HANDLING AND PROCESSING OF NON-BLOOD SPECIMENS

• Non-blood specimens - liquid or semiliquid substances produced by the body, found within various organs and body spaces
• bladder, peritoneal cavity, pleural cavity, joints - These are Non-blood specimens
• physician - They are collected by a ____ for specimens like amniotic fluid, synovial fluid, and serous fluid.
• phlebotomist - Other specimens are collected by the patient while the ____ gives the instructions
• Nasopharyngeal - are swabs are collected by the phlebotomist
• Specimen collection - throat swab collection (role of phlebotomist)
• Gives instruction - Urine collection Stool/feces collection (role of phlebotomist)
• Labeling or transporting the specimens to the laboratory - verify proper labeling before accepting a specimen for transport, They label the specimens collected by the physician (role of phlebotomist)
• Processing - accessioning and preparing the specimen for testing (role of phlebotomist)
• parts of labelling: Name, date and time of collection, type and/or source of the specimen
• Non-blood specimens

  • Urine
  • CSF
  • Amniotic fluid
  • Synovial fluid
  • Serous fluids
  • Sputum
  • Oropharyngeal swab and nasopharyngeal swab
  • Semen
  • Saliva
  • Bone marrow aspirate
  • Breath samples
  • Tissue specimens
  • Feces/stool
• Non-blood specimens


  • Liquid or semiliquid substances produced by the body
  • Found within various organs and body spaces (bladder, peritoneal cavity, pleural cavity, joints, etc.)
• Phlebotomist


  Collects throat swabs, gives instructions for urine and stool collection, labels and transports specimens, processes specimens for testing
• Most non-blood specimens are not collected by a phlebotomist. They are collected by a physician or the patient.
• Nasopharyngeal swabs are collected by the phlebotomist.
• Labeling


  Name, date and time of collection, type and/or source of the specimen, label pasted on the body of the container, not the lid
• All body substances are potentially infectious, so standard precautions must be observed (wear PPE).
• Urine


  Most frequently analyzed non-blood body fluid, readily available, easy to collect, and inexpensive to test
• Accurate urine test results depend on

  • Collection method
  • Container used
  • Specimen transportation and handling (transported with ice, cold temperature)
  • Timeliness of testing (should be examined immediately, up to two hours from collection, or preserved if not examined within two hours)
• Routine Urinalysis (UA)


  Most commonly requested urine test, screens for urinary and systemic disorders, part of a physical examination
• Components of Routine Urinalysis

  • Physical/Macroscopic Observation
  • Chemical Analysis
  • Microscopic Analysis
• Physical/Macroscopic Observation


  Examine urine using the eyes (color, clarity, specific gravity, odor, volume, osmolality)
• Chemical Analysis


  Use chemical or reagent strips to determine the presence of substances in the urine (bacteria, bilirubin, blood glucose, ketones, leukocytes, nitrite, protein, urobilinogen)
• Microscopic Analysis


  Examine cells, crystals, and microorganisms in the urine sediment under a microscope
• Pyuria (WBCs in urine) and hematuria (RBCs in urine) can indicate a urinary tract infection (UTI).
• Urine Collection


  Use a clear, dry, chemically clean container with tight-fitting lid, transport promptly to the lab, refrigerate if not examined immediately
• Urine Culture and Sensitivity


  Confirms urinary tract infection (UTI), measures urine on a special nutrient medium, incubates for 18-24 hours, checks for bacterial growth, significant if bacterial count > 100,000 cfu/ml
• Urine Sensitivity/Antibiotic Susceptibility Test


  Determines which antibiotics will be effective against an identified microorganism
• Urine Cytology Studies


  Detects cancer, cytomegalovirus, and other viral/inflammatory diseases of the urinary tract, uses Papanicolaou (PAP) stain to examine cells
• Urine Drug Screening


  Detects illegal use of recreational drugs, anabolic steroids, or unwarranted prescription drugs, monitors therapeutic drug use, confirms drug overdose diagnosis
• Urine sample collection for drug testing


  • Ensures specimens are not adulterated, substituted, or diluted, uses waterless urinal and separate sink, checks temperature and specific gravity/creatinine to ensure freshness
• Urine Glucose and Ketone


  Glucose in urine indicates diabetes mellitus or renal disease, ketones in urine indicate diabetic ketoacidosis
• Urine Pregnancy Testing


  Detects human chorionic gonadotropin (HCG) hormone, first morning specimen is preferred, HCG can also appear in urine of cancer patients
• Types of Urine Specimens

  • Random
  • First Morning/8-Hour
  • Fasting (Fasting second morning)
  • Timed (e.g. 2 hours after meal, 24-hour collection)
  • Tolerance Test Specimen
• Negative


  Line is only in control area
• Invalid

  No line in control area
• Types of urine specimens

  • Random Urine Specimen
  • First Morning/8-Hour specimen
  • Fasting (Fasting second morning)
  • Timed
• Random Urine Specimen


  Collected at any time, commonly analyzed urine
• First Morning/8-Hour specimenFirst voided specimen/overnight specimen, collected in the morning after 8 hours of sleep, most concentrated sample, higher specific gravity, first urine in the morning
• Fasting (Fasting second morning)


  Second specimen voided after fasting, ideal for glucose monitoring, do not collect the first urine in the morning because it still has remnants of food from last meal