FED EX SHIPPING CONTAINERS * SMALL * MEDIUM * LARGE

Transcription

1 PHLEBOTOMY SUPPLIES

2 FED EX SHIPPING CONTAINERS * SMALL * MEDIUM * LARGE The shipping box is used to ship specimen via Fed Ex to Castle Medical. Place specimen in orange and white Clinical Pak bag, along with diaper and at least 2 ice packs. The Clinical Pak bag will then be placed into the Fed Ex Clinical Box.

3 FED EX SHIPPING LABEL THE SHIPPING LABEL LOCATED ON THE LEFT IS AN EXAMPLE OF THE SHIPPING LABEL PROVIDED BY CASTLE MEDICAL. The shipping label should be aligned on the top of the Fed Ex box in the designated space. Be sure to record the 12-digit Tracking Number for your records.

4 FED EX CLINICAL PAK Specimen are placed in the clinical pak, along with the gray diaper (which is an absorbent material used to aid in leakage). The clinical pak is then placed inside the cardboard fed ex shipping container.

5 FED EX VS. COURIER PICK-UP IF YOU ARE A LOCAL CLIENT AND UTILIZE COURIER PICK-UP, PLEASE FOLLOW THE FOLLOWING STEPS WHEN SHIPPING SPECIMEN: 1. ENSURE THAT SPECIMEN AND/OR URINE ARE SHIPPED THE SAME DAY. 2. NOTIFY CASTLE OF ANY FROZEN SPECIMEN. CASTLE WILL NOTIFY THE COURIER TO BE EQUIPPED WITH DRY ICE DURING PICK-UP TO TRANSFER SPECIMEN, WHILE MAINTAINING SPECIMEN STABILITY. 3. IF SPECIMEN ARE NOT PICKED UP FROM INSIDE THE OFFICE, THEY SHOULD BE PLACED IN A LOCKBOX. 4. ENSURE THAT YOU PLACE AT LEAST 2-4 ICE PACKS IN THE LOCKBOX WITH SPECIMEN, DEPENDING ON THE NUMBER OF SPECIMEN THAT YOU ARE SHIPPING FOR THE DAY. PLACE MORE ICE PACKS, IF NEEDED. 5. ENSURE THAT COURIER PICK-UP COORDINATES WITH THE OFFICE S SCHEDULED WORK HOURS.

6 BIOHAZARD SHARPS CONTAINER What goes in the Sharps Container? Sharps include, but are not limited to, needles, lancets, syringes, used tubes and pipettes, used urine straws, etc. How do I dispose of my sharps waste? 1. Securely close the container. 2. Place disposable container inside a red biohazard bag and place in the biohazard sharps box. Make sure that you do not overfill the Sharps Container. Use the Fill Line as a guide to aid in knowing when to dispose of the container. Once the Fill Line is reached, the container should be disposed of DO NOT stick your hand in the container DO NOT transfer materials from the container into any other container, bag, etc. DO NOT reuse the container

7 SHARPS CONTAINERS IN ASSORTED SIZES

8 COMMONLY USED NAMES: * SST TUBE * TIGER TOP TUBE * SERUM SEPARATOR TUBE * GEL BARRIER TUBE * MARBLE TOP TUBE Serum separator tube (sst) is used for serum determinations in chemistry and serology. It contains separator gel and should not be used for toxicology or drug testing. Inversions ensure mixing of clot activators with blood. Blood clotting time 30 minutes. Must be centrifuged at least 10 minutes.

9 COMMONLY ORDERED PANELS IN SST TUBE * BMP (BASIC METABOLIC PANEL) * CMP (COMPLETE METABOLIC PANEL) * LIPID PANEL * THYROID PANEL * HEPATIC PANEL * ESTROGEN PANEL * RENAL FUNCTION PANEL * IRON PANEL * COMPLETE LIVER PANEL * ELECTROLYTE PANEL COMMONLY ORDERED INDIVIDUAL TESTS IN SST * ALBUMIN * AMYLASE * ANTINUCLEAR ANTIBODIES (ANA) * C-REACTIVE PROTEIN (CRP) * CALCIUM * CARCINOEMBRYONIC ANTIGEN (CEA) * CHOLESTEROL, TOTAL * CORTISOL * CREATININE/CREATININE KINASE * DHEA-S * ESTRADIOL * FERRITIN * FOLATE (FOLIC ACID)6 * FOLLICLE-STIMULATING HORMONE (FSH) * GLUCOSE, SERUM * GLUCOSE, 1 HOUR TOLERANCE * GLUCOSE, 3 HOUR TOLERANCE * HCG, BETA, QUANTITATIVE * HDL CHOLESTEROL * INSULIN * IRON * LIPASE * MAGNESIUM * PHOSPHORUS * POTASSIUM * PROGESTERONE * PROLACTIN * PROTEIN, TOTAL * PROSTATE-SPECIFIC ANTIGEN (PSA) * REVERSE T3 * RHEUMATOID FACTOR * SHBG * T3, FREE * T3, TOTAL * T3 UPTAKE * T4, FREE * T4, TOTAL * TESTOSTERONE, FREE * TESTOSTERONE, TOTAL * THYROID PEROXIDASE (TPO) * TRIGLYCERIDES * THYROID-STIMULATING HORMONE (TSH) * URIC ACID * VITAMIN B12 * VITAMIN D, 25 HYDROXY * NOTE: THE TESTS LISTED ABOVE ARE NOT ALL THE TESTS THAT ARE TESTED USING THE SST TUBE. IF IN QUESTION, PLEASE CALL CASTLE MEDICAL TO CLARIFY.

10 GOLD SST TUBE THIS TUBE IS USED INTERCHANGEABLY WITH THE TIGER TOP TUBE. THE SAME TESTS CAN BE TESTED IN BOTH TUBES.

11 RED TOP TUIBE This tube is a plain vacutainer containing no anti-coagulant used for collection of serum for selected chemistry tests as well as clotted blood for immunohematology. It is also used for therapeutice drug levels. Once this tube is drawn, do the following: Place in a centrifuge for at least 15 minutes, separating serum from cells pipette the serum into a clean, plastic screw cap vial Label the plastic transfer vial with patient s name, Date of birth and serum. it is very important that you list the specimen as serum.

12 COMMONLY ORDERED TESTS IN RED TOP TUBE Serum chemistry tests Cholesterol Potassium Amylase Alkaline Bun Ck Liver enzymes Rpr Monospot Rheumatoid factor DHEA-S Digoxin Lithium Valporic acid, free and total Vancomycin, peak and trough

13 LAVENDER OR PURPLE TOP TUBE (EDTA) This tube contains EdtA (the postassium salt, or K2edta) this is a strong anticoagulant and these tubes are usually used for complete blood count (CBC). These tubes are generally used when whole blood is needed for analysis. Note: after the tube has been filled with blood, immediately invert the tube several times, usually 8-12 times, to prevent coagulation. Some test require the specimen to be centrifuged and the plasma is separated from the blood. When necessary, separate the plasma and transfer the plasma to a plastic transport vial, labeling with patient name, date of birth and edta plasma.

14 COMMONLY ORDERED TESTS IN LAVENDER TUBE Cbc Ammonia B-type natriuretic peptide (bnp) Hemoglobin a1c Parathyroid hormone (pth), intact Sed rate (esr) Rbc and wbc count Hematocrit determinations Sickle cell screening Note: if bnp or pth is ordered, centrifuge the lavender tube, separating plasma from whole blood. Once centrifuged, remove tube and transfer the plasma into a plastic transport tube and clearly label the tube with patient s name, date of birth and edta plasma.

15 LIGHT BLUE TUBE light blue tube (sodium citrate): this tube contains sodium citrate as an anticoagulant used for drawing blood for coagulation studies, such as pt, ptt and pt/inr. Note: it is imperative that the tube be completely filled. The ratio of blood to anticoagulant is critical for valid prothrombin time results. Immediately after draw, invert the tube 6-10 times to activate the anticoagulant. If test requires the plasma to be transferred, centrifuge and transfer to plastic transport vial, labeling with patient name, date of birth and citrate plasma

16 LIGHT BLUE TUBE Commonly ordered tests in blue-top tube Pt/inr Partial thromboplastin time (ptt) Prothrombin time (pt)

17 GRAY TOP TUBE Additives Potassium oxalate and sodium fluoride Ths tube contains potassium oxalate as an anticoagulant and sodium fluoride as a preservative used to preserve glucose in whole blood and for other special chemistry tests. The tube must be inverted 4-5 times after collection to allow adequate mixing of the blood with the additive, to prevent coagulation. Commonly ordered tests in gray top tube Glucose levels Blood alcohol levels Lactate/ lactic acid bicarbonate

18 GREEN TOP TUBE Green top tube (sodium heparin) Green top (sodium lithium) This tube contains sodium heparin or sodium lithium used for the collection of heparinized plasma or whole blood for special tests. Note: after the tube has been filled with blood, immediately invert the tube several times to prevent coagulation. Commonly ordered tests with green top tube: Chemistry tests on plasma Ammonia Carboxyhemoglobin Stat electtrolytes Chromosome screening

19 ROYAL BLUE TOP There are two general types of this tube one with k2 esta and one with no anti-coagulant. This tube is used primarily for trace metal analysis. Primarily used for the following: Trace elements Toxicology Nutritional chemistry testing

20 YELLOW TOP TUBE This tube contains either acd solution a or solution b. this tube is used for drawing whole blood for special tests. Tubes with acd are for cellular studies, hla typing and paternity testing

21 STERILE URINE SPECIMEN CUP The sterile urine specimen cup is used to collect urine to be transported to the laboratory for urinalysis testing. The screw top cap should be tightly secured prior to shipping of specimen. Be sure to write patient name and date of birth on the urine cup.

22 URINE CULTURE & SENSITIVITY (C&S) TUBE WITH URINE TRANSFER STRAW Urine transfer straw is a non-sterile, plastic holder device that contains a needle with a straw attached that can be used with most urine collection cups to fill evacuated c&s tubes. This tube should be used when the physician has ordered a urine culture & sensitivity. C&s tubes have a light gray stopper with a preservative. The tube has a minimum draw line. Once the tube is pierced by the needle, the volume is automatically drawn into the tube. Be sure to label the tube with patient s name and date of birth.

23 URINE TRANSFER CONTAINER This flip-top container can be used to transport urine to the laboratory for a urinalysis. The top is secure and locks in place, preventing leakage of the specimen during transporting.

24 24-HOUR URINE JUGS 24-hour timed urine collection procedure 1. When you get up in the morning, empty your bladder by discarding this urine in the toilet. Record this time. This will be your starting time. 2. For the next 24 hours after your first void, collect all urine. Carefully pour or transfer the urine collected each time into the large gallon jug. Mix the jug after each addition of urine. Keep the jug in the refrigerator between collections. 3. At the end of the 24-hour period (next morning), empty your bladder. Collect this urine and add it to the gallon jug. Record this as your ending time. 4. Bring the 24-hour jug and the times you recorded to the clinic on the day that the collection was completed.

25 Toilet/urine hat TOILET HAT SPECIMEN COLLECTION IS A URINARY ACCESSORY COMMODE SPECIMEN COLLECTION. IT IS A UNIT USED FOR THE COLLECTION OF URINE AND STOOL SAMPLE OR KIDNEY STONES.

26 COMMON VENIPUNCTURE NEEDLE GAUGES WITH NEEDLE TYPE AND TYPICAL USE IN VENIPUNCTURE 21 gauge 22 gauge 23 gauge 25 gauge Never reuse a needle Never use if shield is broken Never recap, cut, bend or break size of needled is indicated by the gauge Larger gauge number indicates smaller needle diameter 21 or 23 gauge needles routinely used for venipuncture Note: the slides that follow outlines each needle gauge and their uses

27 PARTS OF THE NEEDLE This slide outlines the parts of the needle. The bevel is always face up when inserting into the vein. The shaft is the section inserted into the vein The threaded hub is where the holder is screwed onto the needle The rubber sleeve pierces the tube once it is placed inside the hub during the venipuncture

28 21 GAUGE BD VACUTAINER ECLIPSE NEEDLE WITH HUB/HOLDER (PRE-ASSEMBLED) This is considered the standard venipuncture needle for routine venipuncture on patients with normal veins or syringe blood culture collection. This needle also included the safety device which is engaged by lifting the pink, plastic piece over the used needle before disposal into a sharps container.

29 21 GAUGE NEEDLE WITHOUT HUB/HOLDER This needle requires the attachment of the hub/holder. The hub/holder is screwed onto the threaded end of the needle, where the rubber sleeve is located. This piece will pierce the tubes as they are placed inside the holder.

30 DISPOSABLE TUBE HOLDER THIS DEVICE IS DESIGNED FOR SINGLE-USE ONLY Commonly used names Hub Holder Needle holder Tube holder adapter

31 ASSEMBLY OF NEEDLE AND HUB/HOLDER This slide outlines the assembly of needle and the hub/holder, when the needle is not pre-assembled.

32 22 GAUGE BD VACUTAINER ECLIPSE NEEDLE WITH HUB/HOLDER 22 gauge bd vacutainer eclipse needle without hub/ holder

33 USE OF A 22 GAUGE NEEDLE THE 22 GAUGE NEEDLE IS USED ON OLDER CHILDREN AND ADULTS PATIENTS WITH SMALL VEINS.

34 23 GAUGE PUSH BUTTON BUTTERFLY NEEDLE MOST COMMON SIZE BUTTERFLY NEEDLE. THIS BUTTERFLY NEEDLED IS USED ON VEINS OF INFANTS AND CHILDREN. IT IS ALSO USED ON DIFFICULT DRAWS OR HAND VEINS OF ADULTS. 21 gauge push button butterfly needle This butterfly needle is the same gauge as the straight needle

35 A TOURNIQUET IS A CONSTRICTING OR COMPRESSING DEVICE, SPECIFICALLY A BANDAGE, USED TO CONTROL VENOUS AND ARTERIAL CIRCULATION TO AN EXTREMITY FOR A PERIOD OF TIME. apply the tourniquet 3-4 inches above collection site Never leave the tourniquet on for over 1 minute

36 ANDWIN SCIENTIFIC NO TOUCH ONE-SLIDE PAP SMEAR KIT The no touch specimen pack provides maximum slide specimen protection Ventilation folds allow wet slides to dry in courier pack

37 BD SUREPATH LIQUID BASED PAP TEST The cytology sample is collected using one of the following: Broom-like device, with detachable head Combination of brush and spatula, with detachable head

38 BRUSH AND SPATULA (USED WITH SURE PATH AND THIN PREP PAP KITS) Broom with detachable head (used with sure path and thin prep pap kits)

39 THE THIN PREP PAP KIT

40 PARA-PAK CULTURE & SENSITIVITY STOOL KIT What is the purpose of a stool sample? A stool analysis is a series of tests done on a stool (feces) sample to help diagnose certain conditions affecting the digestive tract. These conditions can include infection (such as from parasites, viruses or bacteria), poor nutrition absorption or cancer. These vials are used when a physician has ordered stool culture with culture & sensitivity. Collection of stool specimen 1. Collect the stool specimen in clean vial or stool hat. 2. Transfer no more than one ounce of the specimen using the spatula attached to the container lid into the vial and mix thoroughly.

41 PARA-PAK OVA & PARASITES STOOL SPECIMEN COLLECTION KIT A stool ova & parasites (o&p) test is used to detect parasites and eggs in the intestines. Collection instructions: 1. Pass stool into hat or clean container. 2. Collect a sample of the stool with the collection spoon provided in the cap of the container. Place enough stool in the vial so the liquid reached the fill line. do not overfill. Mash the stool specimen until it is thoroughly mixed with the liquid. 3. Using second vial spoon, repeat step #2 with the other vial (if a second vial is needed). 4. Label the specimen with name, date and time of collection.

42 PARA-PAK CLEAN VIAL FOR STOOL SPECIMEN Stool transfer vial without preservatives. A 30-ml leak-proof vial for transport of specimen that do not require a transport medium. The vial contains a built-in spoon for safe and easy manipulation of the specimen. This clean vial is used for collecting stool specimen for tests which cannot have any preservatives. Example of testing requiring unpreserved stool: Clostridium difficile toxins (c-diff) Occult blood Rotovirus H pylori stool antigen Fecal fat

43 TRANSYSTEM STERILE TRANSPORT SWABS Aerobic & anaerobic multipurpose transport system Sampling sites that may be tested using the swabs include the following: Throat Vaginal Wound Skin naropharyngeal Male urethera Can be used when testing for the following: gonorrhoaea, streptococcus, etc.

44 gen-probe aptima urine specimen collection kit SPECIMEN COLLECTION: ONCE URINE IS COLLECTED, TRANSFER TO THE YELLOW GEN-PROBE URINE SPECIMEN COLLECTION VIAL, BEING SURE TO PUT ENOUGH URINE TO THE FILL LINE. USED TO TEST FOR THE FOLLOWING: CHLAMYDIA TRACHOMATIS AND OTHER STD TESTING

45 Gen-probe aptima unisex swab collection kit COLLECTION INSTRUCTIONS: 1. REMOVE THE CAP FROM THE SWAB SPECIMEN TRANSPORT TUBE AND IMMEDIATELY PLACE THE SWAB INTO THE TUBE. 2. CAREFULLY BREAK THE SWAB SHAFT AT THE SCORE LINE. 3. RE-CAP THE SWAB SPECIMEN TRANSPORT TUBE TIGHTLY, LABEL AND SHIP. THIS KIT IS USED FOR STD TESTING IN MALES AND FEMALES

46 GEN-PROBE APTIMA VAGINAL SWAB SPECIMEN COLLECTION KIT Collection procedure: 1. Collect specimen following urine or swab collection procedure. 2. Place specimen into transport tube 2. Label the specimen tube and send to laboratory for testing This kit is used in std testing

47 Throat swab culture A THROAT SWAB CULTURE, OR THROAT CULTURE, IS A TEST COMMONLY USED TO DIAGNOSE BACTERIAL INFECTIONS IN THE THROAT. THESE INFECTIONS CAN INCLUDE STREP THROAT, TONSILLITIS, WHOOPING COUGH AND MENINGITIS. A SWAB SAMPLE CAN ALSO DETECT THRUSH, BACTERIAL VAGINOSIS AND VARIOUS OTHER GERMS (BACTERIA) WHICH ARE NOT SEXUALLY TRANSMITTED INFECTIONS. THIS SWAB CAN ALSO BE USED FOR WOUND CULTURES COLLECTING A THROAT CULTURE: * USING A STERILE COTTON SWAB, TOUCH THE INFECTED AREA WITH THE SWAB WITH SEVERAL STROKES TO COLLECT ANY PATHOGENIC OR BACTERIA FOR A MICROBIOLOGIST TO ANALYZE. * BE CAREFUL NOT TO TOUCH THE TONGUE, UVULA, OR LIPS DUE TO POSSIBLE CONTAMINATION. * THIS SHOULD NOT BE A PAINFUL PROCEDURE BUT EXPECT THE PATIENT TO GAG SINCE YOU ARE TOUCHING THE BACK OF THEIR THROAT. * PREPARE THE SWAB FOR TRANSPORTATION TO THE LABORATORY FOR ANALYSIS.

48 PRE-FILLED FORMALIN CONTAINER This pre-filled formalin container is designed for safe collection, preservation, transportation and storage of specimen of various sizes. The most commonly used cup sizes are 20, 40, 60, 90 and 120ml. Used to transport tissue specimen

49 AMBER VIAL TRANSPORT TUBES These vials offer protection protection from light. Some tests require that the specimen is protected from light. An example of a test that requires shipment in an amber vial, is the vitamin b6. In the even that you do not have access to an amber transport vial, wrap the specimen in aluminum foil to protect from the light, being sure to label the foil with patient information.

50 PLASTIC TRANSPORT VIALS These vials are used to transport serum or plasma that has been separated from the whole blood and needs to be transported to the laboratory. Please be sure to write patients name and date of birth on the transport vial. Clearly specify on the outside of the vial whether the contents are serum or plasma by clearly labeling the vial.

51 BLOOD TRANSFER PIPETTES Blood transfer pipettes feature large bulbs and are commonly used to transfer blood to and from tubes and vials.

52 ALCOHOL PREP PADS Alcohol prep pads are used to clean the venipuncture site. Always cleanse in a circular motion from the inside of the site to the outside. Allow the site to air dry.

53 2X2 GAUZE PADS The 2x2 gauze pads are using to place on the venipuncture site following collection of the blood. The site should be allowed to air dry and should not be dried with the gauze pads. Do not use cotton balls, as the cotton fibers may stick to the wound, and when pulled off, reopen the puncture site.

54 TEST TUBE RACK Test tube racks hold blood once it is drawn. Place the tubes in the rack while allowing the specimen to clot. This rack also improves organization and efficiency during phlebotomy.

55 BIOHAZARD STICKERS According to osha, warning labels must be affixed to the following: Containers of regulated waste Refrigerators and freezers containing blood or other potentially infectious materials Other containers used to transport, store or ship blood or other potentially infectious materials Equipment that may become contaminated with blood or other infectious materials Sharps containers

56 BIOHAZARD BAGS Biohazard bags are an essential item used in controlling the spread of diseases from human waste, discarded medical supplies and biological contaminants. These high density red bags are marked with the international symbol to alert others. Tie closed or use twists. 10 gallon capacity. Red bags should be used to dispose of solid or liquid items contaminated with blood, vaginal fluids and feces, or any item used to handle, store or dispose of body fluids. Red bags are also used to contain and store used test tubes, glass slides, cotton swabs, etc. Do not put any materials in red bags that are not soiled or contaminated with blood and other infectious body fluids.

57 BIOHAZARD SPECIMEN BAGS These bags are marked with biohazard symbol and have a zipper seal to prevent leakage. There is a separate document pouch that keeps documents, such as requisitions, clean and close to the specimen in transport and storage. All specimen should be placed in a shipping bag and shipped according to laboratory regulations.

58 CENTRIFUGE centrifuge operation guidelines The centrifuge must be operated on a rigid, flat, level surface. There must also be sufficient free space around the centrifuge for adequate ventilation. The centrifuge load must be balanced by placing tubes of equal size, shape and containing an equal volume opposite each other. Do not overload the centrifuge. Fully close the centrifuge lid. Do not attempt to open any centrifuge until it has come to a complete stop. Centrifuge maintenance Always unplug the power cord before cleaning or servicing the centrifuge, while wearing protective gloves. At least weekly, wipe the centrifuge housing, rotor chamber, rotors and rotor accessories with a neutral cleaning agent. Annually or as needed, the centrifuge functions and maintenance verification should be performed by qualified personnel.

59 DISPOSABLE LAB JACKETS Lab jackets are often worn to protect the worker from accidental exposure to potentially harmful agents. As a general principle, lab jackets should not be worn outside the laboratory. This will minimize the exposure of other workers to these same harmful agents. Disposable lab jackets can withstand wear up to 5 to 10 times.

60 SOFT TAPE OR PAPER TAPE Soft tape or paper tape can be used to apply to a venipuncture site, along with gauze after blood draw is performed. It is often used as an alternative to bandaids.

61 REUSABLE ICE PACKS Ice packs are using during the transporting of blood to help with the stability of the specimen, while keeping the specimen chilled. It is very important to use ice packs when shipping via fed ex or when placing specimen in a an outside lockbox.

62 PHLEBOTOMY TRAY A phlebotomy tray can be used to help better organize phlebotomy supplies. It is also used when traveling between exam rooms within an office, placing everything at your fingertips.