oropharnegeal specimen-collection-slides

For educational purpose

1. SPECIMEN COLLECTION OF
NASOPHARYNGEAL SWAB AND
OROPHARYNGEAL SWAB

2. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
SUPPLIES/EQUIPMENT NEEDED
•COVID-19 Case Investigation Form (CIF) and RITM linelist
•Virus Transport Media (VTM) or Universal Transport Media (UTM) or
Sample Storage Reagent (Sansure)
•Nasopharyngeal swab, Sterile Dacron/Rayon swab with pliable shaft
•Oropharyngealswab, Sterile Dacron/Rayon swab with plastic shaft
•Sterile tongue depressor
•Test Tube rack
•Resealable plastic bags (zip lock)
•Laboratory sealing film (parafilm)
•Masking tape
•Permanent tube marker
•Scissors
•PPE (Laboratory gown, gloves, N95mask, goggles)
•Refrigerator

3. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
COLLECTION KIT
•Virus Transport Medium
•Nasopharyngeal swab
•Oropharyngeal swab

4. COPAN SAMPLE COLLECTION KIT
⚫Universal Transport Medium (UTM)
or equivalent
⚫Copan Flocked Swab or
equivalent
breakpoint

5. Sample Storage Reagent (Sansure) and OPS
5

6. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
DIRECTIONSFORUSEOFSWAB
•Swabsshouldnotbeusedif
▪thereisevidenceofdamageorcontamination
▪theexpirationdatehaspassed
▪theswabpackageisdamaged
▪thereareothersignsofdeterioration
•Duringsampling,theswabshallonlycomeincontactwiththe
suspectedinfection.
•Donotuseexcessiveforcewhencollectingswabsamplesfrom
patientsasthismayresultinaccidentalbreakageoftheswabshaft.
•Swabsareforsingleuseonly.

7. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
Swabheldcorrectly
Swabheldincorrectly
TECHNICALNOTES:CORRECT
HANDLINGOFSWAB

8. Correctlyheldswabcanslide
outoftheway.
Incorrectlyheldswabcaninjure
patient.

9. RELEVANT
ANATOMY:
THERESPIRATORY
SYSTEM

10. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
AREAFORNASOPHARYNGEALSWABSAMPLING
TARGET
SITEFOR
NPS

11. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
THEORALCAVITY
Sensitiveto
gagreflex
TARGETSITE
FOROPS
Togainaccesstothe
oralcavity,usea
tonguedepressor

12. GUIDELINESPRIORTO
SPECIMEN
COLLECTION

13. INFECTIONCONTROL
GUIDELINES
•Personalprotectiveequipment:
wearN95maskanddisposable
gloves.
•Whencompleted,disposeofall
PPEandothercontaminated
materialsintheappropriate
trashbin.
•Washhandsthoroughlywith
soap and wateror alcohol based
handgelbefore AND after the
procedure.

14. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
SPECIMENCOLLECTIONPOLICIES
•Specimensshallbecollectedwithin10daysfrom
onsetofillness.
•Only qualifiedandtrainedstaffshall
performthe procedures.
•DoNOTusewoodenandcottonswabs.
•CheckforintegrityoftheOPS/NPSswabsand
donot usebeyondexpiration.
•Useonlytheapprovedkitsforspecimencollection.

15. SPECIMENCOLLECTIONPOLICIES
•CorrectlyidentifythepatientandlabeltheUTMtubepriorto
collection.
•Labelthetubewiththepatient’sfullname,ageanddate
ofcollection.TheinformationonthelabelmustMATCH
theinformationontheCIF.
•Removepossiblevisualobstructions.
•Strictlyfollowinfectioncontrolguidelinespriortoeach
procedure.(Protectyourselffromthepatient)

16. SPECIMENCOLLECTION
PROPER
NASOPHARYNGEAL
SWAB(NPS)

17. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
•Usingtheswab,visually
measure*fromthebaseof
thenostriltowardsthe
auditorypit.
•Dividethelengthintohalf
inordertoknowintowhat
extentwillbeinsertedinto
thenostril(usually5–6cm
inadults)toensurethatit
reachestheposterior
pharynx.
*Alternatively,youmayusearulerformore
accuratemeasurements

18. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
NPS:STEP2
•Withthepatient
seated,tiltthe
headslightly
backwards.Insert
theswabintothe
nostrilparallelto
thepalate

20. NPS:STEP3
•Inserttheswabinto
thenasalcavityuntil
aslightresistanceis
met.
•Rotatetheswaband
applyalittleforceto
takelargequantities
ofmucosa
•Repeatintheother
nostrilusingsame
swab

21. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
NPS:STEP4
•PlacetheNPS
immediatelyinthe
UTMtubetoavoid
dryingoftheswab.
•Break/Cuttheendof
theshaftthatsticks
outofthetube(break
point)andclosethe
tubetightly.
•Securethecapwith
Parafilmtoprevent
leakageduring
transport

22. NPS:STEP5
•Transportthespecimen
tothelaboratoryand
immediatelystoreinside
refrigerator(2-8C).
•Ifsiteisfarfroma
refrigerator,usea
thermobag/box
with4-6icepacks

23. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
SPECIMENCOLLECTION
PROPER
OROPHARYNGEAL
SWAB(OPS)

24. OPS:STEP1
•Havethepatient
seatedcomfortably.
•Havethepatient
open
hismouth.
•Withglovedhands,
holddownthe
tonguewithasterile
tonguedepressor
•Havethepatientsay
͞AAH͟to elevate the
uvula

25. OPS:STEP2
•Useasweepingmotion
toswabtheposterior
pharyngealwalland
tonsillarfossa.
•Avoidswabbingthe
softpalate.
•Donottouchthe
tonguewiththeswab
tip.

27. OPS:STEP4
•PlacetheOPS
immediatelyinthe
sameUTMwithNPS.
•Cuttheendofthe
shaftthatsticksoutof
thetubeandclosethe
tubetightly.
•Securethecapwith
Parafilmtoprevent
leakageduring
transport.

28. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
BESTPRACTICES
✓Askpatienttoremoveextrasecretionsbefore
procedure.
✓Askpatienttoclosehisorhereyes.
✓Visuallyestimatethedepthofinsertion.
✓LabelthetubefirstPRIORtocollection.
✓REMEMBER:Yoursafetyfirstandforemost.

29. RESEARCH INSTITUTE FOR TROPICAL MEDICINE
SPECIMENCOLLECTIONPOLICIES
Sample Storage Reagent
(Sansure)
Room temperature or 2-8C