How to collect specimens in pathology laboratory ?

Pathology Specimen collection procedures:-

When the patient is come in to Laboratory for blood testing needs to verify -

• Patient details is on in test requisition forms , below maintained information should be filled up by the patients on the TRF

• First name, surname, date of birth & gender

• Email ID & Mobile No.

• Address

• Name of referral physician

• Clinical history if applicable for correct interpretation of the results

• Date & sign of the patient

• Sign of executive doing registration

• Cross check  that all the details mentioned on TRF are right.

Verify  patient details of identifications:-

• The phlebotomist should identify himself or herself, established relationship with patient, and gain the patient’s confidence.

• Identification of the patient is crucial.

• With   the patients detail available on   the Test request form. The phlebotomist’s calls out a loud and clearly with his first & last name.

• Patient’s identification reconfirmed before collecting blood sample by taking patient's signature on request form. Phlebotomists verify demographic details, test names.

• After phlebotomy, the phlebotomist signs on Test request form with the time and date of collection.

Ask to patient for diet restrictions :-

There are Some tests require proper fasting and/or eliminate certain foods from diet before the  blood is drawn. Time and diet restrictions vary according to the test.

Follow the order of draw:

What is the order of draw?

order of draw  is the sequesce of specimen collection , order of draw in phlebotomy refers to the sequence in which multiple blood collection tubes should be filled during a single venipuncture procedure. This helps to avoid  sample contamination and false test results. The standard order of draw is as follows:

1. Blood culture bottles (sterile)

2. Sodium citrate tubes (for coagulation testing)

3. Serum tubes without additives (Red/Yellow tube for  clinical chemistry tests)

4. Heparinized tubes (for TB gold ,Newborn screening)

5. EDTA tubes (for hematology tests  like ESR,CBC)

6. Glycolytic inhibitor tubes (for Glucose ,GTT, blood gas analysis)

7.Black -ESR tube.(for ESR)

It's important to note that the order of draw may vary slightly depending on the specific requirements of the laboratory or hospital policy.pathology laboratory or hospital should always follow the guidelines.

Need to be take Medical history :-

Patient or relative needs to fill the test requisition form  carefully. Phlebotomist must confirm that, patient or relative has filled all the details mentioned on TRF so that delay can be minimized. Clinical history must be taken for tests wherever applicable e.g. Oral anti-coagulant medication taken, for PT INR test, LMP for UPT & HCG test.

And it is mandatory to fill requisition form for Histopathology, consent form for cytology, H1N1 for RT PCR, Dual/Quadruple Marker test, maternal  Risk assessment form, Microbiology test related forms, Covid 19 / ICMR and others.

Following consumables Need to be for  Blood  Collection :

Inspect all supplies for possible defects and applicable expiration dates. The following supplies should be available at any location where venipunctures are routinely performed.

1 Blood collection tubes (Sodium citrate tube, Red / Yellow - Plain tube, Heparin tube, EDTA tube, Sodium Fluoride/Grey), Blood culture bottles.

2 Syringes and Needles.

3 Tourniquet

4 Alcohol 70% isopropyl or ethyl alcohol.

5 Cotton balls / alcohol swab .

6 Gloves, Head caps, Mask,

7 BMW Discard Compliances (red bag, yellow bag, white container, Needle cutter)

Specimen  need to reach in laboratory  is on respective time lines , then sample is access in accession  section and accept or reject as per rejection  cireteria 

Following are the sample rejection criteria

1.Samples collected in improper blood collection tubes.

2. Not received HIV CONSENT form

3. Missing or incomplete patient details (labeling mismatch)

4. Grossly lipemic that interferes with test interpretation

5. Grossly Hemolysed sample.

6. Inadequate sample volume.

7. Overfilled or Under filled specimen container.

8. Specimens that have not been properly transported and handled

9. Inadequate sample volume

10. Delayed transportation / Aged sample

11. Sample tube broken

12. Temperature condition not maintained.  

Then   specimens go to secssion wise for test procedures. 

Rejected Specimen again collect .