Assisting in the clinical laboratory
Analyte
the substance or chemical being analyzed or detected in a specimen.
aligout
a portion of well mixed sample removed for testing.
Anticoagulant
chemicals added to a blood sample to prevent clotting.
Caustic
Capable of burning, corroding or damaging tissue by chemical action
Cytology
The study of cells using microscopic methods
Diluent
a liquid used to dilute a specimen or reagent
Exudates
fluids with concentration of protein and cellular debris that have escaped from the blood
Centrifuges
device that separates liquids from solids.
Hemolyzed
used to describe a blood sample in which the red blood vessels have erupted
Preservatives
substance added to a specimen to prevent deterioration of cells or chemicals
specimen
sample of blood fluid, waste or tissue collected.
Lab
a place in which a collected specimen is analysed and evaluated
Referral lab
private or hospitalized based lab that performs a variety of tests
Abnormal tests valies
--> Change in hemostasis
A complete blood cell count for a healthy adult.
the RBC's (red blood cells) Number 5 million per cubic millimeter (5x10^6/m^3), the Hemoglobin value is 15 grams per deciliter (15g/dL) , and the hematocrit is 45%
FDA
U.S. Food and drug administration
CLIA
regulatory categories based on their potential risk to the public health:
Waived tests include
- Waived tests, moderate complexity tests and high complexity tests.
- lab exams and procedures approved by the FDA for home use*
CDC
Centers for disease control and prevention*
labs must meet CLIA regulations
are subject to unannounced inspections Every 2 YEARS
Urinalysis include
Physical, chemical and microscopic examination of Urine
Hematology -
may be Qualitative or Quantitative.
Blood cell count Determine the Exact number of RBC's (red blood cells) or Erythrocytes,
White blood cells (WBC's or Leukocytes) or Platelets (Thrombocytes) either by manual or automated counting
Qualitative test determine
- the Characteristics of Cells such as size, shape and maturity
Quantitative
Has numeric results
Dipstick or tablet urinalisys
urine screening
- diabetes
- kidney disease
- UTI
Chemistry analyzes
blood, cerebrospinal fluid (CSF), urine, and joint fluid (Synovial fluid)
Microbiology
involves the study of bacteria, fungi, yeast, parasites, and viruses.
Safety standards for labs are initiated, regulated and reviewed by several agencies or committees. They include-
the US. Department of Labors Occupational Safety and Health Administration (OSHA) The Clinical and laboratory standards Institute (CLIS);
Physical Hazards:
.
can be classified as electrical, fire, and mechanical hazards
Open flames:
are rarely used in a lab but potential for fire still exists. Flammable material should not be stored near any source of ignition. Fires may be ignited by smoking, heating elements, and sparks. Fire blankets should NOT BE WRAPPED AROUND SOMEONE. PAT OUT THE FLAMES.
Mechanical hazards:
- arise from the use of lab equipment centrifuges,
- devices that separate liquids from solids,
- present a hazard not only from moving parts but also from glassware that might break during centrifugation and
- from aerosis that might be created if the tubes are not capped tightly,
- Pressurized types of equipment, such as autoclaves used in sterilization, present a danger if opened prematurely.
Chemical Hazards:
- the clinical lab is home to chemicals that are flammable,
- CAUSTIC, (capable of burning, corroding, or damaging tissue by chemical action),
- poisonous, carcinogenic, and or teratogenic. exposure can occur through inhalation,
- direct absorption through skin,
- ingestion entry through a mucous membrane, or entry through a break in the skin.
MSDS
Material safety data sheet
Material safety data sheet
- Includes the trade name,
- chemical name and synonyms,
- chemical family,
- manufacturer's name and address, emergency telephone number,
- hazardous ingredients,
- physical data,
- fire and explosion data, and
- health hazard and protection information.
Hazard identification system:
- developed by the national fire protection association that provides information at a glance on the potential health,
- flammability, and chemical reactivity hazards of material,
- consists of four small colored,
- diamond shaped symbols grouped into a larger diamond shape.
Left blue
indicates hazards to heath
Top-red:
indicates flammability
Bottom-White:
provides special hazard information, including radioactivity, special bio-hazards, and other dangerous situations
Right-yellow
indicates a reactivity or stability hazard.
The system indicates the severity of the hazard by using numbers imprinted in the diamonds from 0 - 4
with 0 representing no hazard and 4 representing an extremely hazardous substance.
STANDARD PRECAUTIONS
the hepatitis B (HBV) hepatitis C virus
(HCV) and human immunodeficiency Virus (HIV) are constant threats to
the health and safety of clinical lab personnel. They are transmitted
through exposure to blood and body fluids
OSHA mandated the blood born pathogens (BBP) standard which covers all employees who could be "reasonably anticipated as the result of performing their job duties to face contact with blood and other potentially infectious materials"
Hand washing is
the most effective way of preventing the spread of all infections.
wash Hands
- When you enter and before you leave an area.
- before and after every patient procedure.
- after contact with body fluid, even if gloves were worn.
- before and after eating.
- before and after using the restroom.
SPECIMEN LABELS SHOULD INCLUDE
- patients full name
- the date and time of collection
- the type of specimen
Information typically required when specimens are sent to a reference lab includes:
- Physicians name, account number, address and phone number.
- patients full name, surname first; age date of birth and gender;
- address and insurance information.
- source of specimen.
- date and time of collection.
- specific test (or tests) requested.
- medications the patient is taking.
- possible diagnosis.
- indication of whether test is to be performed stat.
MEASUREMENTS: Basic units of the metric system are
Grams (g) for weight
Meter (m) for length
Liter (L) for
volume
prefixes are added to each symbol to reduce or enlarge
them by units of ten.
most common metric units used in the labs are:
millimeters (mm)
centimeters (cm)
micrograms (mcg)
Milligrams (mg)
grams (g)
microliters (mcL)
milliliters (mL)
Liters(L)
Cubic centimeters (cc)
System internationale (SI)
is a system of reporting numbers that has been recognized by international organizations such as the world health organization (WHO)
Beakers -
wide straight - sided cylindrical vessels that are used for mixing or reagent prep can be used for mixing or reagent prep can be used for estimating volume. not calibrated.
Erlenmeyer flasks -
are used for reagent prep and have a narrower mouth than a beaker. not calibrated.
Test tubes -
come many sizes and are typically disposable. may be sterile and some may be calibrated.
Graduated Cylinders -
used for measuring exact amounts of a liquid the size of the cylinder should be matched as closely as possible to the volume of the liquid being measured to obtain the most accurate reading.
Volumetric Glassware, Including flasks and pipets
must go through rigorous calibration to ensure the accuracy of the measurement. They are calibrated to single specific amounts such as 100mL or 500mL and cannot be used to measure volumes other than those indicated.
Pipets -
cylindrical calibrated tubes used to deliver or transfer specified volumes of liquid.
Volumetric pipet -
used for transferring
Graduated pipet -
used for measuring
used for measuring
Microscope
Binocular - 2 eye pieces
Monocular - 1 eye piece
Usual
magnification is 10 times (10x)
Shortest objective
has the lowest power (4x) and is called the scanning lens. used to scan the field of interest and then focus on a particular object.
The next (second) longest has
low power (10x) used to observe greater detail
The high or high dry objective (longest objective)
usually has a magnification of 40x or 45x\the longest objective, oil immersion 100x allows for the finest focusing of the object and requires the use of a special oil that is placed directly on the slide.
Immersion oil -
prevents refraction of light and improves the resolution of the magnified image.
Centrifuge
( looks like a crockpot) - used when solids must be separated from liquids,
INCUBATOR -
cabinets that maintain constant temperatures. (35c - 37c (FOR THIS * means DEGREE))
AUTOCLAVE -
an instrument to use steam under pressure to sterilize materials that can withstand high temperatures.
Condenser -
Directs light up through the stage
Quantity assurance -
(QA) is the pledge of healthcare professionals to work to achieve the highest degree of excellence in the health care given every patient.
Chain of Custody
When specimens needed as evidence in court cases, certain procedures must be followed for collecting and handling the specimen. Forensic or medicolegal implications require that any results of the testing of a specimen be obtained in such a fashion that they are recognized by a court of law.
Specimen processing must be documented meticulously, ensuring that no tampering with the evidence has occurred. Chain of custody refers to
the stepwise method used to collect, process, and test a specimen. documentation must be signed by every person who has contact with the specimen, from the collection to final reporting of results, Blood alcohol level testing and drug screening often require chain of custody handling. Everything needed for collection of the specimen is provided in a kit--even the gloves, vacuum tube, and the needle to collect the blood specimen. Documentation is included and must be signed by all personnel, Medical assistants and phlebotomists have been subpoenaed to testify in court about specimens they have collected therefore, it is in your best interest to follow chain of custody procedures rigorously.
Greenwich time
10:30 pm / 5:55 Am / USE OF AM OR PM
Military Conversion Times.
1 PM - 1300 2PM - 1400 Ranges from Midnight 0000 (zero hundred) to 1200 (Twelve hundered hours(noon)) to 23:59.
PM: add 12 to time
AM: 1-9 = 0100 - 0900
10-12= 1000-1200
Freezing temp
32*F
0*C
Room Temp
59-86* F
15-30* C
Autoclave temp
254* F
121* C
Contact Who for out of date drugs?
Sales manufacturer
Urine pregnancy tests
pregnancy test
Urine chemistry analyzer for microalbuin 7 creaitine
kidney disease
Ovulation test
detection of ovulation
fecal acult blood
colorectal sceening to detect hidden blood in the stool
erythrocyte sedimentation rate
diagnosis of inflammatory process; > in pressure of arthritis, infection, leukemia, & mast cancers
...
hemoglobin-copper sulfate, nonautomated
measurement
of hemoglobin levels
HemoCue Hemoglobin system
measurement of hemoglobin levels in whole blood
blood glucose by glucose monitoring devices cleared by he FDA
monitoring blood glucose leves
HemoCure B
measurement of glucose levels in whole blood
Blood mononucleous antibodies
rapid, qualitative test to detect antibodies to help diagnose infectious mononucleous
Streptococcus A thoat swab
Qualitative rapid strep test
Urine & Blood
substance abuse
Nasal Influenza A & B
quick qualitative diagnosis of influenza antigenins in nasal secreations or swab
Stat-Crit hematacit
screening for certain types of anemi
Spun microhematacit
measurement of blood count, sceening for certain types of anemia
Borrelia burgdarferi antibodies
rapid whole-blood test to detect H. pylori antibodies to determine the cause of a peptic ulcer
Explain how dilutins are prepared
dilutions are prepared by mixing volumes of sample, such as blood, body fluids or regents and volumes of diluent, such as water, saline solution or buffer.