LESSON 3: SPECIMEN HANDLING AND PROCESSING Flashcards
All steps taken before the actual testing
➢ Specimen handling, processing, and blood
collection are part of this phase. Patient
identification, preparation of materials.
Pre-analytical phase (Pre-examination)
This is the actual testing phase. All procedures belonging to measurement methods belong to this phase
Analytical phase (Examination)
Processes after the test performance such as
reporting of results, interpolation of results,
recording of results, relaying of results to
physician. Everything done after test
performance.
Post-analytical phase (Post-examination)
Factors that alter test results that are introduced into the specimen before testing, including before and during collection, and during transport, processing, and storage.
Pre-analytical errors
PRE-ANALYTICAL VARIABLES
○ Physiologic
○ Lifestyle (smoking, diet, exercise, alcohol intake)
○ Drug administration
Controllable
PRE-ANALYTICAL VARIABLES
Non-controllable includes:
Biological Influences
Environmental factors
Long term cylindrical changes
Underlying Medical conditions
high altitude could affect the
Oxygen level
Heat expands the plasma volume and could cause significant decrease on
plasma protein
Factors affecting the variation of results
Patient Preparation
Affects skeletal muscle enzymes
Exercise
If you exercised before collection, your
_____________ may be increased falsely
aldolase and creatine kinase
Basal state collection means blood is collected
early in the morning before rising
Glucose requires _______ hours of fasting
6 - 8 hrs
lipid profile (triglyceride, total cholesterol, HDL, LDL) requires ______ fasting
10-12 hours maximum of 14.
If both glucose and lipid profile is need, required fasting is __________
8-12 hrs
serotonin-rich banana and tomato increases
production of
5-HIAA, a metabolite of serotonin
Sudden position change could result to
Hemoconcentration and Hemodilution
Also known as circadian rhythm
Physiologic Variation
Highest in the morning
Potassium
Renin
Iron
Calcium
Insulin
Aldosterone
Highest at night
Growth hormone
Testosterone
TSH
Prolactin
Vigorous mixing may result in
Hemolysis
How to transfer different type of specimen
■ Blood specimens
plastic bag with biohazard
logo, liquid tight closure, slip pocket for
paperwork
How to transfer different type of specimen
■ Non-Blood specimens
Leak proof containers
How to transfer different type of specimen
■ Pneumatic tube system
protected from shock,
sealed in zipper type plastic bag
Blood samples are allowed to clot within
20-30 minutes
Arrived within the laboratory within _____ minutes of collection
45 minutes
Once arrived in the lab, separate serum to cell within _____of collection
1 hour, OSHA recommended maximum time is 2 hours.
Temperatures related to specimen handling
○ Body temperature : 36.4°C - 37.6°C
○ Room temperature : 15°C - 30°C
○ Refrigerated temperature : 2°C - 10°C
○ Frozen temperature : -20°C or lower
Examples of tests that require chilling of specimen
Gastrin
Ammonia
Lactic Acid
Catecholamines
Pyruvate
PSH(Parathyroid Hormone)
To chill specimens, you can use
Ice packs or crushed ice in water
In case of needing freezing temperature, you can use
Solid CO2 and nitrogen gas
anaerobic conditions, such as in
Blood gas analysis (BGA), Ionized/ non-ionized calcium
Examples of tests that require transport of specimens at 37°C
Cold agglutinins
Cryofibrinogen
Cryoglubulins
Tests that requiring protection from light
Billirubin
All Vitamin Levels
Beta carotene
Porphyrins
Folate
Set centrifuge at
850 - 1000 gravitation force for 10 - 15 mins 1000 - 3000 RCF for 10 minutes
Removal of stopper may result
Loss of CO2 and Increases pH
Repeated centrifugation results to
Hemolysis and Analytes deterioration
Complete clotting :
30-60 minutes at room temperature
Clotting time of other tubes
SST and tubes with clot activators = 20 -
30 minutes
➢ Thrombin tubes = 5 minutes
➢ Anticoagulant medication = longer time to
clot
Incomplete clotting result to
Fibrin formation
Reasons for rapid separation of blood (after
centrifugation)
○ To prevent glycolysis
○ To prevent lipolysis
○ Certain substances are very unstable
○ To prevent shift of electrolytes
○ To prevent hemolysis
The tests that require plasma specimens are the
Prothrombin time and activated partial thromboplastin time (uses citrate tube)
Aliquot?
The portion of specimen that is used for testing
When transferring, used
disposable transfer pipettes
(Pasteur pipette)
TRUE OR FALSE:
● Yellowish discoloration is not really a reason for rejection. It could be due to increased bilirubin levels due to a
condition.
True
TRUE OR FALSE:
if serum is turbid / milky could be due to high
triglyceride level. If the patient fasted properly, then serum is still accepted
True
