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Manual Ofbasic Techniques for a Health Laboratory

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Manual Ofbasic Techniques for a Health Laboratory MANUAL OF BASIC TECHNIQUES FOR A HEAL MANUAL OF BASIC TECHNIQUES This manual provides a practical guide to the safe and accurate perfor- mance of basic laboratory techniques. Intended for use by laboratory technicians working in peripheral-level laboratories in developing coun- M A N U A L tries, the book emphasizes simple, economical procedures that can yield accurate results where resources, including equipment, are scarce and the climate is hot and humid. O F B A S I C The book is divided into three parts. The first describes the setting-up of a peripheral health laboratory and general laboratory procedures, including use of a microscope and laboratory balances, centrifugation, TECHNIQUES measurement and dispensing of liquids, and cleaning, disinfection and sterilization of laboratory equipment. Methods of disposal of labora- tory waste, dispatch of specimens to reference laboratories and labora- tory safety are also discussed. The second part describes techniques for the examination of different specimens for helminths, protozoa, bacte- ria and fungi. Techniques for the preparation, fixation and staining of smears are also discussed. The third and final part describes the examination of urine, cerebrospinal fluid and blood, including tech- TH LABORA niques based on immunological and serological principles. For each technique, a list of materials and reagents is given, followed by a detailed description of the method and the results of microscopic FOR A HEALTH examination. – TORY Numerous illustrations are used throughout the book to clarify the LABORATORY different steps involved. A summary of the reagents required for the 2nd edition various techniques and their preparation is provided in the annex. 2 n d e d i t i o n ISBN 92-4-154530-5 World Health Organization 9 789241 545303 WHO Geneva Selected WHO publications of related interest Basic laboratory methods in medical parasitology. 1991 (122 pages) Basic laboratory methods in clinical bacteriology. 1991 (128 pages) Laboratory diagnosis of sexually transmitted diseases. Van Dyck E, Meheus AZ, Piot P. 1999 (146 pages) Maintenance and repair of laboratory, diagnostic imaging, and hospital equipment. 1994 (164 pages) Safe management of wastes from health-care activities. Prüss A, Giroult E, Rushbrook P, eds. 1999 (244 pages) Safety in health-care laboratories. (document WHO/LAB/97.1) 1997 (157 pages) The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s Laboratory biosafety manual, 2nd ed. constitutional functions is to provide objective and reliable information and advice in the field of human 1993 (133 pages) health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies and address the most pressing public health concerns of populations around the world. To respond to the needs of Member States Basics of quality assurance for intermediate at all levels of development, WHO publishes practical manuals, handbooks and training material for specific and peripheral laboratories, 2nd ed. categories of health workers; internationally applicable guidelines and standards; reviews and analyses of health policies, programmes and research; and state-of-the-art consensus reports that offer technical advice El-Nageh MM et al. and recommendations for decision-makers. These books are closely tied to the Organization’s priority WHO Regional Publications, Eastern Mediterranean Series, No. 2 activities, encompassing disease prevention and control, the development of equitable health systems based on primary health care, and health promotion for individuals and communities. Progress towards 2002 (256 pages) better health for all also demands the global dissemination and exchange of information that draws on the knowledge and experience of all WHO’s Member countries and the collaboration of world leaders in public health and the biomedical sciences. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures the broad international distribution of its publications and encourages their translation and Further information on these and other WHO publications can be obtained from adaptation. By helping to promote and protect health and prevent and control disease throughout the Marketing and Dissemination, World Health Organization, world, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health. 1211 Geneva 27, Switzerland. Contents i Manual of basic techniques for a health laboratory Second edition World Health Organization Geneva 2003 ii Manual of basic techniques for a health laboratory WHO Library Cataloguing-in-Publication Data Manual of basic techniques for a health laboratory. — 2nd ed. 1.Clinical laboratory techniques — handbooks 2.Technology, Medical — handbooks 3.Manuals ISBN 92 4 154530 5 (NLM classification: QY 25) © World Health Organization 2003 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 2476; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to repro- duce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar na- ture that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. Design by minimum graphics Typeset in Hong Kong Printed in Malta 99/12670 — SNPBest-set/Interprint — 15000 Contents iii Contents Preface x 1. Introduction 1 1.1 Aim of the manual 1 1.2 Reagents and equipment 1 1.2.1 Reagents 1 1.2.2 Equipment 1 1.3 The responsibility of laboratory workers 2 1.4 Units of measurement 2 1.4.1 Quantities and units in the clinical laboratory 2 1.4.2 SI units and names for quantities 2 PART I 9 2. Setting up a peripheral health laboratory 11 2.1 Plan of a peripheral medical laboratory 11 2.1.1 A one-room laboratory 11 2.1.2 A two-room laboratory 12 2.2 Electricity 12 2.2.1 Sources of electricity 13 2.2.2 Setting up simple electrical equipment 15 2.2.3 What to do in case of failure of electrical equipment 17 2.3 Plumbing: simple procedures 20 2.3.1 Tools and materials 20 2.3.2 Taps 20 2.3.3 Sink traps 22 2.4 Water for laboratory use 23 2.4.1 Clean water 24 2.4.2 Distilled water 24 2.4.3 Demineralized water 27 2.4.4 Buffered water 29 2.5 Equipment 32 2.5.1 Essential laboratory instruments 32 2.5.2 Additional items 33 2.5.3 Equipment and supplies 33 2.5.4 Making glass equipment 33 2.5.5 Specimen containers 42 2.5.6 Storage, stocktaking and ordering supplies 45 2.6 Registration of specimens and preparation of monthly reports 46 2.6.1 Registration of specimens 46 iii iv Manual of basic techniques for a health laboratory 2.6.2 Preparation of monthly reports 47 3. General laboratory procedures 53 3.1 Use of a microscope 53 3.1.1 Components of a microscope 53 3.1.2 Setting up the microscope 58 3.1.3 Focusing the objective 61 3.1.4 Use of an ocular micrometer 63 3.1.5 Dark-field microscopy 64 3.1.6 Routine maintenance 64 3.2 Weighing: use of laboratory balances 66 3.2.1 Sensitivity of a balance 67 3.2.2 Open two-pan balance 67 3.2.3 Analytical balance 68 3.2.4 Dispensary balance 69 3.3 Centrifugation 69 3.3.1 Principle 69 3.3.2 Types of centrifuge 70 3.3.3 Instructions for use 71 3.4 Measurement and dispensing of liquids 73 3.4.1 Pipettes 73 3.4.2 Volumetric flasks 75 3.4.3 Burettes 77 3.4.4 Graduated conical glasses 77 3.5 Cleaning, disinfection and sterilization 77 3.5.1 Cleaning glassware and reusable syringes and needles 77 3.5.2 Cleaning non-disposable specimen containers 81 3.5.3 Cleaning and maintenance of other laboratory equipment 83 3.5.4 Disinfectants 83 3.5.5 Sterilization 85 3.6 Disposal of laboratory waste 90 3.6.1 Disposal of specimens and contaminated material 90 3.6.2 Incineration of disposable materials 90 3.6.3 Burial of disposable materials 91 3.7 Dispatch of specimens to a reference laboratory 91 3.7.1 Packing specimens for dispatch 91 3.7.2 Fixation and dispatch of biopsy specimens for histopathological examination 95 3.8 Safety in the laboratory 96 3.8.1 Precautions to prevent accidents 97 3.8.2 First aid in laboratory accidents 98 3.9 Quality assurance in the laboratory 101 3.9.1 Specimen collection 102 PART II 103 4.
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