PMLS 2 LEC

• Laboratory Safety


  • Safety begins with the recognition of hazards and is achieved through the following:
  • Application of common sense
  • Listen to the instructions
  • A safety-focused attitude
  • Good personal behaviour
  • Good housekeeping in all laboratory work and storage areas
  • Continual practice of good laboratory technique
• Two Primary Causes of Accidents


  • Unsafe activities
  • Unsafe environmental conditions
• Safety Equipment


  • Safety showers & eye wash station
  • Fire extinguisher
  • Fume hood
  • Biosafety cabinets
  • Personal Protective Equipment
• Biological Hazard


  Biological substances that pose a threat to the health of living organisms, primarily that of humans
• Infection control


  Healthcare facilities developed procedures to control and monitor infections occurring within the facilities
• Biological Hazard Components


  • Infectious agents (bacteria, fungi, parasites, viruses)
  • Reservoir (contaminated clinical specimen, infected patient, equipment, soiled objects)
  • Portal of Exit (mucous membranes, blood, body fluids)
  • Means of transmission (direct contact, airborne, droplet, vehicle, vector)
  • Portal of Entry (mucous membranes, breaks in skin, open wounds)
  • Susceptible host (patients, visitors, healthcare personnel)
• Chain of Infection


  Proper hand hygiene, correct disposal of contaminated materials, and wearing personal protective equipment (PPE) are of major importance in the laboratory
• OSHA Blood-Borne Pathogens Exposure Categories

  • Category I - daily exposure to blood and body fluids
  • Category II - regular exposure to blood and body fluids
  • Category III - no exposure to blood and body fluids
• Employers must offer HBV vaccine to all personnel (Category I and II)
• Specimens should be "capped" during centrifugation
• Cleaning up blood, body fluid, or other potentially infectious material spill

  1. Use spill cleanup kit

  2. Use common aqueous detergent

  3. Use 10% bleach with appropriate contact time
• Chemical Hazard


  When skin contact occurs, the best first aid is to flush the area with large amounts of water for at least 15 minutes and then seek medical attention
• Chemicals should never be mixed together unless specific instructions are followed, and they must be added in the order specified
• Chemical Hygiene Plan


  OSHA requires all facilities that use hazardous chemicals to have a written chemical hygiene plan (CHP) available to employees. The purpose of the plan is to detail appropriate work practices, Standard operation procedures, PPE, Engineering controls, Employee training equipment's and Medical consultation guidelines.
• Chemical Classifications


  • Flammable/Combustible (based on flash point)
  • Corrosive (injurious to skin, eyes, respiratory and gastrointestinal tract)
  • Reactive (spontaneously explode, ignite, or evolve heat or flammable/explosive gases)
• Chemical Labelling


  Hazardous chemicals should be labeled with a description of their particular hazard, such as poisonous, corrosive, flammable, explosive, teratogenic, or carcinogenic
• MSDS Contents


  • Physical and chemical characteristics
  • Fire and explosion potential
  • Reactivity potential
  • Health hazards and emergency first aid procedures
  • Methods for safe handling and disposal
  • Primary routes of entry
  • Exposure limits and carcinogenic potential
• Actions to take when a fire is discovered

  1. Rescue

  2. Alarm

  3. Contain

  4. Extinguish/Evacuate
• NFPA 704 Hazardous Material Symbol


  Standard System for providing codes and standard information about the chemicals/solutions
• Radioactive Hazard


  • All areas where radioactive materials are used or stored must be posted with caution signs, and traffic in these areas should be restricted to essential personnel only
  • Exposure to radiation during pregnancy presents a danger to the fetus, and personnel who are or who think they may be pregnant should avoid areas with this symbol
  • The symbol must be displayed on the doors of all areas where radioactive material is present
• Electrical Hazard Precautions


  • Equipment should not be operated with wet hands
  • Designated hospital personnel monitor electrical equipment closely; however, laboratory personnel should continually observe for any dangerous conditions
  • Equipment that has become wet should be unplugged and allowed to dry completely before reusing
  • Equipment also should be unplugged before cleaning
  • All electrical equipment must be grounded with three-pronged plugs
• Sharp Hazard


  All sharp objects must be disposed in puncture-resistant, leak-proof container with the biohazard symbol
• Physical Hazard Precautions


  • Avoid running in rooms and hallways
  • Watch for wet floors
  • Bend the knees when lifting heavy objects
  • Keep long hair pulled back
  • Avoid dangling jewelry
  • Maintain a clean, organized work area
  • Wear closed-toed shoes that provide maximum support
• Mechanical Hazard


  Centrifuges must be balanced to distribute the load equally and the lid must not be opened until the rotor has come to a complete stop
• Disposal of Biological/Biohazardous Waste

  1. All biological waste (EXCEPT URINE) should be placed in appropriate containers labeled with biohazard symbol

  2. URINE may be discarded by pouring it into the lab sink and the sink should be flashed with water after

  3. Decontaminate the sink by 1:5 or 1:10 dilution of sodium hypochlorite (bleach solution) daily

  4. Empty urine containers can be discarded as nonbiologically hazardous waste

  5. Incineration, inactivation, burial, chemical disinfection, encapsulation in a solid matrix
• Disposal of Chemical Waste

  1. Flush water-soluble substances down the drain with large quantities of water

  2. Strong acids and bases should be neutralized before disposal

  3. Foul smelling chemicals should never be disposed down the drain

  4. Flammable solvents should be collected in approved containers

  5. Flammable material should be disposed in specially designed incinerators

  6. Solid chemicals should be disposed in landfill
• Waste Disposal Techniques


  • Incineration
  • Recycling
  • Landfill burial
  • Flushing down the drain
• Phlebotomy


  An incision into a vein
• History of Phlebotomy


  • Oldest medical procedures by early Egyptians
  • Bloodletting used to cure diseases and maintain the body in a state of well-being
  • Hippocrates believed disease was caused by an excess of body fluids and removal of the excess would cause the body to return to or maintain a healthy state
  • Bloodletting is now called "therapeutic phlebotomy"
  • Greek "Phleb" (vein) and "tomia" (to cut) - Oldest medical procedure dating back to the early Egyptians
• Techniques for bloodletting (earlier times)

  1. Suction cup devices with lancets that pulled blood from the incision

  2. Application of blood-sucking worms called "leeches" to an incision

  3. Barber surgery – blood from an incision produced by the barber's razor was collected in a bleeding bowl
• Primary role of phlebotomy

  Collection of blood samples for laboratory analysis to diagnose and monitor medical conditions
• Phlebotomist


  • Cross-trained in venipuncture, capillary collection, patient care, receptionist duties, sample processing and computer work
• Traditional Duties of a Phlebotomist

  • Correct identification and preparation of the patient before sample collection
  • Collection of the appropriate amount of blood by venipuncture or dermal puncture for the specified tests
  • Selection of the appropriate sample containers for the specified tests
  • Correct labelling of all samples with the required information
  • Appropriate transportation of samples back to the laboratory in a timely manner
  • Effective interaction with patients and hospital personnel
  • Processing of samples for delivery to the appropriate laboratory departments
  • Performance of computer operations and record-keeping pertaining to phlebotomy
  • Observation of all safety regulations, quality control checks, and preventive maintenance procedures
  • Attendance at continuing education programs
• Additional Duties of a Phlebotomist

  • Training other health-care personnel to perform phlebotomy
  • Monitoring the quality of samples collected on the units
  • Evaluation of protocols associated with sample collection
  • Performing and monitoring point-of-care testing (POCT)
  • Performing electrocardiograms
  • Performing measurement of patient's vital signs
  • Collection of arterial blood samples
  • Collection of samples from central venous access devices(CVADs)
• Professional and Personal Characteristics of a Phlebotomist

  • Dependable, cooperative, committed
  • Compassionate, courteous, respectful
  • Integrity, honesty, competence
  • Organized, responsible, flexible
  • Appearance (Clothing, Hygiene)
  • Verbal Skills
  • Nonverbal Skills
  • Body language
  • Respecting Cultural Diversity
  • Telephone skills
• Ethical and Legal Issues


  Principles of right and wrong, called the code of ethics, provide the personal and professional rules of performance moral behaviour as set by members of a profession. Medical ethics or bioethics focus on the patient to ensure that all members of a health-care team possess and exhibit the skill, knowledge, training, professionalism, and moral standards necessary to serve the patient.
• Patient's Rights (DOH)


  • Right to information
  • Right to choose
  • Right to privacy and confidentiality
  • Right to dignity
  • Right to safety
  • Right to file a complaint
  • Right to be treated without discrimination
• Tort


  A wrongful act committed by one person against another that causes harm to the person or his or her property.
• Ethical and Legal Issues

  • Assault -threat to touch another person without his or her consent and with the intention of causing fear of harm
  • Battery-actual harmful touching of a person without his or her consent
  • Defamation-spoken or written words that can injure a person's reputation
  • Libel-false defamatory writing that is published
  • Slander -false and malicious spoken word
  • Invasion of Privacy -is the violation of the patient's right to be left alone and the right to be free from unwanted exposure to public view
• Medical Malpractice


  Misconduct or lack of skill by a health-care professional that results in injury to the patient