(M) Lesson 9: Direct Sputum Smear Microscopy Flashcards
Test to see whether there are TB bacilli present in the phlegm
Direct Sputum Smear Microscopy (DSSM)
- To test this, the MedTech will smear phlegm on a thin glass slide with a special stain and look for TB bacilli on the slide under the microscope
- This usually takes 1 day to get the results
DSSM
- Main tool for the diagnosis of Pulmonary TB
- It provides a definitive diagnosis of active TB
- Active TB means it spreads/multiplies inside the body
DSSM
- Simple and economical procedure
- Usually easy to set up (All you need is a skilled microscopist, compound microscope and materials for sputum smear)
DSSM
- Is an infectious disease caused by Mycobacterium tuberculosis
- It is an illness in which the bacteria are multiplying, attacking a part of the body (usually the lungs)
TB Disease
- TB disease that occurs in lungs
- If a patient is infected, it produces cough that lasts 3 weeks or longer
Pulmonary TB
- A condition which TB bacteria are alive but inactive in the body
- Patient with latent TB do not have symptoms and cannot spread TB to other people
- Usually have a positive TB skin test
Latent TB Infection
- TB disease in any part of the body other than the lungs
- Example: Kidney, Spine, Brain, or Lymph Nodes
Extra-Pulmonary TB
- Liquid that is injected under the skin during TB skin test to diagnose latent TB infection.
- PPD stands for Purified Protein Derivative
Tuberculin or PPD
- Directly observed therapy
- You will meet the health worker everyday for several weeks in the health center
DOT
- Good Ventilation
- Table/bench to prepare smears
- A sink or plastic basin to stain smears
- Table/bench for Microscope and paper works
- Non-slip flooring
- Area for receiving of specimens
Basic requirements for TB Microscopy Laboratory
Zone Divisions in TB Laboratory
For microscopy, record keeping and storage areas
Clean Zone
Zone Divisions in TB Laboratory
Specimen receiving, and smear preparation and staining are performed
Dirty Zone
- Moving in a single direction
- You may open your windows or fan for proper ventilation, but the airflow should still be unidirectional
- Clean to dirty areas
Unidirectional airflow
Potential Hazards
- Coughing is a good mechanism for producing aerosols through droplet nuclei.
- Provide a designated area for sputum collection.
Sneezing or Coughing by TB patients
T or F: Patients are allowed to collect sputum in the bathroom.
F (not allowed)
Potential Hazards
- It still produces aerosol
- Flaming a wire loop with adherent sputum
- Heat fixing the smear while still wet
Potential Hazards
- One of the most common potential hazard (in the whole laboratory)
- Wear PPEs in handling specimen
Poor handling of specimen
Potential Hazards
- Ensure proper storage of reagent and use small containers
Fire from flammable reagent
Familiarize yourself with the safety practices in TB laboratory.
- Assume ALL specimens are potentially infectious
- Never smoke, eat or drink in the laboratory
- Wash hands with soap and water at least before and after performing any procedure
- Keep the windows open to establish airflow in working areas
- Quantities of flammable reagents should be safe, cool and in well-ventilated storage place
- Formation of aerosols must be avoided as strictly as possible
T or F: We should reject broken or leaking containers.
Teh, edi T
____ is a potential hazard to the laboratory personnel
Leaking containers
Once collected, allow the sputum specimen to stand undisturbed for ____ before opening to settle any aerosol.
at least 20 minutes
Open sputum containers with care and away from the face to prevent ____.
Splashes