Specimen Collection Guide

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Margaret Atkins
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1 Specimen Collection Guide

2 1 Blood Collection Tubes SODIUM CITRATE TUBE - PALE BLUE TOP 2.7 Coagulation studies: Prothrombin time Factor assays etc. APTT Fibrinogen Thrombophilia tests INR D-Dimer SERUM SEPARATION TUBE (SST) - YELLOW PLASTIC TOP After clotting, tube should be centrifuged for 10 mins. It may then be left refrigerated overnight. Endocrinology tests (Thyroid function tests, FSH, LH, etc.) E/LFT (including urea, glucose, electrolytes, liver function tests, cholesterol, triglycerides (lipids)) Autoantibodies (including antisperm antibodies) Microbial, parasitic and viral serology (hepatitis serology, rubella antibodies, etc.) Pregnancy tests Tumour markers Iron studies/b12 PLAIN TUBE - RED PLASTIC TOP TRACE METAL TUBE - NAVY TOP LITHIUM HEPARIN TUBE - GREEN TOP, ORANGE TOP LH Lithium Heparin All drug assays Vitamin D After clotting, the tube should be centrifuged for 10 minutes. Zinc Selenium Aluminium Used for a wide variety of tests covering biochemistry, haematology and genetics Heavy metals screens Chromosome analysis BLOOD BANK EDTA TUBE - PINK TOP Blood group Rh antibodies Crossmatch Group & hold serum (+ EDTA lavender top) (+ EDTA lavender top) HLA-B27 testing Genetics (some) EDTA TUBE - LAVENDER TOP Full blood count (including haemoglobin, white cell count, platelet count) Red cell folate Hb EPP ACTH HbA1c ESR FLUORIDE OXALATE TUBE - GREY TOP Blood alcohol Lactate studies Blood glucose (if a delay in cell separation is unavoidable) ACID CITRATE DEXTROSE - ACD TUBE - YELLOW RUBBER TOP ACD-A HLA tissue typing Leukaemia marker studies (1 ACD and 1 EDTA) Lymphocyte studies (1 ACD, 1 EDTA and 1 SST) Lymphocyte subset analysis (1 ACD and 1 EDTA)

3 Specimen Containers Urine for biology (MUC M/C/S) Transport to the laboratory immediately. If transport to the laboratory is likely to be delayed for more than 12 hours, refrigerate until transport is available. Suprapubic aspirates should be collected into a sterile and refrigerated if transport to the laboratory is delayed. Synovial fluid collection kit 1. Crystals, rheumatoid factor latex, gram stain and culture. Several ml in a sterile screw top (urine). 2. Cell count and differential. 1-2 ml in lithium heparin (green top) tube to prevent specimen clotting. 3. Protein, albumin and glucose. 1-2 ml in a EDTA (lavender top) tube. LH Lithium Heparin Seminal fluid Collect specimen into a sterile. This sample needs to reach the laboratory within 2 hours. Histology specimen Routine histology tissue and biopsy specimens are placed into 10% formalin for fixation and submitted to the laboratory for paraffin processing. FUNGAL SCRAPINGS DO NOT ENCLOSE BLADE Faeces Skin scrapings s SPECIMEN DATE OF BIRTH NAME Liquid stools should be examined promptly - please contact the laboratory to arrange pick up. Formed and semi-formed stools should be received by the laboratory within 24 hours of collection. Superficial mycoses may infect skin, hair and nails. Skin scrapings from the active edge of the lesion and scrapings from nails, together with clippings of nails and hair, may be placed in a sterile. The paper envelope may also be used for collecting skin scrapings. If the lesion is exuding material and may be painful to scrape, a swab may be collected as an alternative. Use a dry swab previously moistened with saline to swab the lesion. Place the swab in a without transport medium. (Bottles may vary from image) Urine Drug Screen Collection Kit FOR SINGLE USE ONLY TAMPER EVIDENT BAG FOR CHAIN OF CUSTODY SAMPLE Blood culture bottles ADULTS: Take ml of blood on each occasion and divide evenly into 2 adult culture bottles (aerobic and anaerobic). CHILDREN: Take 1-3 ml of blood on each occasion and place in a paediatric blood culture bottle. If difficulty is experienced in obtaining blood from an adult, the paediatric blood culture bottle will suffice. Urine collection bottles Used for timed urine collections. Patient instructions can be found on the bottle. The bottle should be refrigerated between collections. Certain collections may need preservative Urine drug screen collection kit

4 Cytology Liquid-based cytology After preparing a conventional Pap smear, the head of the collection device is dropped into the preservative solution in the vial. Transport the Pap smear in slide carrier and the labelled vial to the laboratory. Single-use Pap smear kit (Colours may vary from image) Endocervical Brush Spatula Endocervical Sampler Rovers Cervex Combi-Brush Skin Devices BIOPBLADE The sterile, single-use BIOPBLADE is a flexible scalpel used for cutaneous surgery, including: shave biopsy, saucerisation of flat lesions and levelling of pedunculated lesions. The unique design of the BIOPBLADE incorporates a comfortable and protective Fingerguard in addition to the flexible super sharp blade. This flexibility allows the blade to be positioned at the correct angle for the intended procedure. Skin punch biopsy devices 2 mm punch biopsy with internal plunger Available in several sizes: Punch Biopsy with internal plunger available in 2, 3 and 4 mm Punch Biopsy without internal plunger available in 2, 3, 4, 5, 6 and 8 mm. 2 mm punch biopsy without internal plunger

5 Swabs Bacteriology transport swab May be left overnight at room temperature except where gonorrhoea or anaerobic infection is suspected. Bacterial culture from any site To isolate bacteria, fastidious organism, N. gonorrhoeae & yeasts For screening: - MRSA - VRE - Multi-resistant gram negative bacteria (MRGN) Viral culture transport swab May be left overnight refrigerated. Viral PCR for - CMV - HSV - Enteroviruses - Respiratory viruses Flocked swab (Dry flexible swab) Store at room temperature before and after collection. PCR for - HSV - VZV - CMV - Enteroviruses - Syphilis from chancre lesion - Bordetello Pertussis PCR - Respiratory viruses PCR APTIMA 2.9mL Chlamydia / N. gonorrhoeae swab Store at room temperature before and after collection. Molecular testing Chlamydia trachomatis/n. gonorrhoeae PCR (genital and extra genital sites)

6 2.7 Order of Draw - Vacutainer & Syringe Method 1 BLOOD CULTURE BOTTLES Aerobic bottle Anaerobic bottle bottle SODIUM CITRATE** PALE BLUE TOP mini Tube MUST be filled to indicated level 3 TUBES WITHOUT CHEMICAL ADDITIVE SST, RED TOP, NAVY TOP 4 LITHIUM HEPARIN GREEN TOP mini LH Lithium He EDTA PINK TOP, LAVENDER TOP mini 6 FLUORIDE OXALATE GREY TOP 7 ACD (ACID CITRATE DEXTROSE) YELLOW RUBBER TOP ACD-A ** NOTE: If the citrate tube is the only tube to be drawn (or if it is the first tube to be drawn), this tube is acceptable for routine coagulation testing (APTT and PT/INR). For special coagulation testing (e.g., Factor VIII and Heparin Therapy) the citrate tube should not be the first tube drawn. Use of a plain discard tube may be considered in this situation. SPECIMEN LABELLING REQUIREMENTS Please ensure all request forms and specimens have correct patient details. Minimum requirements: þ SURNAME þ GIVEN NAMES þ DATE OF BIRTH þ ADDRESS (MUST BE ON REQUEST FORM) þ DATE & TIME OF COLLECTION Please understand that incorrect or insufficient labelling can necessitate a recollection. All tubes MUST be signed by patient or collector to confirm patient identity. 247 Wellington St, Launceston 7250 P: (03) Specialist Diagnostic Services Pty Ltd (ABN ) t/a Tasmanian Medical Laboratories PUB/MR/006 version 1 (Jun-14)

COLLECTION TUBES FOR PHLEBOTOMY

COLLECTION TUBES FOR PHLEBOTOMY Red Top None Blood clots, and the serum is separated by centrifugation Chemistries, Immunology and Serology, Blood Bank (Crossmatch) Gold Top None Serum separator tube (SST)