lesson 8 -special collections and point of care testing

• special collection procedures - are non-routine laboratory tests that may not only involve additional preparation and procedure but may require other specimens such as urine or feces
• list of special collection procedure:

  1. BLOOD BANK: BLOOD TYPE AND SCREEN
  2. BLOOD BANK: CROSS-MATCH TEST
  3. BLOOD CULTURE
  4. COAGULATION TEST
  5. 2-HOUR POSTPRANDIAL GLUCOSE
  6. GLUCOSE TOLERANCE TEST (GTT) AND ORAL GLUCOSE TOLERANCE TEST (OGTT)
  7. LACTOSE TOLERANCE TEST
  8. PATERNITY/PARENTAGE TESTING
  9. THERAPEUTIC DRUG MONITORING
  10. THERAPEUTIC PHLEBOTOMY
  11. TOXICOLOGY TEST
  12. TRACE ELEMENTS
• blood bank: blood type and screen - determines the blood type and rh factor
• blood bank: cross-match test - checks the compatibility between the donor's and recipient's blood
• blood culture - determines the presence of infection , identifies types of organism involved and measures the extent of infection
• coagulation test - evaluates the blood clotting function
• 2-hour postprandial glucose - screens for diabetes and other metabolic disorders
• GLUCOSE TOLERANCE TEST (GTT) AND ORAL GLUCOSE TOLERANCE TEST (OGTT) - diagnoses problems in carbohydrate metabolism and checks the ability to metabolize glucose through the tolerance level
• lactose tolerance test - determines lack of mucosal lactase which is responsible for conversion of lactose into glucose
• paternity/parentage testing - verifies the probability that the patient fathered a particular child
• therapeutic drug monitoring - tests the drug level at specific intervals to establish proper drug dosage and avoid toxicity
• therapeutic phlebotomy - treats polycythemia and hemochromatosis
• toxicology test - checks the presence of toxins in the blood, hair, urine, and other substances
• trace elements - checks the presence of aluminum, arsenic, copper, lead, iron and zinc
• blood bank specimen - important in determining which blood product can be safely used for blood transfusion
• blood donor collection - is done mainly for the purpose of blood transfusion
• blood donors should be 17 to 66 years of age with a minimum weight of 110 lbs
• The unit of blood can be separated into rbcs, plasma, and platelets
• blood culture - is a test that checks the blood for pathogens for patients who have a fever of unknown origin (FUO)
• bacteremia - bacteria in blood
• sepeticemia - presence of microorganisms and toxins in the blood
• skin antisepsis - crucial in the blood collection because it prevents the contamination by microbial flora in thw skin
• Antiseptics used:

  • betadine swab sticks
  • chloroprep
  • PVP ampule
  • Frepp/Sepp II
  • benzalkonium chloride
• Tests in Coagulation Specimens:

  • prothrombin time (PT)
  • activated partial thromboplastin time (aPTT)
  • thrombin time (TT)
• polycythemia - overproduction of red blood cells
• hematocrit test - used tp check RBC level
• hemochromatosis - excess iron deposits in the tissues which could be due to problems with iron metabolism caused by multiple blood transfusions or excessive intake of iron
• forensic specimens/toxicology specimens - are ordered by the law-enforcement agencies for legal or forensic purposes
• Point-of-care Testing (POCT) - any analytical test that is done outside the centralized laboratory and near the site where the patient receives treatment
• bleeding time test - is a non-instrumented test ordered by the physician to evaluate the capillaries for platelet plug formation, which is indicative of disorder in the platelet function or problems in capillary integrity
• arterial blood gases test - measures the level of oxygen, carbon dioxide, and acid base (ph) in the blood , which gives the physician an idea about the status of the function of the patient's lungs, heart, and kidneys .
• pH - refers to the concentration of hydrogen ions in a solution
• arterial pH test - checks the balance of the acid-base level which shows the metabolic and respiratory status of the patient
• PCO2 - an indicator of how well air is exchanged between the blood and lungs
• hypoventilation - happens when the PCO2 level increases to an abnormal level
• hyperventilation - occurs when PCO2 level decreases
• PO2 - representative of the pressure exerted by the dissolved 02
• SO2 - is used to evaluate the oxygenation status of the patient . It measures the percentage of the binding sites of the hemoglobin that is occupied by oxygen in the blood.
• A normal person exhibits 98% oxygen saturation.
• sodium - help keep the normal balance of fluids in the body and plays a role in transmitting nerve impulses