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 TimePT
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