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Laboratory Science for Non-Laboratory Personnel. Presented by: Michelle Draper, MBA, MT(ASCP) Bellarmine University. Personnel in the Laboratory. Directors, Managers, Supervisors Clinical Laboratory Scientists (Med Techs) Bachelors degree plus!, Bench Scientists

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laboratory science for non laboratory personnel

Laboratory Science for Non-Laboratory Personnel

Presented by:

Michelle Draper, MBA, MT(ASCP)

Bellarmine University

personnel in the laboratory
Personnel in the Laboratory
  • Directors, Managers, Supervisors
  • Clinical Laboratory Scientists (Med Techs)

Bachelors degree plus!, Bench Scientists

  • Clinical Laboratory Technicians (MLT’s)

Associate degree, Bench Scientists,

Limited complexity testing

  • Phlebotomists

No degree required, certification preferred,

Most trained OTJ

types of specimens
Types of Specimens
  • Whole Blood
  • Plasma
  • Serum
  • Stool
  • Urine
  • Body Fluids
  • Sputum
  • Cultures…to name a few
whole blood
Whole Blood
  • Represents blood as it circulates through the body
  • Contains erythrocytes, leukocytes, and platelets
  • Sodium EDTA
  • Uses: CBC, Blood Bank, Flow cytometry, BNP, Hemoglobin A1c
plasma
Plasma
  • One type of liquid portion of the blood
  • HAS NOT CLOTTED!
  • Sodium citrate
  • Contains fibrinogen, and clotting factors
  • Uses: PT, APTT, Fibrinogen, Dimer
plasma1
Plasma
  • Liquid portion of the blood
  • Sodium or lithium heparin
  • Has not clotted!
  • Uses: Rapid chemistry ie, glucose, electrolytes
serum
Serum
  • Tube has been allowed to clot before centrifugation
  • No clotting factors or fibrinogen present
  • Liquid portion of the blood
  • Contains proteins, enzymes, organic and inorganic chemicals and antibodies
  • Uses: Chemistry, Therapeutic drug levels, Immunology, Blood Bank
  • Has no additive
serum1
Serum
  • Same analytes as before
  • Gel: activates clot and acts as a barrier
  • Popular for ease of use
  • Not suitable for TDMs
  • Not recommended for Transfusion testing
why is this important
Why is this important?

“The quality of any test result is only as goodas the specimen that

is tested!”

slide10

We can monitor testing personnel through competency testing…We can monitor instruments and procedures by means of calibrations and controls…BUT, we can’t monitor specimen collection very well!!

specimen criteria
Specimen Criteria
  • Specimens must be drawn in the correct

tube and they must be filled to the proper

level

  • Timely delivery to laboratory is critical
  • Anticoagulant additives can contaminate subsequent tubes
  • Some additives change the shape or size of the cells
  • Additives can give falsely elevated results
specimen labeling
Specimen Labeling
  • Proper specimen labeling is essential
  • Correct patient identification:
  • Two forms of identification is best….birthdate, medical record number, full name
  • Patient preparation…fasted, dose time, medications, transfusion status
  • Time of collection
  • Collector’s identification
specimen problems
Specimen Problems
  • Clotted specimens collected with anticoagulant
  • Hemolyzed specimens
  • Lipemic specimens
  • Icteric specimens
  • IV fluid contamination in specimens…Never collect above an IV line!
non blood specimens
Non-Blood Specimens
  • Must always be properly labeled
  • Must be collected in a sterile container
  • Volume of collection is critical to the test
  • Transport to lab must be timely
  • If held, storage requirements must be met
what do the results mean
What do the results mean?
  • Complete Blood Count (CBC)
urinalysis
Urinalysis
  • Recommended volume is 12 mls
  • Specimen is tested with a dipstick for:
  • Glucose, Ketones, Blood, pH, Bilirubin, Urobilinogen, Leukocytes, Protein
  • Specimen is centrifuged and sediment is examined with microscope to report cells, and other structures: crystals, casts, bacteria, yeast, parasites and more!
  • Color and appearance (clear, hazy, cloudy, bloody)
cultures
Cultures
  • Plated on differential and selective media to grow the organisms present
  • Gram stain is done except on urine and stool (too much normal flora present)
  • Organisms determined to be pathogenic are tested for sensitivity to antibiotic drugs
  • Cultures take from 2 – 30 days or more
  • Fungal and viral cultures are kept the longest