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Laboratory Science for Non-Laboratory Personnel

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Presentation on theme: "Laboratory Science for Non-Laboratory Personnel"— Presentation transcript:

1 Laboratory Science for Non-Laboratory Personnel
Presented by: Michelle Draper, MBA, MT(ASCP) Bellarmine University

2 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

3 Types of Specimens Whole Blood Plasma Serum Stool Urine Body Fluids
Sputum Cultures…to name a few

4 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

5 Plasma One type of liquid portion of the blood HAS NOT CLOTTED!
Sodium citrate Contains fibrinogen, and clotting factors Uses: PT, APTT, Fibrinogen, Dimer

6 Plasma Liquid portion of the blood Sodium or lithium heparin
Has not clotted! Uses: Rapid chemistry ie, glucose, electrolytes

7 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

8 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

9 “The quality of any test result is only as good as the specimen that
Why is this important? “The quality of any test result is only as good as the specimen that is tested!”

10 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!!

11 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

12 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

13 Specimen Problems Clotted specimens collected with anticoagulant
Hemolyzed specimens Lipemic specimens Icteric specimens IV fluid contamination in specimens…Never collect above an IV line!

14 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

15 What do the results mean?
WBC White blood cell count RBC Red blood cell count HGB Hemoglobin HCT Hematocrit MCV Mean cell volume-cell size MCH Mean cell color MCHC Mean cell hemoglobin concentration PLT Platelet count RDW Red cell population variation Complete Blood Count (CBC)

16 Basic Metabolic Panel GLU Glucose (sugar) Pancreas/insulin NA Sodium
Hydration/Electrolytes K Potassium Heart/Muscle/Hydration/Electrolytes CL Chloride CO2 Carbon Dioxide Oxygen level/Electrolytes BUN Urea Nitrogen Kidney CREA Creatinine CA Calcium General Health AGAP Anion Gap Electrolyte Balance

17 Comprehensive Metabolic Panel
ALB Albumin Protein-Immune System ALKP Alkaline Phosphatase Liver ALT Alanine Amino Transferase AST Aspartate Amino Transferase TBIL Total Bilirubin TP Total Protein Immune System

18 Prothrombin Test Activated Partial Thromboplastin Time
PT Measured in seconds How long to clot Monitors oral anticoagulants INR Ratio Compares therapies and instrumentation PTT Monitors IV anticoagulants

19 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)

20 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

21 Questions

22 Blood Cell Morphology

23 Urine Microscopics

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