Laboratory Investigation

Laboratory investigation
Microbiology Swabs eye, nose, throat, umbilical, ear, wound, rectal, urethral
and vaginal) CSF (3 samples. First for culture, second for biochemistry and
the thered for cell count)
Parasitology urine and stool)
Biochemistry (All chemistry in plane tube or heparins)
Hormones (All in plane tube or gel separating tube)
Hematology (EDTA Blood for CBC and Citrated Blood for Coagulation
Blood bank (ask for donor replacement for any bags used to the patient)
(plane tube for crox matching and blood grouping)
Histopathology (complete identification & clinical details)
Technique
Venous stasis (tourniquet application) should always be minimised.
Cell counts, and the levels of proteins (including enzymes) and protein bound
substances (eg. calcium, cholesterol, many drugs) will be increased by
prolonged excessive venous stasis.
Venepuncture should be clean and atraumatic.
If difficulty is experienced, the attempt should be abandoned.
A second venepuncture (preferably by a more experienced collector) should

be attempted with a new needle and syringe, or evacuated container, at a
different site
Blood must be added to the tubes immediately but gently and without
frothing.
If a syringe with needle is used, the needle must be removed before adding
blood to the specimen tubes.
If tubes containing anticoagulant are used, the correct amount of blood must
be added to the tube (usually indicated by a mark on the label) and mixed
immediately by thorough, but gentle, inversion.
Tubes should never be shaken and blood should never be poured from one
container to another.
Blood culture specimens should, if possible, be collected from a separate

venepuncture site. If a single venepuncture is necessary, the blood culture
bottles must be inoculated first.
The needle should then be removed for addition of blood to the remaining
specimen tubes.
Specimen tubes should be labelled immediately after the specimen is

collected
Safety
All blood samples must be treated as potential infection risks.
Care should be taken to avoid over-filling of tubes which is likely to be

associated with leakage of blood and contamination of the external surface of
the container.
Needles must be disposed of with care into a 'sharps' container.
Syringes, swabs, or any other blood contaminated materials must be placed

in an appropriate contaminated waste container immediately after use.
Evacuated collection systems are now frequently used for blood collection as
there is less chance of blood spillage and thus exposure to blood-borne
diseases
Specimen transport
Blood samples should be transported to the laboratory in biohazard bags with

minimum delay.
Rapid transport samples eg: PTH & glucose
If delay is inevitable it is generally better to refrigerate samples.
However refrigeration may itself cause artefactual changes in the results.
Samples which need ice and anaerobic condition eg: Arterial blood gases and
ammonia)
Electrolytes
Blood for electrolytes should not be refrigerated; if delay is anticipated,
plasma should be separated and stored at 4C.
Unseparated samples of blood must never be frozen.
Samples should not be subject to temperatures of >25C, even for short

periods.
Some tests involve especially labile components (eg, complement) and blood
must be transported to the laboratory immediately
Microbiological examination
Specimens for microbiological examination must be appropriate eg, sputum

rather than saliva.
In general, specimens should be collected into, and transported in, a sterile

container.
Aspirated pus may be transported in a syringe, which must be capped

immediately the needle has been removed and disposed of safely.
Specimens should be delivered promptly to the laboratory.
Although many specimens will tolerate a delay of several hours if

refrigerated, cerebrospinal fluid must be transported to the laboratory
immediately, without refrigeration.
Similarly, for the detection of Neisseria gonorrhoeae and other fragile

organisms, special arrangements may be needed: eg, express delivery,
inoculation of plates at the time and place of collection, provision of special
transport containers.
Special requirements, for individual tests, are noted in the Test listing
Type of urine specimens

Laboratory Investigation

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Laboratory investigation

Parasitology urine and stool)

Biochemistry (All chemistry in plane tube or heparins)

Hormones (All in plane tube or gel separating tube)

Histopathology (complete identification & clinical details)

Venous stasis (tourniquet application) should always be minimised.

Venepuncture should be clean and atraumatic.

If difficulty is experienced, the attempt should be abandoned.

A second venepuncture (preferably by a more experienced collector) should

Blood culture specimens should, if possible, be collected from a separate

Specimen tubes should be labelled immediately after the specimen is

All blood samples must be treated as potential infection risks.

Care should be taken to avoid over-filling of tubes which is likely to be

Needles must be disposed of with care into a 'sharps' container.

Syringes, swabs, or any other blood contaminated materials must be placed

Blood samples should be transported to the laboratory in biohazard bags with

Rapid transport samples eg: PTH & glucose

If delay is inevitable it is generally better to refrigerate samples.

However refrigeration may itself cause artefactual changes in the results.

Unseparated samples of blood must never be frozen.

Samples should not be subject to temperatures of >25C, even for short

Specimens for microbiological examination must be appropriate eg, sputum

In general, specimens should be collected into, and transported in, a sterile

Aspirated pus may be transported in a syringe, which must be capped

Specimens should be delivered promptly to the laboratory.

Although many specimens will tolerate a delay of several hours if

Similarly, for the detection of Neisseria gonorrhoeae and other fragile

Type of urine specimens

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