Collection and preservation of Sputum.pptx

sputum collection

1. Biological specimens

2. General Information ▪ Sputum is mucous or phlegm coughed from deep in the lungs. It is not saliva from the mouth or mucous from the back of the throat . ▪ Sputum specimens should be collected in the early morning if possible . ▪ Collect 3 sputum specimens on 3 consecutive days unless otherwise instructed . ▪ Specimens should be kept in the refrigerator until they are submitted to the laboratory . ▪ To reduce the likelihood of transmission, patients are encouragedto collect sputum specimens outdoors whenpossible and away from other people.

3. SPUTUM COLLECTION PREPARE THE SPUTUM CONTAINER Give clean containers to the patient. On the side of container (not on the lid), the following information should be written (see figure 10. 2): - The patient’s name. - The date of each sputum collection. - The sputum number .

4. SPUTUM COLLECTION This is the responsibility of medics, nurses or lab technicians : patients should be carefully instructed about sputum collection. This MUST NOT be done in the lab. It should be done in special well-aerated room or outside with nobody around. Tell the patient to spit in the morning : 1 ) The patient should be standing if possible. 2 ) Before eating anything, just when he gets up, he should wash his mouth by waterfirst . This will avoid the bacteria and cells from the mouth. 3 ) Take a very deep breath, filling his lung. 4 ) He should empty his lung in one breath; cough as hard and deeply as he can. 5 ) Spit into the container. The patient must spit every morning during 3 consecutive days.

5. Specimen Collection Methods for Pulmonary TB Disease There are four methods for the collection of sputum . 1.Spontaneous (most common ) 2.Induced 3.Bronchoscopy 4.Gastric Aspiration

6. SPUTUM SPECIMEN CONTROL The patients should bring the sample with the request from correctly filled to the laboratorytechnician . Always check the quality and quantity of the sputum specimen . The quality of the sputum: Good sputum contains: Particle of pus (white, yellow or green), thread of fibrin, thick mucus and occasionally brownish streaks of blood. Bad sputum is a liquid secretion and transparent (only saliva) coming from the mouth and Should not be processed.

7. Sputum Collection Take a deep breath and hold for 5 seconds Slowly breath out Take another deep breath and cough hard to bring up the sputum The specimen must be sputum, and not mucous from the nose or mouth At least three consecutive sputum specimens are needed . Specimens must be at 8-12 hours apart with one of them being collected the first thing in the morning . Specimens can be sent through Postal Service using MDCH specimen containers.

8. SPUTUM PREPARATION Wear gloves and a “duck” mask. With 2 bamboo sticks take a thick part of sputum and put it on a clean slide. Cover it with a clean cover slip as shown. Remove the sputum from the bamboo sticks by dipping them in a bottle containing sand and alcohol. Burn the bamboo sticks and throws them away with sputum, which has been soaked in disinfectant. WASH YOUR HANDS.

9. After the Specimen is Collected Transport specimen within two hours to the lab and give directly to lab personnel. When more than one specimen has been ordered, collect specimens on consecutive mornings. Transport each specimen as collected to the laboratory.

10. The quantity of the sputum: The quantity of the sputum should be at least 2 ml. SPUTUM SMEARING Materials (see figure): New frosted-end slides Pencil Examination gloves “ Duck” mask Bamboo sticks Wide mouth pot with sand immersed in alcohol Spirit lamp, matches Dustbin

11. Method: Clean the slides Write on each slide (see fig 10. 4): - The patient’s name - The number of the sputum - The date written on the container 3 . Put the gloves and mask on. 4. Light the flame of the spirit lamp . 5. Carefully open the specimen container POINTING AWAY FROM YOU

12. 6. With two bamboo sticks take a solid part of sputum (pus) and put it on the slide. 7 . With the point of the sticks, smear the sputum as regularly as possible, with a circular movement. The smear should be in an oval shape of about 3 cm across.

13. 8. Rub the bamboo sticks into the wide-mouth pot containing sand and alcohol in order to remove all of the sputum particles from the sticks. 9 . Burn the sticks up to the middle. Throw them in the dustbin. 10 . Close the specimen container. Do not discard yet; if anything happens, you may still need the specimen. 11 . Let the smear air-dry in a safe place protected from flies, ants and dust. 12. Remove your mask and gloves, and dispose of in the bin. 13 . Wash your hands. 14 . When the smear is completely dry, fix it by passing the slide over the flame 3 times (smear on the upper side). Don't burn it. It must be possible to lay the slide on the back of your hand without feeling uncomfortably hot. Allow the smear to cool down before staining