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Chapt 12
as per class notes
| Question | Answer |
|---|---|
| How are Specimens tracked? | From time of collection until tests are reported. |
| Mishandling specimens prior to testing results in | useless/erroneous test results |
| Improper collection can result in | useless/erroneous test results |
| The first phase of Specimen Handling and processing is | Pre-examination/preanalytical |
| The second phase of Specimen Handling and processing is | Examination/Analytical |
| The third phase of specimen handling is | Post exam/postanalyitical |
| a quick summary of what Pre-examination/preanalytical consists of | Actions occurring prior to specimen analysis |
| a quick summary of what Examination/Analytical consist of | Actions taken during specimen analysis |
| a quick summary of what Post Examination/Postanalytical consists of | Actions occurring after specimen analysis |
| Steps taken before the actual testing of the sample is what part of specimen handling | Pre-examination/preanalytical |
| What is the percentage of lab errors that are estimated to happen prior to analysis? | 50 to 70 percent. |
| Specimen handling is part of what phase of collection? | Pre-examination/Preanalytical phase |
| What are the stages during collection in which pre-exam or pre-analytical errors can be introduced | Before collection, At time of collection, Durring specimen transport, during specimen processing, during Specimen Storage. |
| Sources of possible errors before collection include | Altitude, Dehydrated patient, Duplicate test orders, Exercise, Inadequate fast, incomplete requisition, medications. |
| Sources of possible errors at time of collection include | Wrong Patient ID, Antiseptic not dry, expired tube, Failed to invert correctly, improper vein selection, inadequate volume, undefiled tube, wrong collection time, wrong use of PST or SST, wrong needle, mislabeled items, patient position TQ on too long. |
| Agitation - induced hemolysis can happen during | transport |
| A delay in transport can lead to | Lab errors |
| Errors that can take place during specimen processing include | Contamination, delays in processing, delays in fluid separation, Failure to centrifuge specimen according to test requirements, failure to separate fluid from cells, Incomplete centrifugations, rimminf of clots, mislabeled aliquot. |
| Errors that can take place during Specimen storage include | Exposure to light, Temperature change outside defined limits. |
| Metabolic changes in the sample can be a result of | a delay in separating the blood cells from the plasma or serum. |
| Ruff handling and agitation can | Hemolyze specimens activate platelets and affect coagulation tests as well as break collection tubes. |
| According to CLSI tubes should be transported how? | vertically with the stopper up to reduce agitation that can cause hemolysis or red cell damage. |
| What can help reduce accidental aerosols spray when stoppers are removed. | Correct transport position stopper up. |
| Transporting in an upright position can assist with___ and prevents ___ | clot formation in serum tubes, Clot from sticking to the stopper. |
| What are requirements for labeled biohazard bags or containers | Clearly marked, Light tight, Specimen collection paperwork. |
| A pneumatic tube system is what kind of transport system | Automated transport system |
| Items that should be used to prevent cross contamination / damage in an automated transport system include? | Plastic liners, Padding/foam. |
| What is the maximum time for separation serum and plasma from cells | 2 hours |
| What are the specimen that do not require further processing | CBCs & hematology specimens drawn in EDTA tubes, Whole blood specimens for tests, such as cyclosporine, hemoglobin a1c, lead analysis. CSF, serous fluids, synovial fluid & BAL, Microbio, Urinalysis. |
| What tests require special handling? | Body temp specimens, Chilled specimens, Specimens that must not be chilled, Light sensitive specimens. |
| Special handling considerations for body temp specimens | Specimen change if cooled below body temp, tubes may need to be pre warmed. |
| Chilling specimens can slow down | metabolic processes that keep going in cells after collection, hanging analyze levels |
| Specimens may be chilled in | Container of crushed ice and water. |
| Some specimens may have to be frozen before being | Centrifuged, having plasma or serum removed and frozen. |
| Specimens that MUST not be chilled are | Light sensitive |
| Light can break down analyses in _ resulting in falsely decreased values | Bilirubin, vitamin c b vitamins, carotene |
| amber colored micotainers and could should be used for | pediatric collections to protect from light. |
| OSHA required gear for collection | Masks, Gloves, goggles, fluid resistant lab coat, face shields. |
| What are the steps in specimen processing | Centrifugation, Specimen Storage, Reporting results, Resolving errors. |
| QNS stands for? | Quantity not sufficient |
| A centrifuge is used to | Cause separation of blood components based on their density. (cells & plasma or serum) |
| failure to leave stoppers on before centrifuge can cause | inaccurate results, evaporation & contamination. |
| How must tubes be placed in centrifuge | Balanced equal size with equal volumes of specimen opposite one another. |
| What specimens can be centrifuged right away? | Plasma |
| Before serum specimens can be centrifuged they | Must be completely clotted. |
| Complete clotting of serum specimens takes | 30 to 60 mins |
| A specimen maybe centrifuged more than once. | False |
| Most machines do not require stopper removal after centrifugation is done | False |
| If removing stoppers manually these must be used | Face shield or splash shield or splash shield, gauze or tissue. |
| Stoppers should be pulled straight up to remove | True |
| What is an Aliquot | A portion of specimen used for testing when, multiple tests are ordered, tests are preformed on different instruments or in different areas. |
| How is aliquot transfer performed | moving a portion of a specimen with plastic transfer pipet in one or more tubes labeled with the same ID info as specimen tube. |
| Missing, incomplete or incorrect label | Reason(s) Lab Will Reject a Specimen |
| Additive tube has inadequate volume | Reason(s) Lab Will Reject a Specimen |
| Hemolysis (e.g., hemolyzed specimen for K) | Reason(s) Lab Will Reject a Specimen |
| Wrong tube | Reason(s) Lab Will Reject a Specimen |
| Tube outdated | Reason(s) Lab Will Reject a Specimen |
| Clot or micro clots in anticoagulation tube | Reason(s) Lab Will Reject a Specimen |
| Contaminated specimen (e.g., C&S specimen in non-sterile container | Reason(s) Lab Will Reject a Specimen |
| QNS | Reason(s) Lab Will Reject a Specimen |
| Collected at wrong time | Reason(s) Lab Will Reject a Specimen |
| Incorrect transport (e.g., frozen specimen received thawed) | Reason(s) Lab Will Reject a Specimen |
| Specimen too old (e.g., ESR must be done within 4 hours of collection if at RT) | Reason(s) Lab Will Reject a Specimen |
| Delay in processing (e.g., serum not separated from cells within 2 hours) | Reason(s) Lab Will Reject a Specimen |
| Handling errors can happen during or with | Mixing, Transporting, Specimens exposed to extreme heat or cold. |
Created by:
Producer456