PRELIMS

• What must laboratory personnel learn to work safely in the laboratory environment?

  Laboratory personnel must learn about hazards, basic safety precautions, and common sense rules for safety.
• What are biologic hazards?

  Biologic hazards are biological substances that pose a threat to the health of living organisms.
• According to the CDC, how should human blood and body fluids be treated?

  They should be treated as potentially infectious for HIV, HBV, and other bloodborne microorganisms.
• Why is understanding the chain of infection essential?

  It is essential for preventing infection.
• What are the components of the chain of infection?

  • Infectious Agents: organisms capable of causing infection (e.g., bacteria, viruses).
  • Reservoir: where microorganisms live (e.g., humans, animals).
  • Portal of Exit: path by which a pathogen leaves its host (e.g., mouth, nose).
  • Mode of Transmission: how an infectious agent is transferred (e.g., direct contact, airborne).
  • Portal of Entry: manner in which a pathogen enters a susceptible host (e.g., mouth, nose).
  • Susceptible Host: organism affected by the infectious disease (e.g., patients, elderly).
• What are major safety practices in the laboratory?

  • Proper hand hygiene
  • Correct disposal of contaminated materials
  • Wearing personal protective equipment (PPE)
• What are the steps for proper handwashing in the laboratory?

  1. Stand in front of the sink without leaning on it.
  2. Use a paper towel to turn on the water.
  3. Wet hands thoroughly.
  4. Apply soap and wash hands with friction.
  5. Interlace fingers and rub for ten seconds.
  6. Rub nails against the palm.
  7. Rinse hands thoroughly.
  8. Dry hands well.
  9. Use a paper towel to turn off the water.
• What is the correct procedure for removing soiled gloves?

  1. Pinch the outside of the glove near the wrist.
  2. Peel downwards, turning the glove inside-out.
  3. Hold the inside-out glove with the gloved hand.
  4. Use the ungloved hand to slide under the wrist of the remaining glove.
  5. Peel downwards, turning the glove inside-out.
  6. Pull the glove down over the inside-out glove being held.
• What are the components of Standard Precautions in the laboratory?

  • Hand hygiene (washing and antiseptics)
  • Personal protective equipment (PPE)
  • Patient care equipment
  • Environmental control
  • Preventing injuries with sharp instruments
  • Respiratory hygiene/cough etiquette
• What are Engineering Controls in laboratory safety?

  • Providing sharps disposal containers
  • Requiring safety devices on needles
  • Labeling biohazardous materials
• What are Work Practice Controls in laboratory safety?

  • Practicing Standard Precautions
  • Prohibiting eating, drinking, and smoking in work areas
  • Establishing daily disinfection protocols
• What is included in Personal Protective Equipment (PPE) for laboratory personnel?

  • Laboratory coats
  • Gowns
  • Face shields
  • Gloves
  • Laundry facilities for non-disposable clothing
• What medical provisions are provided for laboratory employees?

  • Free immunization for hepatitis B virus
  • Medical follow-up for accidental exposure to bloodborne pathogens
• What documentation is required in laboratory safety standards?

  • Annual training documentation
  • Evaluations of safer needle devices
  • Employee involvement in device selection
  • Maintaining a sharps injury log
• How should biologic waste be disposed of in the laboratory?

  • Place in containers labeled with the biohazard symbol (yellow bag)
  • Discard urine in the sink with running water
  • Disinfect the sink daily with sodium hypochlorite
• What should be done with sharp objects in the laboratory?

  Sharp objects must be disposed of in puncture-resistant, leak-proof containers with the biohazard symbol.
• What is the best first aid for skin contact with hazardous chemicals?

  Flush the area with large amounts of water for at least 15 minutes, then seek medical attention.
• What does the NFPA 704 symbol indicate?

  It indicates the fire hazards of materials, including health, flammability, reactivity, and personal protection.
• What information is contained in a Material Safety Data Sheet (MSDS)?

  • Physical and chemical characteristics
  • Fire and explosion potential
  • Reactivity potential
  • Health hazards and first aid procedures
  • Safe handling and disposal methods
  • Primary routes of entry
  • Exposure limits and carcinogenic potential
• What is the purpose of a Chemical Hygiene Plan?

  • Detail appropriate work practices
  • Outline standard operating procedures
  • Specify personal protective equipment
• What should personnel do when exposed to radioactive hazards?

  Personnel who are pregnant or think they may be should avoid areas with radioactive symbols.
• What should laboratory personnel avoid when operating electrical equipment?

  They should avoid operating equipment with wet hands.
• What actions should be taken in case of an electrical shock accident?

  • Remove the electrical source immediately without touching the person.
  • Turn off the circuit breaker or unplug the equipment.
  • Use a nonconductive object to move the equipment if necessary.
• What does the acronym RACE stand for in fire safety?

  • Rescue: rescue anyone in immediate danger
  • Alarm: activate the fire alarm system
  • Contain: close all doors to affected areas
  • Extinguish/Evacuate: extinguish the fire if possible or evacuate
• What are the Clinical Laboratory Improvement Amendments (CLIA)?

  CLIA provides requirements for employees working inside the laboratory.
• What does the Clinical and Laboratory Standards Institute (CLSI) do?

  CLSI creates standards and guidelines for sample collection and laboratory testing.
• What must be done immediately when a electrical source is discovered?

  The electrical source must be removed immediately.
• Why should one avoid touching the person or equipment involved with an electrical source?

  To avoid transferring the current.
• What are safe procedures to follow when dealing with an electrical source?

  Turning off the circuit breaker, unplugging the equipment, or moving the equipment using a nonconductive glass or wood object.
• What does the acronym RACE stand for in fire safety procedures?

  • Rescue: rescue anyone in immediate danger
  • Alarm: activate the institutional fire alarm system
  • Contain: close all doors to potentially affected areas
  • Extinguish/Evacuate: attempt to extinguish the fire, if possible or evacuate, closing the door
• What does CLIA stand for and what does it provide?

  Clinical Laboratory Improvement Amendments; it provides requirements for the employees working inside the laboratory.
• What does CLSI stand for and what is its role?

  Clinical and Laboratory Standards Institute; it creates standards and guidelines for sample collection and laboratory testing.
• What is the principle behind the phagocytosis demonstration using whole blood and bacterial culture?

  A drop of whole blood is mixed with a drop of a bacterial culture and incubated at room temperature to demonstrate engulfment of bacteria by leukocytes.
• What are common bacterial cultures used in the phagocytosis demonstration?

  Bacillus subtilis and Staphylococcus epidermidis.
• What is the purpose of preparing a blood smear and staining it with Wright's stain?

  To observe the engulfment of bacteria by leukocytes under the microscope.
• What are the steps in the pre-analytical phase of specimen collection?

  • Disinfect the working area
  • Use Personal Protective Equipment
  • No special preparation needed for the patient
  • Minimum of 2ml Heparinized blood (green top evacuated tube)
• What materials are needed in the analytical phase for the phagocytosis experiment?

  • Broth culture of Bacillus subtilis or Staphylococcus epidermidis
  • Microscope slides
  • Pasteur pipettes
  • Rubber bulb
  • Test tubes
  • Wright’s stain
• What is the procedure for the analytical phase of the phagocytosis experiment?

  1. Label three test tubes: Patient test tube (0min, 15min, and 30min) and Control test tube
  2. Add 4 to 8 drops of buffer coat to the tubes
  3. Add 2 to 3 drops of bacterial broth culture to each tube
  4. Incubate at room temperature for 15 and 30 minutes
  5. Prepare a smear from the incubated specimen
  6. Stain with Wright’s stain
• What are the steps in the Wright's stain procedure?

  1. Cover smear with Wright’s stain for at least 5 minutes
  2. Add distilled water or buffer until it overflows
  3. Gently blow to mix stain and buffer
  4. Allow buffer to remain for at least 5 minutes
  5. Wash off stain and buffer with distilled water
  6. Air dry or blot the slide
  7. Examine microscopically with immersion oil (100x)
• What indicates a positive result in the phagocytosis experiment?

  Demonstration of the engulfment of bacteria.