- To assure the safety and health of America's workers by setting and enforcing standards - Providing training, outreach and education - Establishing partnerships - Encouraging continual improvement in workplace

Lab 1 Flashcards by Joeffrey Calatrava

All blood and other potentially infectious materials are treated as if infected with blood born pathogens, including:

Hepatitis B (HBV)
Hepatitis C (HCV)
Human Immunodeficiency Virus (HIV)

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Universal precautions apply to:

Blood
Tissue
Semen
Other body fluids

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Universal Precautions do not apply to:

Feces
Nasal Secretions
Sputum
Sweat
Tears
Urine or vomit unless they contain blood

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Specialize Clothing or equipment worn by a person to

Protect against a hazard

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Face shields must be

Chin Length

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Googles must have

Solid side shields

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Who is in charge of OSHA

US Department of Labor and responsible for developing and enforcing workplace safety and health regulations

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What is the Federal level organizations for laboratory safety requirements and procedures

Occupational Safety and Health Administration (OSHA)
National institute for occupational Safety and Health (NIVOSH)
Code of Federal Regulations (CFR)

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OSHA mission is

To assure the safety and health of America’s workers by setting and enforcing standards
Providing training, outreach and education
Establishing partnerships
Encouraging continual improvement in workplace

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Who is in charge of NIOSH?

US department of Health and Human services and is an agency established to assure safe and healthful and working conditions for working men and women by providing research

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What does the CFR regulate

Pertaining to the transportation of hazardous waste, and if violated there are fines and penalties.

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What areas does CLIP apply to?

Medical departments aboard ships considered Non-Fixed Medical treatment Facilities

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Clinical Laboratory Improvement Program DOD instruction

CLIP DOD 6440.02

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When does the CLIP inspection occur and who can conduct it

Every 2 years

- Medical Laboratory officer or appointed Laboratory technician from hospitals in the area of responsibilities (AOR)

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The CLIP binder must include

Quality control on samples, test kits and analyzers
Log of refrigerator and freezer temperature
Maintenance logs for equipment maintained by biomed

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Instructions for BUMED Laboratory management

BUMED 6280.1 series Management of Infectious Waste Instruction

NAVEDTRA 14295 series, chapter 19

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What is SOFA

An agreement between a host nation and military forces. When a host nation’s rules and the Navy’s rules conflicts, always go with the stricter rule

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Management of Infectious Waste Instruction

BUMED 6280.1 series

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What is consider Non-Infectious

Medical waste that does not contain enough pathogen to be harmful

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What are the criteria for Non-Infectious waste

Disposable products (diapers and used paper towels)
Non originating from post-partum suites or gynecological surgical wards
Small amounts of blood or other bodily fluids
Disposable products like bedpans, urinary catheters, and NG Tube, with no contents
Containers rinsed free of regulated body fluids

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What are the regulated body fluids

Blood and blood components
Pleural fluids
Amniotic fluid
Synovial fluid
Peritoneal fluid
Pericardial fluid
CSF
Semen
Dialysate

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What is considered infectious waste

Liquid or solid waste containing potential pathogens in sufficient numbers and virulence to cause disease in susceptible host exposed to the waste

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What is considered Sharp

Objects or devices having acute rigid corners, edges, or protuberance capable of cutting or piercing

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Segregate waste at

point of origin

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Where do general, normal or non-infectious waste is placed

Standard trashcans and discarded via regular trash procedures

Where are infectious/regulated waste place?

Red biohazard bags

How are infectious waste/regulated waste bags handled when throwing them away

Double bagged, goose-necked, and secured with heavy tape

Sharps are placed in?

In a rigid, puncture-resistant, leak proof container

When are sharped containers taken out of service

90 days, 3/4 full or if a foul odor is detected

The storage area of infectious waste and the limit they must be in there

- Mark with biohazard and authorized personnel only sign on the exterior - Should be near treatment or transport site and lockable - Keep clean and free of pest/rodents - up to 7 days storage limit

When disposing waste ashore, who must you comply with

Local, state, federal, and/or status of forces agreement (SOFA)

What should be monitored for disposal ashore

``` date time amount type disposition ```

What are the following criteria for requesting overboard discharge of infectious waste

- Endangers health or safety - Creates unacceptable nuisance - Compromise of combat readiness

What the following conditions must be met for overboard discharging

- CO Approval - Must be greater than 50 nautical miles from shore - Properly packaged and weighted for negative buoyancy - Entries must be made in the ships deck log and medical journal

Entries must be made in the ships deck log and medical journal indicate what

Date Time Ships location Number of bags

What methods are used for blood collection

Venipuncture and capillary puncture

When is capillary puncture use for

Pediatric Patients, Adults with extreme obesity, severe burns, and thrombotic tendencies

Most common sites for capillary puncture in infants

Plantar surface of the heel perpendicular to the big toe

Do not draw from IV sites because of

Dilutes Specimen | Alters test results

What is the max depth for a finger puncture from a lancet

not exceed 2mm into the finger tip

Which liquid anticoagulant is used in purple top

Ethylenediaminetetraacetic acid (EDTA)

What studies are usually used for purple top

CBC Differential WBC ESR A1C

Laboratory policies aim to:

Provide a safe and healthful environment for everyone

Needles are not to be

Recapped, bent, cut, broken, removed from syringes, or otherwise manipulated by hand

Who to inform of all accidents, exposures or unsafe conditions and what to submit

Chain of command and A&I report

Who is in charge of NIOSH?

US department of Health and Human services and is an agency established to assure safe and healthful and working conditions for working men and women by providing research

How does EDTA prevent clotting

Binds to Calcium in the blood

What does EDTA do to the cell

Does not affect cellular morphology

How long can purple tops be refrigerated

24 hours

What liquid anticoagulant used in light blue tops

Sodium Citrate

What are typically used for light blue tops

Coagulation Studies: - Prothrombin Time (PT) - Partial Thromboplastin Time (PTT) - Fibrinogen (Fib) - D-Dimer

What does Sodium citrate do to prevent clotting

A chelating agent that binds to calcium

How long are blue tops good for?

4 hours after collection

What liquid or powder anticoagulant is used in green tops

Heparin

What is heparin used for?

Plasma studies and Chemistry testing: - Ammonia - Adrenocorticotropic hormone (ACTH)

How does Heparin prevent clotting?

Inhibits the clotting enzyme, thrombin, by creating antithrombin - Antithrombin prevents conversion of prothrombin to thrombin

What are red tops used for and what do they contain

- No anticoagulating factors Used for: - Chemistry - Serology - Other test requiring serum

What are Serum separator tube (SST)/Gold tops, tiger top, HIV tube (red/yellow) testing for and what do they have for anticoagulants

Does not contain any anticoagulation Primarily for chemistry testing

Where are sodium fluoride found in what tube and what do they test for

- Grey top tube | - Used for glucose studies, ETOH level analysis, and Inhibits glycolysis

Contraindications for leaving a tourniquet for prolonged situations

Produce measurable increase blood cell concentration (hemoconcentration)

What is the fill additive-containing tubes Order

Blood Culture tubes, Blue top, red top, SST, green top, lavender top, and gray top

What is the normal WBC count range

4.5-11.0 x 10^3/mm^3

What are the critical values for WBC count

Low: <2000/mm^3 High: >30,000/mm^3

Neutrophils percentage in the blood

50-70% most abundant

Eosinophils in the blood percentage

1-5%

Basophils percentage in the blood

0-1%

Lymphocytes percentage in the blood

20-40% second most abundant

What are the granulocytes

Neutrophils Eosinophils Basophils

What are the agranulocytes

Lymphocytes | Monocytes

Monocytes percentage in the blood

1-6%

Normal range for Male and Female RBC

Male: 4.5-5.9 x 10^6 cells/uL Females: 4.5-5.1 x 10^6 cells/uL

What is the Mean Corpuscular Volume. What does it mean when there is an increase of MCV and a decrease of MCV

An estimate of the average volume size of RBC Increase: Vitamin B12 or folate deficiency Decrease: Hgb Synthesis

What is Mean Corpuscular Hemoglobin. What happens if there is a increase and decrease

Amount of Hemoglobin per RBC Increase: Vitamin B12 or folate deficiency Decrease: Iron Deficiency

What is the Mean Corpuscular Hemoglobin Concentration (MCHC). What is the normal range and the calculations for it

Average Concentration of hemoglobin in a given volume of packed red blood cells Normal: 30-35 g/dl Equation: MCHC= Hgb/Hct x100

What is the main component of the red blood cell and is a protein that helps transport oxygen and carbon dioxide

Hemoglobin

Normal range for male and female and the critical value of RBC

Males: 14-17.5 g/dL Females: 12.3-15.3 g/dL Critical Value (Low): <8 g/dL

What is the ratio of the volume of erythrocytes to that of the whole blood and is 3 times the Hgb

Hematocrit

Normal range of Hematocrit for Males and Femals

Male: 42-52% Females: 37-47%

Normal range for Platelet count and the Critical value

150,000-400,000 /mm^3 Low: <20,000 /mm^3; Risk of hemorrhage or spontaneous bleeding considered life threatening High: >1,000,000 /mm^3; Risk of Thrombosis

What is low WBC and high WBC count and the causes for both

Low: Leukopenia; Bone marrow deficiency or failures, Collagen-vascular disease and Chemo High: Leukocytosis; Sever Emotional or physical stress, Trauma, intense exercise

What is used to describe malignant appearing cells and what causes this?

Atypical Lymphocytes Infectious mononucleosis

What is eosinophilia

An increase of eosinophils is typical in parasitic infections and allergic disorders

Hct value below the reference interval of age and sex

Anemia

Hct value above the reference interval of age and sex

Polycythemia

What is hypochromasia

Seen in iron deficiency anemia and in thalassemia

What color does Granulocytes appear in a QBC star tube

Orange

What color does Lymphocytes/monocytes appear in a QBC star stain

Green

What color does platelets stain in a QBC star

Yellow

What is used to clean a QBC star

10% household bleach and allow to stand 10 min, then rinse with water and dry