Lecture 1. Introduction

CHAPTER-1
COLLECTION, HANDLING AND

SHIPMENT OF LABORATORY
SPECIMENS
OBJECTIVE
After completion of this chapter, the student will be able to:
 Define different types of specimen
 Identify different types of specimen
 Familiarize how to collect different types of specimen
 Know specimen rejection criteria
 Label and transport different types of specimen

OUTLINE
3.1. Definition
3.2. Basic Concept in Specimen Collection
3.3. General Rejection Criteria

3.1: DEFINITION
 Definition of specimen
o Specimen is a part taken to determine the character of the whole.
 Safety during collection, processing & transportation
o Masks (e.g. sputum)
o Gloves
o Protective eye ware (goggles)
o Protective clothing (gown)

SPECIMEN COLLECTION…..
 Several different kinds of specimens are used routinely in the clinical laboratory.
 These are:
 Blood
 Urine
 Stool
 Sputum
 Pus (discharge)
 Throat, eye, ear, vaginal swabs
 Skin snips
 Body fluids (pleural, pericardial, peritoneal, synovial, and cerebro spinal)
 Hair, nail, coetaneous tissue
 Biopsy tissue from an organ.

SPECIMEN COLLECTION……
o Correct treatment depend on accurate result
o Accurate result depend on quality specimen
o Quality specimen depend on proper :
 Collection
 Transportation
 Processing of specimens
SPECIMEN COLLECTION……
o Purpose of quality specimen:
 provide high yield positive result
Provide that a negative result indicates the absence of the pathogen.

IMPORTANCE OF QUALITY
SPECIMEN ON PATIENT CARE
o Key to accurate laboratory diagnosis.
o Directly affects patient care & patient outcome.
o Influences therapeutic decisions.
o Impacts hospital infection control.
o Impacts patient length of stay, hospital costs, and laboratory costs.
o Influences laboratory efficiency.

3.2 BASIC CONCEPT IN
SPECIMEN COLLECTION
1. Site selection
a. Clinician
• Should locate right anatomic site & select appropriate tests & specimens based on:
• - Physical examination (sign & symptoms)
 - Radiological examination
b. Laboratory personnel
• Should collect specimens from actual infection site with little external contamination by using :
Aseptic technique
• To prevent contamination of specimen &
• To protect the patient from infection
Sterile container
• . Should collect specimens from right site
BASIC CONCEPT IN SPECIMEN
COLLECTION…..
 Sites of Infection where the Specimen is Likely to Become Contaminated
During Collection
o Lower respiratory tract ----- Oro-pharynx
o Bladder ……………..… Urethra
o Cervix …………. Vagina

COLLECTION…..
 Approaches to Avoid contamination :
o Careful patient education
 There are occasions when patients participate actively in specimen collection
(e.g. sputum, urine).

 Therefore, they must be given full instructions & cooperation by the care giver.
o Educating the clinicians
 How to collect & transport specimens through written document & make
available at every patient care unit.
COLLECTION…..
2. Volume of specimens
 Collecting & processing too little specimen will give us lower sensitivity.
 Collecting adequate volume:
o enhance recovery of the pathogen.
o enable to perform all procedures required or to permit complete
examination.
 For example;
o Sputum: 5 -10 ml for mycobacterium examination.
o Blood:
 Serology: minimum 2 - 3 ml.
 Culture: 10 – 20 ml (adult) & 1-5ml (infant).
o CSF: 5 – 10 ml.
3. Time of collection
 Provide best chance of recovery of the causative agent .
Sputum & urine
 early in the morning soon after the patient awaken.
Blood
 when the patients temperature begins to rise.
4. Collect specimens before the administration of antimicrobial

 Because antimicrobials limits recovery of pathogens.
5. Age of specimens
o Age of the specimen directly influences the recovery of protozoan organism.
6. Stage of the disease at which the specimen is collected

o Enteric pathogens are present in great numbers during the acute or diarrheal stage of intestinal infection.
7. Labeling
 Make sure that you are collecting/drawing the right person first.
 Then label with:
o Patient name
o Unique identification number
o Patient demographic information
o Specimen collection date
o Specimen collection location
o Diagnostic test results
 During Labeling:
o Make sure that container label & the requisition match.
o Label should be on the container not on the lid, since the lid can be mistakenly placed on a
different container.
o Ensure the labels on the containers are adherent under refrigerated conditions.
SPECIMEN TRANSPORTATION
Required when:
o Specimens are to be sent to referral laboratory.
o For teaching purpose.
o For Quality assurance.
o Unavailability of trained personnel around the collection site.

o Specimens are collected in the field.
o Lack of time to examine within the recommended time due to laboratory workload.
SPECIMEN
TRANSPORTATION......
 This transportation is made by using different
preservation methods
 Physical
 chemical.
- chemical method of preservation is most common.

SPECIMEN
Purpose of preservation :
o Maintain protozoan morphology
o Prevent development of helminthes eggs & larvae
o Maintain viability of microorganisms
o Prevent overgrowth of normal flora
o Prevent instability of solutes & degeneration of sediments (e.g. urine)

SPECIMEN
Specimen packaging
o Screw container tops on firmly
o Wrap in absorbent wadding to absorb any fluid leakage
o Place in a self-sealing plastic bag
o Place the request form into the secondary pocket of the specimen bag.
o Hazard labels with internationally accepted biohazard label (HIGH RISK).
o Pack specimens in strong cardboard box or a grooved polystyrene box.
o Seal with self-adhesive tape.

SPECIMEN
Specimen Storage (Prior to Dispatch)
o Urine can be stored at either freezer or refrigerator at +4 oc.
o Blood samples should be kept at +4 oc.
o Serum & plasma can be stored either frozen or at +4 oc.
Note: If they are frozen, they should not be unfrozen until dispatch to the laboratory.
SPECIMEN
Transport
o Urgent requests within normal laboratory hours.
o Transport with labelled, tightly fitted, leak proof container.
o Wet ice or ice pack should be used.

3.3 GENERAL REJECTION
CRITERIA
1. Un-labelled Specimens
o Common specimen like blood, urine, swabs, sputum, stool, can be easily recollected.
o less common specimens like CSF, fluids, tissues, etc. are more difficult to recollect.
o Call the person who collected it for the identification of the specimen.
o If he is unable to identify the specimen, the ordering physician will be notified.
2. Incorrectly labeled (mislabeled) specimens

o Use same criteria as for Un-labelled Specimens.
GENERAL REJECTION
CRITERIA……
3. Incorrect container or Preservative
o Specimens received in an incorrect container, or without appropriate preservative, will
require recollection.
o So the patient will be contacted to arrange for recollection of the specimen.
4. Insufficient specimen for procedure

o If insufficient, recollect (urine, stool, sputum, blood, etc.)
o If the specimen is not re-collectable (CSF, fluids, etc.), the physician will be contacted to
establish a priority order of tests.

GENERAL REJECTION
CRITERIA……
5. Unsuitable Specimen for Procedures
 Specimens which are unsuitable for the procedure requested saliva for sputum test or specimen too
long for a valid result.

Lecture 1. Introduction

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CHAPTER-1

COLLECTION, HANDLING AND

 Identify different types of specimen

 Familiarize how to collect different types of specimen

 Know specimen rejection criteria

 Label and transport different types of specimen

3.2. Basic Concept in Specimen Collection

3.3. General Rejection Criteria

 Safety during collection, processing & transportation

o Masks (e.g. sputum)

o Protective eye ware (goggles)

o Protective clothing (gown)

 Throat, eye, ear, vaginal swabs

 Body fluids (pleural, pericardial, peritoneal, synovial, and cerebro spinal)

 Hair, nail, coetaneous tissue

 Biopsy tissue from an organ.

o Correct treatment depend on accurate result

o Accurate result depend on quality specimen

o Quality specimen depend on proper :

 provide high yield positive result

Provide that a negative result indicates the absence of the pathogen.

o Directly affects patient care & patient outcome.

o Influences therapeutic decisions.

o Impacts hospital infection control.

o Impacts patient length of stay, hospital costs, and laboratory costs.

o Influences laboratory efficiency.

o Bladder ……………..… Urethra

o Cervix …………. Vagina

 There are occasions when patients participate actively in specimen collection

(e.g. sputum, urine).

 Collecting adequate volume:

o enhance recovery of the pathogen.

o enable to perform all procedures required or to permit complete

o Sputum: 5 -10 ml for mycobacterium examination.

 Serology: minimum 2 - 3 ml.

 Culture: 10 – 20 ml (adult) & 1-5ml (infant).

Sputum & urine

 early in the morning soon after the patient awaken.

4. Collect specimens before the administration of antimicrobial

6. Stage of the disease at which the specimen is collected

o For teaching purpose.

o For Quality assurance.

o Unavailability of trained personnel around the collection site.

- chemical method of preservation is most common.

o Prevent development of helminthes eggs & larvae

o Maintain viability of microorganisms

o Prevent overgrowth of normal flora

o Prevent instability of solutes & degeneration of sediments (e.g. urine)

o Wrap in absorbent wadding to absorb any fluid leakage

o Place in a self-sealing plastic bag

o Hazard labels with internationally accepted biohazard label (HIGH RISK).

o Pack specimens in strong cardboard box or a grooved polystyrene box.

o Seal with self-adhesive tape.

o Blood samples should be kept at +4 oc.

o Serum & plasma can be stored either frozen or at +4 oc.

o Transport with labelled, tightly fitted, leak proof container.

o Wet ice or ice pack should be used.

o If he is unable to identify the specimen, the ordering physician will be notified.

2. Incorrectly labeled (mislabeled) specimens

4. Insufficient specimen for procedure

establish a priority order of tests.

long for a valid result.

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