Gen collection procedures

• General Precautions in specimen collection for bacteriologic and chemical

  examinations:

  • The specimen must be material from the actual infection site and must be collected with a minimum of contamination from adjacent tissues, organs, or secretions.
  • Optimal times and total number of specimens for collection must be established for the best chance of recovery of the causative organism
  • A sufficient quantity of specimen must be obtained
  • Use of appropriate collection devices
  • Time of collection
• Routine urinalysis (UA) is one of the most frequently requested laboratory procedures at because it can provide a useful indication of body health.
• It can be performed on a "first morning" or random urine specimen.
• Various diseases and disorders can be detected through a routine UA.
• Random Urine

  • This type of specimen is most convenient to obtain.
  • Routine urinalysis
  • Patient may void at any time of the day or night.
• First Urine of the Morning

  • This urine excretion is the most concentrated.
  • Protein, nitrite, microscopic analysis and routine urinalysis.
  • Instruct the patient to void before retiring at night and discard specimen. On arising the next morning, the patient should void and collect the urine specimen.
• Fasting

  • Used when metabolic abnormalities are suspected and for glucose-level determinations for diabetes mellitus testing.
• Clean-Catch Mid-stream Urine

  • The specimen is free of contamination.
  • Routine urinalysis. Culture for bacteria and/or microscopic analysis.
  • catch some of the mid-stream urine in a clean container
• Timed Urine Specimens (e.g., 2-hour, 4-hour, 24-hour)

  • The excretion rate of the analyte can be determined.
  • Creatinine clearance test, urobilinogen determinations, hormone studies.
  • For many urine chemistry procedures the specimen of choice is 24- hour urine. In some instances, special preservatives or dietary restrictions are required. Prior to collection you should consult the specific test ordered by the requesting physician. Proper specimen collection is critical to obtaining accurate results.
• FECES - Specimens of stools for examination should be sent in a clean out sterile bottles which may be subsequently disposed.
• Rectal swabs can also be used for the detection of the organisms causing food poisoning and dysentery.
• These swabs are of the same type as those used for wound, nose and throat.
• Care should be taken to pass swab through the anus right into the rectum.
• It is advisable to have a specimen of stool, as well, if this is available so that the amount of pus, blood, mucus, and the consistency of the specimen can then be seen.
• PUNCTURE FLUIDS - Large quantities of material for microbiological investigation are usually taken by syringe and may be transferred directly from this syringe to a sterile bottle.
• Pleural, ascetic and synovial fluids are collected into a sterile bottle containing an anticoagulant; 20-30 ml is an adequate amount for bacterial examination, except when tuberculosis is suspected when the whole aspirate should be sent in the laboratory.
• Cerebrospinal fluid should be collected in dry sterile containers and be delivered and processed in the laboratory as soon as possible. It can be stored in the incubator or at room temperature for one hour.
• CSF specimen should not be refrigerated.
• Fluids requiring a cell count should be put into sterile bottles appropriately labeled; the second one should be used for the count since the first may contain extraneous blood cells introduced into the needle as it went through the tissues.
• Catheterized Specimen - collected under sterile conditions by passing a hollow tube (catheter) through the urethra into the bladder
• Suprapubic aspiration - collected by an external introduction of a needle through the abdomen into the bladder

  • cytologic examination
• Prostatitis Specimen - Three-glass collection

  • first urine passed - collected in a sterile container
  • midstream portion - collected in another sterile container
  • prostate is then massaged so that the prostate fluid will be passed with the remaining urine - 3rd sterile container
• Prostatitis Specimen

  Pre and Post massage test

  • clean catch midstream urine specimen is collected
  • second urine sample is collected after the prostate is massaged
• Stamey-Mears test for prostatitis

  • four-glass method consists of bacterial cultures of the initial voided urine, midstream, expressed prostatic secretions, and post-prostatic massage urine specimen
• Feces

  • stool container must be covered, clean, wide-mouthed and colorless
  • watery - 30mins
  • formed - 1hr.
  • watery - 5-6tbsps
  • formed - 2-5g
• Pediatric Specimen

  • sterile specimens may be contained by catheterization or suprapubic aspiration
  • Soft, clear plastic bag with hypoallergenic skin adhesive to attach to the genital area of both boys and girls are available for collecting routine specimens
  • For routine specimen analysis ensure the area is free of contamination
  • for microbiology specimens clean the area with soap and water and sterilely dry the area removing any residual soap residue
• Puncture Fluids

  • Pleural, ascetic and synovial fluids are collected into a sterile bottle containing an anticoagulant
  • bacterial examination - 20-30mL; TB-whole aspirate
  • CSF should be collected in a dry sterile container and be delivered and processed asap
• NCCLS (National Committee for Clinical Laboratory Standards) recommends the use of amber colored containers for light sensitive analytes such as urobilinogen and porphobilinogen which can cause them to degrade leading to inaccurate results
• Spinal tap - removal of fluid from the spine in the lower back through a hollow needle. Between the 3rd and 4th lumbar vertebra of the spinal the Cerebrospinal fluid is collected.
• Amniocentesis - is done by removing the amniotic fluid and cells from the uterus for tests and treatment

  • The amniotic fluid surrounds and protects the baby during pregnancy
• Arthrocentesis - or also called the joint aspiration, a procedure that is performed to obtain synovial fluid from within the joint capsule
• Thoracentesis - a procedure that is performed to remove fluid or air from the thoracic cavity
• Catheter Line Order of Draw

  1.3-5 mL in a syringe

  2. Blood culture tube

  3. Anticoagulant tubes

  4. Plain tube
• Three glass collection

  • used to collect urine samples from diff parts of urinary tract
• VB1 and VB2 detect in urology

  • test for urethral infection

  • test for urinary bladder infection