BANK OF QUESTIONS | LABOARATORY SPECIMEN COLLECTION AND TRANSPORTATION | MLT NTA LEVEL 5

Questions:

• What is the purpose of the tourniquet?

• What are 3 common containers used for blood collection?

• List the requirements for common containers used for urine, sputum, stool and seminal fluid.

Answers:

The tourniquet increases venous pressure to allow for palpation of the vein.

3 common containers used in blood collection are plain tube (no anticoagulant), EDTA tube and sodium citrate tube.

Universal sterilised bottles are used for collection routine urine culture. Plastic waxed container with wide mouth is used for collection of sputum (For AFB or culture). Empty, clean, screw-top (universal) container is used for collection of seminal fluid (fertility testing) and empty plastic clean waxed container with a spoon like applicator is used for stool specimen collection.

Questions:

• What specific sites on an infant heel should be avoided in capillary blood collection?

• Why are those sites avoided?

• What guidelines should be followed in dried blood spot collection on filter paper?

Answers:

Only the lateral sides of the heel and the posterior portion are punctured to avoid damage to the bone and cartilage in the posterior portion.

Blood from heel prick should fully fill the circles of the DBS filter paper and soak through to the back.

Questions:

• When gloves should not be worn? Why are safety glasses sometimes worn?

Answers:

Gloves should not be worn for paperwork such as writing reports, when handling the telephone or opening doors or when leaving the lab area.

Safety glasses are not required to be worn at all times but when splashes in the eyes are expected.

Questions:

• What is the maximum time a tourniquet should be on a client’s arm?

• What needle gauge is commonly used for blood collection in adults?

Answers:

The maximum time a tourniquet should be in place is 1 minute.

The most common needle gauge used for adults is 21g.

Questions:

• What are key safety practices needed for proper collection of venous blood?

Answers:

Lab coats, gloves and close toe shoes are required when collecting blood specimens.

The collector should have clean hands before putting on gloves and remove gloves and wash hands at the end of the procedure.

The gloves and cotton wool should be disposed in a biohazard container and the needle should be scooped to cap and disposed in the sharps container.

Safety for the patient includes cleaning the site with 70% alcohol before puncture, using cotton wool to apply pressure after and re-examining to make sure puncture site is no longer oozing blood.

Questions:

• What is key safety practices needed for handling aspirate specimens?

Answers:

Lab coats, gloves and close toe shoes are required when handling aspirate specimens. The processor should follow the specimen rejection criteria and provide a clean, screw capped container for the specimen to be placed in if it is delivered in a syringe.

Questions:

• Explain why balancing a centrifuge is an important safety measure.

Answers:

An unbalanced centrifuge can cause the sample tubes to break, could cause the lid to open and create aerosols, can harm the centrifuge and can even cause the centrifuge to fall off the bench and harm others due to the force created At the centrifuge.

Questions:

• What tubes should be collected for Rh tube testing, hepatitis and syphilis testing if ordered on the same patient?

• What tubes should be collected for glucose and full blood count?

• 3. What are some strategies to reduce the pain to patients due to blood collection?

Answers:

For Rh, hepatitis and syphilis testing, 1 plain tube (first) followed by EDTA purple cap tube.

For glucose and FBC, 1 plain tube (first) followed by EDTA purple cap tube.

Pain can be reduced by proper position of the arm and needle insertion, treating the patient with care and respect.

Questions:

• What is the reaction of whole blood when placed in a plain tube compared to the reaction of whole blood when placed in an EDTA tube and mixed well?

Answers:

whole blood when placed in a plain tube will allow clotting to occur and serum will be the resulting liquid portion. Serum does not contain clotting factors.

Whole blood when placed in an EDTA tube and mixed well prevents clotting so plasma is the resulting liquid portion which contains clotting factors but calcium has been chelated out. The blood cells from EDTA whole blood or clotted blood may both be used to type Rh and ABO blood groups.

Questions:

• What is the purpose of the tourniquet?

• What are 3 common containers used for blood collection?

• List the requirements for common containers used for urine, sputum, stool and seminal fluid.

• What are MSDS?

Answers:

The tourniquet increases venous pressure to allow for palpation of the vein.

3 common containers used in blood collection are plain tube (no anticoagulant), EDTA tube and sodium citrate tube.

Questions:

• Can Rh test be performed on EDTA plasma or serum? Explain your answer.

Answers:

no Rh antigen is found on red blood cells so needs to be tested on clotted or EDTA cells but not plasma or serum.

Questions:

• What is hepatitis?

• What is the organism that causes syphilis?

Answers:

Hepatitis is a general term for inflammation of the liver. Most commonly hepatitis is caused by a virus such as HepA or HepB and HepC virus.

The rapid hepatitis test is designed to detect antibodies to Hepatitis A, B or C which may indicate current or recent infection from the virus.

Answers:

Treponema pallidum is the organism that causes syphilis, a veneral disease.

The screening rapid tests for syphilis are historically designed to measure antibody to reagin, a substance that is similar to the antigenic makeup of T. pallidum. New methods measure IgA, M or G antibody specific to T. pallidum.

Questions:

• What measures can be taken during blood collection to prevent or minimize hemolysis?

Answers:

use good technique including the right size needle, good placement of the needle in the vein and not shaking the tube.

Questions:

• What is the time requirement for separating serum from cells when measuring glucose and electrolytes in serum specimens?

Answers:

Ideally serum should be separated immediately from cells or within 1 hour of collection for glucose and electrolyte testing.

Questions:

• What are advantages and challenges of electronic labelling (barcode)?

Answers:

Advantages are that they can be easier to read than hand-written labels, they can contain more information such as addresses and hospital registration number within the barcodes and they may be read by optical readers on instruments. Challenges are that they are expensive, not always available and must be placed on the tube in a certain direction in order to be read by an optical reader

Questions:

· Compare the label requirements of blood specimen containers versus non-routine specimen containers. How do the specimen container labels differ for non-routine specimens when compared to blood specimen labels?

Answers:

Non-routine specimen labels must include the type of specimen and the anatomical source and are not required to have the collector (clinician ) initials on the label while blood does need the initials of the collector and generally does not list the site of blood collection.

Questions:

· Listed are the required information for the non-routine specimen label.

Answers:

Client complete name,

Laboratory Registration number

Date of collection

Time of collection (local time using 24 hour clock)

Type of specimen including site

Questions:

· When the liver becomes diseased it may swell. What is the term for swelling of the liver?

Answers:

Megalo means “large” so it is called hepatomegaly.

Questions:

How long should be allowed for DBS filter papers to dry?

Answers:

It takes at least 3 hours for DBS to dry before they can be packaged

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BANK OF QUESTIONS | LABOARATORY SPECIMEN COLLECTION AND TRANSPORTATION | MLT NTA LEVEL 5