Case study- Urinalysis Clinical Laboratory Operations

Question 1

A new instrument is purchased for the hospital’s
clin ical laboratory. Th is instrument needs a compressed n itrogen
gas ta nk attached to it. The laboratory manager is planning the
space for this new instrument adjacent to the urinalysis bench .
The laboratory manager wi ll be orderi ng the n itrogen ta n ks and
is deciding where to store the spare ta nk as there is lim ited space
in the instrument a rea.

1. How must the nitrogen tank that will be in use and the
   backup nitrogen tanks be stored?
2. What precautions must be taken when handling and
   changing tanks?
3. What dangers are associated with compressed gas tanks?

Answer 1

1. How must the nitrogen tank that will be in use and the backup nitrogen tanks be stored?
   - Compressed gas tanks must be chained against the wall so that they remain upright and secure. Protection caps must be kept on the stored tanks to avoid valve damage as the valve is the weakest area of most cylinders
2. What precautions must be taken when handling and changing tanks?
   - Compressed gas tanks must be chained to a transport hand truck during transit and caution must be taken not to knock them over or to damage the valve stem.
3. What dangers are associated with compressed gas tanks?
   - Fire, explosion, asphyxiation, and mechanical injury can result from improper handling or storage of compressed gas cylinders. Do not handle these tanks so that they could fall over, resulting in a sudden release of pressure, making the tank like a torpedo as gas is released under pressure. Do not bang on the stem of the tank with a hammer as these activities could also cause a sudden release of gas under pressure or a slow leak of gas.Some of these gases, such as nitrogen, can be asphyxiating gases.

Question 2

As a technolog ist was open ing a rubber-stoppered
urine col l ection tube, the speci men splashed i nto the face of the
technolog ist and the student with her. Embarrassed, the technologist noticed that the student was busy and had not even noticed
the splash and she said noth ing to the student. They conti nued
working without addressing the splash.

1. What possible infectious agents might this technologist and
   student now be exposed to?
2. What are the proper steps for handling this incident?
3. What should have been done to prevent this incident from
   happening?
4. What ethical issues were not addressed by the technologist?

Answer 2

1. What possible infectious agents might this technologist and student now be exposed to?
   - There may be a variety of infectious agents present in a sample sent for urinalysis testing. While the normal forming urine in the body is sterile, the organism can become contaminated after excretion. Also, it is more likely that urine sent for urinalysis testing comes from a patient with kidney
   disease such as infections. Bacterial, viral, and
   parasitic organisms may be present ranging from bacteria such as Escherichia coli or Mycobacterium tuberculosis to cytomegalovirus or a hepatitis virus
   to a wide variety of other organisms. Care must always be taken to avoid splashes or aerosolization of these specimens
2. What are the proper steps for handling this incident?
   -The technologist should immediately flush and, if appropriate, wash all affected areas, report the incident to a supervisor, and report to employee health for postexposure treatment.
3. What should have been done to prevent this incident from happening?
   - The technologist should have been using PPEs such as a face shield or should have worked behind a specimen shield.
4. What ethical issues were not addressed by the technologist?
   - The technologist had an obligation to inform the student of the splash and guide her through the proper safety measures.