Specialized Laboratory Collections.Fm

Specialized Laboratory Collections

Blood Bank specimen in Ziploc® portion of biobag. All Blood Bank specimens must have accurate patient identification. All specimens drawn are given a label with patient’s full name, date of birth, and medical record number or Social Security number. This label is usually computer generated. The individual drawing the specimen will verify patient demographics after patient is accurately identified from patient identification band, initial the label, and document the time specimen is drawn. This is our method of indicating positive identification of the patient with 3 unique identifiers.

Blood for crossmatching will not be drawn by phlebotomist if patient does not have a wrist band with their name and medical record number, or if there is any discrepancy between band and request label.

Specific transfusion requirements for blood components:

• Date of surgery • Type of surgery • Indication for transfusion

Exceptions:

• In emergency situations, when a wrist band is not available, the phlebotomist will put a red Blood Bank identification wrist band on the patient. The band will be on all Blood Bank records for the next 3 days. Do not remove this identification band. If it is removed, blood cannot be transfused to the patient, the specimen will have to be redrawn, and laboratory work will have to be repeated causing delays which may impede patient care.

Cytology Body Fluids:

• Fresh body fluids are the specimen of choice. Some specimens can be sent to the laboratory in original container in which they were collected (pleural, thoracentesis, etc.) Others, should be put in a clean, dry container. DO NOT add any type of fixative to container. DO NOT ADD FORMALIN. • Label container with patient’s full name, date of birth or medical record number, date and time of collection, type of specimen, and physician. Place • Complete a Laboratory Request Form and attach Place specimen in Ziploc® portion of biobag. it to the outside of Ziploc® portion of biobag. • Complete a Laboratory Request Form and Deliver immediately to laboratory. attach it to outside of Ziploc® portion of • . biobag. Deliver to laboratory.

Conventional Method: Gastric and Esophageal Brushings:

• Smears are made from material collected from • Please call the Laboratory at 207 283 7187 for various regions (vaginal, endocervical, and specific instructions. endometrial smears). Proper specimen collection, preparation, and careful labeling are essential to Gastric Specimens: enhance the accuracy of evaluation of smear. • Write patient’s full name and date of birth on • Due to the digestive properties of the specimen, frosted end of a clean, glass slide with pencil. these should be submitted only Monday through • Smear material collected evenly over clean, glass Friday (8 a.m. to 4:30 p.m.). slide. Spray slide immediately with a spray fixative. DO NOT let smear dry before spraying. Gynecological Material: • When spray is dry, place slide(s) in a • Southern Maine Medical Center’s primary test cardboard or plastic holder. method is the ThinPrep® which requires special • Label slide holder with patient’s full name, date collection materials. Please refer to #TRAP of birth or medical record number, date and time “Cytology, Endocervical” in the alphabetical test of collection, type of specimen, and physician. listing. Fine Needle Aspiration of Cystic Lesions of the Pancreas: • Collect the sputum in a clean, dry container. DO NOT add formalin to the container. • Fine needle aspirates of cystic lesions of the pancrease • Label container with patient’s full name, date of birth or require special handling, therefore, please contact 1 of medical record number, date and time of collection, type the pathologists prior to the procedure. In case you are of specimen, and physician. Place specimen in Ziploc® not able to reach the pathologist, do the following: portion of biobag. — Aspirate the specimen in a syringe or syringes, • Complete a Laboratory Request Form and attach it to remove the needle, cap the syringe and hand the outside of Ziploc® portion of biobag. Deliver deliver it to cytology with the request for CEA, immediately to laboratory. amylase, mucin, and cytology. Do not add any fixative (formalin, CytoLyt, or alcohol), EDTA, or heparin to the specimen. Tests for CEA will be Urine: referred to Mayo Medical Laboratories and the remainder of the testing will be performed • Urine collected for cytology should be sent in the fresh inhouse. If you have any questions please call 207- state. First morning specimens are acceptable for 283- cytologic examination. Twenty-four hour urine 7187.. specimens are not acceptable for cytology. • Label container with patient’s full name, date of birth or Products of Conception: medical record number, date and time of collection, type of specimen, and physician. Place specimen in Ziploc® • Any specimen or material collected in the emergency portion of biobag. room, delivery room, or operating room for products of • Complete a Laboratory Request Form and attach it to conception, D & C, etc., are sent to pathology routinely the outside of Ziploc® portion of biobag. with formalin added. . • Label specimen with patient’s full name, date of birth or • Results are usually available within 1 to 2 days. medical record number, date and time of collection, type of specimen, and physician. Histology Spinal Fluid: Surgical Specimens:

• Spinal fluid for cytology studies must be sent to the • Deterioration produces loss of cellular detail which is laboratory immediately. Spinal fluid should be in a needed for accurate diagnosis. This takes place through separate tube labeled for cytology. DO NOT add any the following: formalin to the tube. —Drying • Label tube with patient’s full name, date of birth or — Chemical decomposition medical record number, date and time of collection, type — Thermal injury of specimen, and physician. Place specimen in Ziploc® — Decomposition is speeded up by heat and slowed portion of biobag. by cold • Complete a Laboratory Request Form and attach it to • Proper specimen labeling and identification are the outside of Ziploc® portion of biobag. Deliver imperative for processing. immediately to laboratory. • Pertinent clinical data must be provided by attending

physician to provide a complete and accurate diagnosis. • Results are usually available within 1 day.

Sputum:

• Sputum should reach the laboratory within 1 hour of expectoration. An early-morning specimen produced by deep coughing is the best material. Specimen Collection: • Call the Pathology Laboratory and tell the secretary the case, name of surgeon • Ten percent formalin is provided by the Histology requesting the frozen section, and OR room Laboratory. Please do not use anything other than 10% number. unless otherwise advised by physician or special • The pathologist will write his/her findings on procedure. the form and give to the surgeon. The signed — S u rg i cal tissue and b i opsy col l ecti o n : copy will be placed in the patient’s chart. The • Specimen is placed in container with 10% tissue will be sent to the Histology formalin immediately unless the surgeon Laboratory for permanent sections. requests otherwise. — Urinary tract calculi (kidney, bladder, and ureteral • Formalin should be used by 5 times the sto n es) - Chemical analysis of urinary tract stones volume of the specimen. is helpful in determining future management of the • Use appropriate size container. There are 4 patient. Different stone types respond differently to sizes to choose from. These may be obtained dietary and drug treatment so knowing the through the laboratory. chemical composition may be clinically relevant. Place the calculi in a dry container. Cover • Multiple specimens from 1 procedure must • tightly. DO NOT ADD FORMALIN. be put in separate containers and labeled Label container with patient’s full name, date appropriately. Only 1 Histology Request • of birth or medical record number, date and Form needs to accompany all specimens. time of collection, stone type if known, and • Proper labeling is essential. Please label physician. Place specimen in Ziploc® portion container directly with patient’s full name, of biobag. date of birth or medical record number, date • Complete a Histology Request Form and and time of procedure, source, and physician. attach it to outside of Ziploc® portion of Pertinent insurance information is also biobag or put into outside pocket. Send to the required. Histology Laboratory. • Histology Request Form must be filled out — F ore i gn b o dies (frag m ent o f g l ass, meta l , sp l inters, completely. etc.) - The surgeon makes the decision to send • All specimens must be biobagged. These are foreign bodies to the Pathology Laboratory. provided by the laboratory. Please make sure • Place the foreign body in a dry container. It container is tightly sealed. Do not put request is not necessary to add 10% formalin; form together with specimen. Either tape the however, formalin is acceptable. requisition to outside of bag and place • Label container with patient’s full name, date specimen inside or put it in outside of birth or medical record number, date and compartment of bag. time of collection, type of foreign body, and • If more than 1 specimen is obtained, ordering physician. Place specimen in complete Ziploc® portion of biobag. only 1 Histology Request Form listing each • Complete a Histology Request Form and specimen on the form. Identify each attach it to the outside of Ziploc® portion of specimen on specimen container. If possible, biobag. Send to Histology Laboratory. place all specimens from 1 case into 1 — Bo n e m arrow - The specimen requirement is a Ziploc® portion of biobag. bone marrow aspirate in an EDTA tube, a biopsy — Frozen Sections - All frozen sections should be in scheduled with Pathology at extension 6-7182. A 10% formalin, a minimum of 4 smears, and 2 pathologist is on call at all times to cover in the peripheral blood smears. event of an unscheduled frozen section. • All specimens delivered to the laboratory • Place tissue for frozen section on a moistened must be labeled with patient’s full name, date saline towel and give to pathologist. Have all of birth or medical record number, date and necessary paperwork with the specimen. DO time of collection, and site of aspiration/ NOT put specimen in fixative of any kind. biopsy (left or right iliac). It must be received in the laboratory within 1 hour of aspiration. • A Histology Request Form must accompany • Whenever possible, specimens should be obtained prior the bone marrow specimen. A Complete to the administration of antibiotics. Blood Count (CBC) must be (or have been) • Specimen source is required on specimen container and run within 24 hours. request form for processing. • Specimens may be submitted at any time, but • DO NOT USE EXPIRED TUBES OR MEDIUM the test is set up Monday through Friday and results are usually available within 3 days. FOR SPECIMEN COLLECTION. — Cy t olo g y s p eci m en c o llec t ion - The purpose in the • Specimens should be properly labeled with patient’s collection of cytology specimens is to facilitate the full name, date of birth or medical record number, processing, diagnosis, and accuracy of the location of patient, date and time of collection, and detection of tumor cells in fluids. source. Refer to individual test listings in “Alphabetical • For conventional Pap smears, only fixed Test Listing” for proper transport media. slides will be accepted. The patient’s name must be written on all slides submitted. Laboratory Instructions for Sputum Collection: • Fill out a Laboratory Request Form for each cytology specimen that is sent to the • Instruct patient to obtain material from a deep cough, laboratory. The laboratory cannot accept any which is expectorated into a sterile container. The specimen without a request form. volume of specimen need not be large (3 mL). The • Label cytology container with patient’s full specimen should be brought to the laboratory as soon as name, date of birth or medical record possible. A Gram stain is performed on all sputum number, date and time of collection, type of cultures. Induced specimens on transtracheal aspirates specimen, and physician. Place specimen in are recommended for adult patients who can not Ziploc® portion of biobag. produce sputum. Antibiotic sensitivities will be • If the cytology specimen is fluid (ie, urine or sputum), refrigerate after collection. DO performed on pathogens isolated. NOT ADD ANY FIXATIVE. • Be sure that the cap is securely sealed on container once specimen is collected. A leaky container is a biohazard. • All cytology specimens delivered to the laboratory between 4:30 p.m. and 7 a.m., Stool Culture: Monday through Friday, weekends, and holidays, are to be left in the Clinical • Collect specimen in Cary-Blair media Laboratory refrigerator. A laboratory technologist should be notified. The Stool Specimen Collection for Ova and Parasites: Pathology Department will be closed during this time. • Random collection - A random stool specimen collected every other day for a total of 3 specimens is Microbiology recommended for an accurate examination for intestinal Following are some general guidelines for collection, labeling, parasites. Specimens should be mixed thoroughly in a and transport of routine microbiology specimens: preservative according to instructions on the outside of the special container (EcoFix™ kit). General Consideration for Collection and Transport: Stool Specimen Collection for Clostridium difficile: • Sterile containers must be used for all cultures. • Specimens should be transported to Southern Maine • Collect specimen in a screw-capped, sterile container Medical Center (SMMC) as soon as possible. without transport media. • Collection containers should be closed securely and precautions taken to prevent leakage of specimen during transport. These specimens are to be considered biohazardous and must be biobagged with paperwork put in the secondary pocket.