OTHER NON-BLOOD SPECIMENS

• Buccal Swabs

  • a less invasive, painless alternative to blood collection for obtaining cells for DNA analysis.
• Buccal Swabs

  • The phlebotomist collects the sample by gently massaging the mouth on the inside of the cheek with a special swab.
  • DNA is later extracted from cells on the swab.
  • Often, these samples are collected for legal purposes such as paternity testing; therefore, follow strict COC protocol.
• Saliva

  • fluid secreted by glands in the mouth
• Saliva

  • used to monitor hormone levels and detect alcohol and drug abuse (recent drug use)
  • Saliva specimens for hormone tests, however, are typically frozen to ensure stability and sent to a laboratory for testing
• Hair

  • collected for trace and heavy metal analysis and the detection of drugs of abuse
• Hair

  • Use of hair samples for drug testing is advantageous because hair is easy to obtain and cannot easily be altered or tampered with.
  • Hair shows evidence of chronic drug use rather than recent use.
• Breath

  • • collected and analyzed for hydrogen content in one type of lactose tolerance test and to detect the presence of Helicobacter pylori (H. pylori)
• BREATH ( C-Urea Breath Test (C-UBT))

  • This test is based on the fact that H. pylori produces urease, an enzyme that breaks down urea but is not normally present in the stomach.
• C-Urea Breath Test (Procedure)

  • A baseline breath sample is collected, after which the patient drinks a special substance that contains synthetic urea. (contains a form of carbon called carbon-13)
  • If H. pylori organisms are present, the urease they produce will break down the synthetic urea and in the process release carbon dioxide (CO2) that contain carbon-13.
• C-Urea Breath Test (Procedure)

  • The CO2 will be absorbed into the bloodstream and exhaled in the patient’s breath.
  • The patient breathes into a special Mylar balloon or other collection device at specified intervals.
  • The breath specimens are analyzed for carbon-13 content. If carbon-13 is found in amounts higher than those in the baseline sample, H. pylori is present in the stomach.
• Hydrogen Breath Test

  • helps identify problems with the digestion of carbohydrates such as lactose (milk sugar) and fructose (fruit sugar) and is thought to be the most accurate lactose tolerance test.
• Hydrogen Breath Test

  • can also be used to detect bacterial overgrowth in the small intestine
• Hydrogen Breath Test (Preparation)

  • must not have taken antibiotics for at least 2 weeks before the test
  • must avoid certain foods for 24 hours prior to the test.
  • must be fasting on the day of the test
  • asked to refrain from vigorous exercise and smoking for 30 minutes prior to and during the test
• Hydrogen Breath Test

  • On the day of the test, a baseline breath sample is taken by having the patient exhale into a special bag or device.
  • Then the patient is given a drink that, depending on the type of test, contains a measured amount of lactose, fructose, or lactulose.
  • Additional breath samples are collected at regular intervals, typically, every 30 minutes for up to 3 hours, depending on the amount of hydrogen detected in the samples.
• Hydrogen Breath Test

  • For those given lactose or fructose, increased hydrogen levels in the breath samples respectively indicate increased lactose or fructose in the intestinal tract, most likely as a result of metabolism.
  • For those given lactulose, if bacterial overgrowth is present, increased hydrogen levels appear twice; the first time when the lactulose reaches bacteria in the small intestine and the second time when it reaches bacteria in the colon.
• Tissue Samples

  • From biopsies may also be sent to the laboratory for processing.
  • Most tissue specimens arrive at the laboratory in formalin or another suitable solution and need only be accessioned and sent to the proper department
• Tissue Samples

  • It is important for the phlebotomist to check the procedure manual to determine the proper handling for any unfamiliar specimen. (For example, tissues for genetic analysis should not be put in formalin.)
  • Improper handling can ruin a specimen from a procedure that is, in all probability, expensive, uncomfortable for the patient, and not easily repeated.