1. Module 8: Blood Collection and Handling Dried Blood Spot
2005
Methodologies and Regulations in Specimen Collection and Management
Module 8: Blood Collection and Handling Dried Blood Spot
Module 14: Blood Collection and Handling (DBS)

2. What Is a Dried Blood Spot (DBS)?
2005
Whole blood collected on filter paper and dried
Made directly from the client’s whole blood
Used for re-testing at a reference laboratory
Testing site results are compared to reference laboratory results
This is part of External Quality Assurance
Module 14: Blood Collection and Handling (DBS)

3. EQA Re-testing
2005
Specimens collected for EQA could be dried blood spots (DBS) or serum/plasma
EQA is a process by which specimens:
Are randomly selected from the routine workload at a test site
Are sent to the reference laboratory for validation of results
Module 14: Blood Collection and Handling (DBS)

4. Learning Objectives At the end of this module, you will be able to:
2005
At the end of this module, you will be able to:
Collect dried blood spots (DBS)
Package and store DBS in a way to maintain specimen integrity
Maintain DBS records
Distinguish between valid and invalid DBS
Module 14: Blood Collection and Handling (DBS)

5. Content Overview Required supplies How to collect and dry DBS
2005
Required supplies
How to collect and dry DBS
How to package and store DBS
Valid and invalid DBS
Hands-on practice
Module 14: Blood Collection and Handling (DBS)

6. What Are Your Responsibilities?
2005
Collect valid specimens
Label and store appropriately until transported for re-testing
Ensure records are properly maintained
Avoid transcription errors
A test result is only as good as the specimen collected
Module 14: Blood Collection and Handling (DBS)

7. EQA Specimen Transfer Log
2005
Example Specimen Transfer Log for Re-Testing
[Insert Name of Referring Testing Site, Contact Name, Address, and Phone Number]
Date:__________________
Referring Testing Site:_______________________________
Specimen Tracking
Number
Test Subject
ID*
Final Result (Test Site)
Date Specimen Collected
Specimen Type (DBS or Serum)
Collected by
Referral Lab Req+ Completed
Date to Referral
Lab
Date
Confirmed Result Received
Result Of
Re-Test
*ID = Identification
+ Lab Req = Laboratory Requisition
Module 14: Blood Collection and Handling (DBS)

8. Required Supplies for DBS
2005
Blood collection card (filter paper)
Glycine weighing paper
Sealable plastic bags
Humidity cards
Desiccant packs
Module 14: Blood Collection and Handling (DBS)

9. How to Collect DBS Use Standard Safety Precautions
2005
Use Standard Safety Precautions
Clearly label card with appropriate identification number
Follow finger prick procedure
Uniformly saturate entire circle
Two complete circles
are better than five
incomplete ones!!
Module 14: Blood Collection and Handling (DBS)

10. How to Dry DBS Avoid touching or smearing the blood spots
2005
Avoid touching or smearing the blood spots
Allow the specimen to fully air dry horizontally (at least 3 hours) at room temperature
Keep away from direct sunlight
Do not heat, stack or allow DBS to touch other surfaces during the drying process
Module 14: Blood Collection and Handling (DBS)

11. Dry Completely Before Packaging
2005
Dry Completely Before Packaging
Module 14: Blood Collection and Handling (DBS)

12. How to Package DBS for Storage
2005
How to Package DBS for Storage
Appropriately stack DBS
Insert into sealable plastic bag
Add desiccant packets
Add humidity cards
Label contents of bag and seal
Module 14: Blood Collection and Handling (DBS)

13. Place filter paper between sheets of weighing paper
2005
1. Stacking DBS
Fold Weigh ends of weighing paper
Place filter paper between sheets of weighing paper
Module 14: Blood Collection and Handling (DBS)

14. 2. Insert Into Sealable Plastic Bag
2005
Module 14: Blood Collection and Handling (DBS)

15. 2005
3. Add Desiccant Packets
Module 14: Blood Collection and Handling (DBS)

16. 4. Add Humidity Cards and Seal Bag
2005
Module 14: Blood Collection and Handling (DBS)

17. 5. Label Outside of Plastic Bag with Contents
2005
Module 14: Blood Collection and Handling (DBS)

18. How to Store DBS
2005
Keep packaged DBS (in sealable plastic bags) cool and dry until transported to reference laboratory
Avoid leaving in vehicle, as sun and heat will deteriorate DBS
Module 14: Blood Collection and Handling (DBS)

19. How to Package DBS for Shipping
2005
How to Package DBS for Shipping
Insert bundled DBS into rip-resistant envelope
Include appropriate documentation
Insert both into brown envelop and seal for shipment
Module 14: Blood Collection and Handling (DBS)

20. EQA Specimen Transfer Log
2005
EQA Specimen Transfer Log
Example Specimen Transfer Log for Re-Testing
[Insert Name of Referring Testing Site, Contact Name, Address, and Phone Number]
Date:__________________
Referring Testing Site:_______________________________
Specimen Tracking
Number
Test Subject
ID*
Final Result (Test Site)
Date Specimen Collected
Specimen Type (DBS or Serum)
Collected by
Referral Lab Req+ Completed
Date to Referral
Lab
Date
Confirmed Result Received
Result Of
Re-Test
*ID = Identification
+ Lab Req = Laboratory Requisition
Module 14: Blood Collection and Handling (DBS)

21. Valid DBS Specimen
2005
Module 14: Blood Collection and Handling (DBS)

22. Valid DBS Specimen
2005
Module 14: Blood Collection and Handling (DBS)

23. Invalid DBS Specimen Specimen quantity insufficient for testing 2005
Module 14: Blood Collection and Handling (DBS)

24. Specimen appears scratched or abraded
Invalid DBS Specimen
2005
Specimen appears scratched or abraded
Module 14: Blood Collection and Handling (DBS)

25. Specimen not dried sufficiently
Invalid DBS Specimen
2005
Specimen not dried sufficiently
Module 14: Blood Collection and Handling (DBS)

26. Specimen appears clotted or layered
Invalid DBS Specimen
2005
Specimen appears clotted or layered
Module 14: Blood Collection and Handling (DBS)

27. Specimen appears hemolyzed, discolored, or contaminated
Invalid DBS Specimen
2005
Specimen appears hemolyzed, discolored, or contaminated
Module 14: Blood Collection and Handling (DBS)

28. Specimen exhibits serum rings
Invalid DBS Specimen
2005
Specimen exhibits serum rings
Module 14: Blood Collection and Handling (DBS)

29. Invalid DBS Specimen No Specimen 2005
Module 14: Blood Collection and Handling (DBS)

30. DBS Collection: Demonstration
2005
Procedures
Fingerprick steps 1-7
Apply pressure
Allow a large drop of free-flowing blood to collect
Quickly and gently touch the card with blood
Let blood soak through
Repeat until at least 2 circles are filled
Fingerprick steps 9-10
Tips
Do not press the filter paper against the puncture site.
Apply blood to only one side of the filter paper.
Do not apply blood more than once in the same collection circle.
Do not “milk” the finger.
Module 14: Blood Collection and Handling (DBS)

31. DBS Collection: Hands-on Practice
2005
Purpose
To practice collecting DBS from another person
Total Time
30 Minutes
Process
Work in Groups of two
Take turns practicing collecting DBS from your partner’s finger
Module 14: Blood Collection and Handling (DBS)

32. Exercise: Valid vs. Invalid DBS
2005
Objective: To distinguish between valid and invalid DBS specimens
Process: Examine the specimens collected from hands-on practice and determine whether each is valid or not.
Total time: 3 minutes
Module 14: Blood Collection and Handling (DBS)

33. Summary Describe the procedures for:
2005
Describe the procedures for:
Collecting DBS
Drying DBS
Packaging DBS for storage
Storing DBS
Packaging DBS for shipping
Describe the criteria for valid DBS samples.
What may have caused a DBS sample to be invalid?
Module 14: Blood Collection and Handling (DBS)