SPECIMEN COLLECTION

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 Specimen collection equipment and laboratory ware

materials
·         Evacuated  tubes
·         Needle Holder
·         Needles
·         Syringes
·         Tourniquet
·         Cotton Wool
·         70% alcohol
·         Marker pens
·         PPE for blood collection: gloves, laboratory coat, close toe shoes
·         Sharps container
·         Waste container

Functions of specimen collection equipment and laboratory ware

·         Evacuated  tubes : Is used for drawing blood.  The tube is evacuated of air (vacuum) creating a negative pressure to allow blood to flow in.
o   Tubes may be glass or plastic
o   Anticoagulant types and uses
§  Ethylenediaminetetraacetic acid in a tripotassium or disodium base
·         (Purple): prevents clotting by binding calcium 
·         Used in Haematology or FBC and CD4
§  Sodium Citrate (Light Blue): prevents clotting by binding the calcium.  Used for coagulation workup (PT and APTT)
·         Ratio of 1 part anticoagulant to 9 parts blood is critical for quality speicmen and quality test result
·         Must be filled with exact amount of blood – NOT UNDERFILLED or OVERFILLED
§  Plain  tube  contains no anticoagulant (red top) is used for Clinical Chemistry Testing
o   Preservatives and other additives
§  Clot activator:
·         initiate or enhance coagulation.  Activator can be thrombin, glass  or silica particles
§  Gel Separator:
·         forms a barrier between the cells and the serum portion after the blood has been centrifuged to protect serum from cells
·         Gel Separator can be Used for Chemistry Testing
·         Needle Holder or Barrel (sometimes called the Bulldog)
o   A plastic tube like device
o   Feet extensions:
§  Used for placement and removal of the evacuated tube
o   Many different kinds of holders:
§  Retract the needle
§  Draw the needle into the barrel
·         Needles : Is used for drawing blood.
o   Sterile, Disposal and for Single use only
o   Color coded for size or gauge
o   Hollow stainless steel shafts
o   Bevel or slant at the end
§  Bevel must face up
o   Shaft:
§  Cylindrical portion, length ranges from .65 to 3.80 cm
o   Hub:
§  Attaches the needle to the holder
o   Gauge:
§  The size of the needle, refers to the diameter of the needle
§  Routine for adults : 21 gauge
§  Children: 23 gauge
§  The larger the number the smaller the needle
o   Multi-sample Needles
§  Used for multiple samples during a single venipuncture
§  Composed of a double pointed needle
§  The hub screws into the needle holder
§  Open with a twist motion



Syringes; Can be used for drawing blood in difficult veins. Evacuated tubes are preferred over a syringe because it is a closed system, the amount of anticoagulant is consistent and prepared by a manufacturer and more blood can be drawn in multiple tubes.

·          
·         glass slides: Is used to hold smears or blood films (specimen for examination)
·         Tourniquet:  to increase venous pressure at site to allow vein to be punctured
·         Cotton wool: apply disinfectant and to close the oozing site
·         Alcohol: 70% Alcohol is used to remove bacteria from the skin.
·         marker pens; For labelling purposes
·         PPE for routine blood collection; gloves, laboratory coat, close toe shoes
Ø  For protecting Health providers from contamination
Ø  Prevent transferring of Infection from one place to another
Ø  Reduces the overall cost in Health care by preventing injuries and illness in the working place.

The steps for use of specimen collection equipment and laboratory ware
·         Prepare the tray for specimens with complete set of equipment and laboratory ware
o   Tutor will demonstrate what a blood collection tray should contain
·         Make sure the equipment and laboratory ware are in good order such that no damage on them
o   Tutor will demonstrate how to check that equipment is not damaged.
§  Needles should be in unopened package and needle should appear smooth
§  Tourniquet should not be cracked or contaminated
§  Evacuated tube should be not be expired with undamaged cap
§  Cotton wool should appear clean and not soaking in spirits
§  Gloves should be clean and not contain rips or holes
§  Fresh pair of gloves should be used for each patient
·         Arrange the equipments and laboratory ware for procedure
o   Use blood collection checklist to make certain that equipment can be arranged in order of use.
·         Choose the equipment and laboratory ware for a specific specimen collection
Ask Students in Groups to discuss:  What type of anticoagulant tube is used for full blood count?  What type for coagulation tests?  What type for electrolytes?  What type for serological tests?
o   Match the anticoagulant type with the test requested.  Eg. EDTA for FBC, Na citrate for PT and APTT, plain red top for serum electrolytes,  Serological tests
·         Make sure the reusable equipment and laboratory ware are clean and sterile.
·         Make sure the equipment and laboratory ware for specimen collection procedure are of the standard quality according to SOP

Demonstration on Application of specimen collection equipment and laboratory ware
The tutor will demonstrate how to use the evacuated tubes, multi-sample needle and holder to collect blood samples using the venous blood collection checklist. Note, this may be done in classroom setting and so blood will not actually be collected.  A practical session will be held later to practice collection of blood.
Specimen collection equipment for drawing blood , aspirating fluids.  What containers are used for different types of specimens?
  • Evacuated blood tubes (Vacutainer ® tubes) Used for collection of blood samples.
  • Vacutainer® holder –component of Vacutainer ® system where the needle is connected and also support the vacutainer tube.


The tutor will show the following collection containers to the students and refer to the patient instruction for self-collecting urine, sputum, seminal fluid and stool specimens.
  • Universal sterilised bottles-for collection routine urine culture
  • Plastic waxed container with wide Mouth –For collection of sputum (For AFB or culture).
  • Empty, clean, screw-top (universal) container – For collection of seminal fluid (fertility testing)
·         Empty plastic clean waxed container with a spoon like applicator-for Stool specimen collection
The tutor will show the following collection containers and equipment to the students and refer to the procedure for physicians or nurses to collect donated blood, sterile swabs, CSF, aspirated fluids.
  • Sterile swab –for high vaginal swab 
  • Blood transfusion set – if blood donor bottles are used; set is incorporated in blood bag
·         Lumber puncture set- for cerebral spinal fluid collection (not collected by laboratory technicians)
·         Transport media-for transport of swabs to preserve micro-organisms, eg. Stuart (R) media

·         Syringes, infusion sets & needles  -for collection of aspirate fluids and blood

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