specimens.pdf

5. What are the precautionary measures in handling & transporting a clinical chemistry specimen?

Specimen handling during transport: Clinical Specimens and Infectious Substances

a. Use a transport container/box for routine transport of clinical specimens. Ice packs should be included in the
transport box. The transport box should be robust enough for its capacity and intended use, and be made of material
that can be cleansed and disinfected.
b. The lid/cover of the transport box should be closed properly and securely during transport.
c. Transport boxes must be handled gently with care during the whole transport process. Throwing, dropping or
dragging the transport boxes on the floor is prohibited.

Safety Guidelines on Transport of Clinical Specimens and Infectious Substances for Courier Team. (n.d.). Centre for
Health Protection. Retrieved December 13, 2022, from
https://www.chp.gov.hk/files/pdf/safety_guidelines_for_courier_team_2009nov.pdf

6. What are the different Biosafety procedures and Protocols in handling and transporting samples?
 Biosafety Level-1 represents a basic level of containment that relies on standard microbiological practices with
no special primary or secondary barriers recommended, other than a sink for hand washing. BSL-1 practices,
safety equipment, and facility design and construction are appropriate for most undergraduate and secondary
educational training and teaching laboratories, and for other laboratories in which work is done with defined
and well-characterized strains of viable microorganisms not known to consistently cause disease in healthy adult
humans or negatively impact the environment.
 Biosafety Level-2 containment and safety practices are suitable for work with a broad spectrum of indigenous
moderate-risk agents that typically cause mild-to-moderate human disease. Additionally, BSL-2 is usually the
default biosafety level when working with diagnostic specimens from humans and/or animals.
BIOSAFETY PRACTICES AND PROCEDURES | Biosafety Program. (n.d.). Biosafety Program. Retrieved December 13,
2022, from https://biosafety.utk.edu/biosafety-program/the-biosafety-program/biosafety-manual/3-biosafety-
practices-and-procedures/