Overview Of Laboratory Management Flashcards
What is chemical pathology
Clinical Pathology is the branch of pathology that deals with the biochemical analysis of biological specimens for assessment of disorders.
Some safety procedures in the laboratory
*Every clinical laboratory must have a formal safety program.
•There must be a safe workplace for all the employees of the lab.
•Location of available fire-fighting equipment and how to use it and where the evacuation routes are.
•The laboratory environment meets accepted safety standards.
•Proper labelling of chemicals, hoods that are in good working order, proper handling and disposal of biohazadous materials and specimens.
•Eye washers or face washers should be available in every chemistry laboratory.
•- A chemical fume hood is a necessity for every clinical chemistry lab (CCL)
•Items to be checked for the lab are;
•SOP- Standard Operating Procedures.
•Criteria used to determine and and implement control measures
•Chemical labelling and storage
•Hazardous waste
•Education and training of employees
Biochemical Hazards
Burns, fire, explosions, toxic fumes.
•D- Hazards from volatiles
•Compressed gass
•Electrical Hazards- Potential for shock or fire hazard wherever there are electrical wires or connections
•Fire Hazards
•Biological hazards- Needle puncture (accidental)
•HIV, HBV. - Material on bench tops or floor
• - Centrifuge accidents
• - Cuts from contaminated vessels
How to avoid biochemical hazards
Mouth pipetting not allowed
•Barrier protection- gloves, masks, protective eye wear and gowns must be used when drawing blood from a patient and when handling patient specimen.
•Wash hands whenever gloves are changed
•Dispose all sharps appropriately
•Wear protective clothing
•Try to prevent accidental injuries
•Your hand away from your mouth, nose, eyes, and any mucous membranes
•Minimize spills and spatters
Types of biological specimens
Blood
•: Urine
•:Stool
•: Saliva
•:Acidic fluid
•: Pleural fluid
•:CSF
•:Synovial fluid
Patient preparation
Identification of patients-
•Request forms - name, hosp .no,diagnosis, Date of birth, sex, type of specimen to be collected.
•- Consider some - cyclic biological variables.
•- patient related physical variables
Procedures: Depends on types of samples to be collected
•1.Blood collection:
•May be venous, arterial for blood gasses estimation or capillary
•Venous is generally needed
Specimen bottles
plain or with anti coagulants
• - Heparin - anti prothrombin and anti thrombin
•- Ethylene Diamine Tetra Acetic acid (seguestrene) chelate calcium
•- Oxalates - chelate calcium
•- Fluoride: ( commonly the sodium salt)
•Fluoride inhibits enolase in the glycolytic cycle and prevent the red cells from using up the glucose in the solution while the specimen in waiting for analysis.
•In plain bottles - the clot retracts and serum is separated.
• Serum does not contain fibrinogen and the other clotting factors.
What is Phlebotomy?
The act of removing blood from a patient using a needle
How to collect blood for blood gases
Heparinized glass or plastic syringe- Glass is preferred to plastic. Glass is inert and impermeable to gases while plastic is permeable. PO2 value increases by 1 to 9mm Hg after 45mins. most of the changes occuring in the first 20 minutes.
•Pco2 change are insignificant in the first 30 minutes if stored in ice. In general, changes are minimised by transporting the specimen in ice until analysed.
•Heparin concentration should be kept low because high concentrations will the PH, HCO3, base excess and calcium.
•Glass activates the coagulation factors & platelets more rapidly than plastic does, glass therefore requires more Heparin.
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Collection of saliva
May be used as alternative to blood in neonates or infants
•Analysis of hormones & drugs;
•Free cortisol, progesterone, oestradiol, 17 - OH- progesterone, testosterone
•Drugs: pcm, caffeine, diazepam, ethanol, theophylline & digoxin.
•Describe the procedures for conclusion
•If specimen is viscous, freeze to eliminate froth & denature mucin.
•Thaw 4 centrifuge
•Do not brush teeth at least within 3hrs before collection. suck with syringe
Collection of blood
Anterial blood- scalp, umbilical, femoral, medial, brachial anteries are used.
•Venous
•Or
•Capillary blood
•If transportation is delayed;
•Glycolysis in the red blood cells:
proceduce lactic acid
shift PH, Hco3 and base excess to range of metabolic acidosis.
•O2 consumption in platelets & leucocytes causes a fall in PO2 in sample Hences samples should be transported promptly in ice water slush & NOT ice cubes
Collection of feaces
Collection of faeces
•occult or frank blood . qualitative
•faecal fat - quantitative
•3 days collection
Collection of urine
First morning urine
•- Random
•- Fasting
• - 24-hr specimen ( 10% thymol in propanol to preserve the urine)
•-MSU
•-Post prandial
•Causes of variability in lab results
