3 Types of Specimens Whole Blood Plasma Serum Stool Urine Body Fluids SputumCultures…to name a few
4 Whole Blood Represents blood as it circulates through the body Contains erythrocytes, leukocytes, and plateletsSodium EDTAUses: CBC, Blood Bank, Flow cytometry, BNP, Hemoglobin A1c
5 Plasma One type of liquid portion of the blood HAS NOT CLOTTED! Sodium citrateContains fibrinogen, and clotting factorsUses: 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 presentLiquid portion of the bloodContains proteins, enzymes, organic and inorganic chemicals and antibodiesUses: Chemistry, Therapeutic drug levels, Immunology, Blood BankHas no additive
8 Serum Same analytes as before Gel: activates clot and acts as a barrierPopular for ease of useNot suitable for TDMsNot 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 thatis 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 properlevelTimely delivery to laboratory is criticalAnticoagulant additives can contaminate subsequent tubesSome additives change the shape or size of the cellsAdditives 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 namePatient preparation…fasted, dose time, medications, transfusion statusTime of collectionCollector’s identification
13 Specimen Problems Clotted specimens collected with anticoagulant Hemolyzed specimensLipemic specimensIcteric specimensIV 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 containerVolume of collection is critical to the testTransport to lab must be timelyIf held, storage requirements must be met
15 What do the results mean? WBCWhite blood cell countRBCRed blood cell countHGBHemoglobinHCTHematocritMCVMean cell volume-cell sizeMCHMean cell colorMCHCMean cell hemoglobin concentrationPLTPlatelet countRDWRed cell population variationComplete Blood Count (CBC)
18 Prothrombin Test Activated Partial Thromboplastin Time PTMeasured in secondsHow long to clotMonitors oral anticoagulantsINRRatioCompares therapies and instrumentationPTTMonitors IV anticoagulants
19 Urinalysis Recommended volume is 12 mls Specimen is tested with a dipstick for:Glucose, Ketones, Blood, pH, Bilirubin, Urobilinogen, Leukocytes, ProteinSpecimen 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 CulturesPlated on differential and selective media to grow the organisms presentGram stain is done except on urine and stool (too much normal flora present)Organisms determined to be pathogenic are tested for sensitivity to antibiotic drugsCultures take from 2 – 30 days or moreFungal and viral cultures are kept the longest