Subscriber Login   Users   Administrators
Integrated cloud-based solutions for clinical laboratories

Alcohol Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Alcohol and links to relevant pages within the course.

Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.



Cerebrospinal Fluid (retired 7/17/2012)
Safety Precautions

Important safety precautions must be observed when handling cerebrospinal fluid. The following guidelines apply:Semi-automatic micropipettes and disposable plastic chambers are the safest option for CSF testing. Many laboratories still use the hemacytometer with disposable pipets.If disposable materials are not used, soak contaminated reusable pipets, hemacytometer and coverslip in 70% alcohol or Wexide.All disposable items should be placed in a biohazard container for appropriate disposal.Wash hands thoroughly when the examination is completed.Spinal fluids which are to be discarded must be placed in biohazard containers for appropriate disposal.Careful attention to specimen processing and handling will help ensure that accurate results are obtained.

View Page

Chemistry / Urinalysis Question Bank - Review Mode (no CE)
Identify the urine sediment elements indicated by the arrow in the illustration:View Page
Which of the following enzymes is the most sensitive indicator of liver damage associated with alcohol ingestion:View Page
Most common methods for measuring bilirubin are based on the reaction of bilirubin with:View Page

Dermal Puncture and Capillary Blood Collection
Finger Puncture

Procedural StepCommentCautionGreet and positively identify patientAlways use at least two patient identifiers to ensure positive patient identification.Never rely on name placards that are placed on or near the patient's bed or crib to identify the patient.If there is a discrepancy in identification, do not proceed until the discrepancy is resolved. Explain the procedureIf the patient is a small child, be at eye level when explaining the procedure. Also explain the procedure to the parent(s). If the patient is aware of what will be happening there is less chance of the patient suddenly jerking away his/her hand when the puncture occurs.Position patient appropriatelyAn outpatient who is a small child should sit on the parent's lap. If necessary, seek assistance for finger puncture if the patient is a small child. Cleanse hands and put on glovesUse soap and water or alcohol-based gel to cleanse hands. Cleanse hands before donning gloves and after removing gloves.Warm puncture site if neededUse the method that is approved by the laboratory for prewarming the puncture site.Never use a moist cloth that has been heated in a microwave as this may cause injury to the patient.Gather appropriate equipmentOnly have needed equipment at hand.Keep track of ALL equipment to prevent patient injury.Cleanse the puncture siteUse 70% isopropanol unless the patient is sensitive to alcohol.Allow the site to air dry. Performing the puncture before the alcohol has dried may hemolyze the blood specimen. Securely grasp and puncture fingerPuncture the side edge of the fleshy pad of fingertip.Avoid extreme side and tip of finger.Discard puncture device into appropriate containerPuncture device should be discarded into a sharps container that is puncture-proof, has rigid sides, and has a lid. Do not discard puncture devices into regular trash or biohazard bags; injury to personnel who handle these bags may occur. Wipe away the first drop of bloodUse slight pressure to facilitate blood flow.The first drop of blood contains tissue fluid that may contaminate or dilute the blood specimen and affect test results.Collect blood into containerAllow blood to flow freely into the collection device. Tap the container gently on a hard surface to move blood further down into the tube if necessary. Do not "milk" the finger or scrape the collection device across the finger to obtain specimen; both actions may cause the specimen to hemolyze. Mix specimen immediately upon completion of the collection. Apply pressure to the puncture site to stop the bleeding.Use gauze to apply pressure to the puncture site.It is not advisable to apply an adhesive bandage over the skin puncture site if the child is less than two years old as the child may place the bandage in his/her mouth. Label specimenSpecimen must be labeled in the presence of the patient.Unlabeled specimens will be rejected by the laboratory.

View Page
Heel Puncture

The heel of the foot is the preferred site for dermal puncture and capillary blood collection for infants less than 12 months old. CAUTION: In premature infants, the bone may be as close as 2.0 mm under the skin of the plantar surface of the heel. The bone may be even closer--maybe half this distance-- on the back curve of the heel. Any puncture more than 2.0 mm may risk a puncture of the bone causing severe consequences to the infant. Only use approved preemie puncture devices on small infants.Procedural StepCommentCautionPositively identify patientAlways use at least two patient identifiers to ensure positive patient identification.Never rely on name placards that are placed on or near the infant's crib to identify the patient.If there is a discrepancy in identification, do not proceed until the discrepancy is resolved. Position patient appropriatelyPosition the infant so that the heel can be easily accessed.If necessary, seek assistance to stabilize baby's foot during the blood collection.Cleanse hands and put on gloves and any other required PPE.Use soap and water or alcohol-based gel to cleanse hands. Cleanse hands before donning gloves and after removing gloves.Choose puncture siteUse the area of heel that is not striped (the white area) in the image on the left.Do not use the center portion of the heel, the arch of the foot, or toes as any of these sites may cause injury to nerves, tendons, and cartilage.Warm puncture site if neededUse only approved warming device.Never use a moist cloth that has been heated in a microwave as this may cause injury to the patient.Gather appropriate equipmentOnly have needed equipment at hand.Keep track of ALL equipment to prevent patient injury.Cleanse the puncture siteUse 70% isopropanol.Allow the site to air dry. Performing the puncture before the alcohol has dried may hemolyze the blood specimen. Securely grasp and puncture the heel.Choose either side of the fleshy part of heel.Avoid center of heel and arch of the foot.Discard puncture device into appropriate containerPuncture device should be discarded into a sharps container that is puncture-proof, has rigid sides, and has a lid Do not discard puncture devices into regular trash or biohazard bags. Injury to personnel who handle these bags may occur.Wipe away the first drop of bloodUse slight pressure to facilitate blood flow.The first drop of blood contains tissue fluid that may contaminate or dilute the blood specimen and affect test results.Collect blood into containerAllow blood to flow freely into the collection device. Tap the container gently on a hard surface to move blood further down into the tube if necessary. Do not "milk" or squeeze the heel excessively. Do not scrape the collection device across the heel to obtain specimen; these actions may cause the specimen to hemolyze. Mix specimen immediately upon completion of the collection to prevent clots. Apply pressure to the puncture site to stop the bleeding.Use gauze to apply pressure to the puncture site.Use a bandage only if this is an acceptable procedure in your facility.Label specimenSpecimen must belabeled in the presence of the patient.Unlabeled specimens will be rejected by the laboratory.

View Page
Miscellaneous Equipment

In addition to the puncture device, additional equipment is required to perform a safe and successful dermal puncture and to collect an acceptable specimen. This may include any of the items discussed below.Plastic microcollection devices: Plastic microcollection devices are small plastic tubes designed to collect capillary blood from a dermal puncture wound. Each small collection tube is color-coded in the same manner as blood collection tubes used for venipuncture. The color of the cap of each container tube corresponds to the type of additive inside the tube, most often an anticoagulant. The additive coats the inside of the tube. Examples of microcollection devices are shown below. Heel warmer: It is best practice to warm the heel of an infant with a warming device known as a heel warmer. The heel warmer, when activated, is designed to warm its contents to a standardized temperature. This temperature will be hot enough to effectively warm the heel and facilitate blood flow to the area without causing heat injury to the patient. It is unacceptable to warm a cloth using a microwave. There may be "hot spots" on the cloth that could potentially burn the patient. Keep in mind, what may feel warm to you, the phlebotomist, may feel hot to your patient!Plastic or Mylar-wrapped capillary tube: In some facilities blood from a capillary puncture is collected directly into a capillary tube. These tubes are very delicate and must be used with great caution. As soon as the tube is two thirds to three-fourths filled, one end is sealed to prevent blood from leaking out.Glass microscope slides: In some facilities, the person collecting the capillary specimen may also be required to prepare a blood smear for laboratory examination. A drop of blood is placed directly on a glass slide and spread to create an area for cell examination. If you are required to prepare blood smears, remember that the slide is considered infectious until fixed or stained. It is also important to remember that glass is a sharps hazard. If not used correctly, the glass may cause injury to both the patient and the phlebotomist. Be as cautious with a glass slide containing blood as you are with a contaminated needle. Dispose of glass slides that will not be used for testing in approved sharps containers.Alcohol and gauze pads: Alcohol is the disinfectant of choice for dermal puncture. The alcohol must be allowed to air dry, which will prevent hemolysis of the specimen and discomfort for the patient. A piece of clean or sterile gauze is used to wipe away the first drop of blood. Gauze is also used to apply pressure to the wound after the specimen collection is complete to stop the wound from bleeding.Iodine or other approved cleaning agents may be used as an alternative to alcohol.Bandage: It may be necessary to apply a bandage to the puncture wound on a finger or heel if the site continues to bleed. However, it is NOT recommended to bandage the finger of a child who is 2-years-old or younger since the bandage may become a choking hazard if the child puts that finger in his/her mouth.Personal protective equipment (PPE): All health care professionals that may come in contact with blood and/or body fluids while performing a laboratory procedure are required to wear intact gloves. It is against safety guidelines to alter gloves in any way that may compromise the integrity of the gloves. Eye protection, such as safety goggles, is recommended if there is the possibility of a splash of blood while collecting a capillary blood specimen. In many facilities, special gowns are required in some patient areas such as special-care nurseries. Always follow the policies of your facility in regard to PPE.

View Page
Oh No...The Blood Has Stopped Flowing

On occasion, blood may stop flowing from the punctured site before the required amount of blood is obtained. When this happens, it is not recommended to squeeze harder. This only serves to cut off the supply of blood to the capillary bed. Additionally, squeezing with too much force, especially on the heel of an infant, may cause injury to the patient. The phlebotomist should never scrape the skin with the collection device in an attempt to scoop up the blood that is laying on the surface of the finger or heel. This could cause the blood specimen to hemolyze, making the specimen unacceptable for some laboratory tests. Always allow the drop to flow freely into the collection tube.If a clot has formed, an attempt could be made to dislodge it and re-establish blood flow by wiping the puncture site again with a new alcohol pad, massaging the finger or heel gently, and attempting to recollect the specimen once the alcohol has dried. If blood is not flowing freely from the initial puncture, it may be necessary to perform a second puncture to obtain enough blood for the testing required. If a second puncture must be performed, do not repuncture the same site.

View Page
If blood has stopped flowing from the finger puncture site, you should repuncture the same site to re-establish the blood flow.View Page
Capillary Blood Collection for Metabolic Testing

The collection of these specimens requires the same attention to detail as with any phlebotomy procedure. Gather all necessary equipment Be certain to choose a device that punctures the heel to a depth appropriate to the size of the infant. Only use the filter cards provided by your state to collect the specimen. These cards are calibrated to the exact specifications needed for testing of metabolic disorders. An alternate or homemade card must not be used. Put on all necessary personal protective equipment Gloves are always required. Gowns and eye protection may also be required. Positively identify the patient Use two identifiers. The infant who is in the nursery should have an identification band attached to the ankle or wrist. In special care nurseries an alternate form of identification may be used. However, a crib card should never be used as a form of identification. Follow the practice for your facility. Position the infant Be certain that the heel can be easily accessed. Follow all nursery requirements that apply to safe handling of newborns. Warm the heel using an approved warming device Clean the site with alcohol or the approved disinfectant. Allow the site to air dry before proceeding with collection of the specimen. Grasp the heel firmly but not tightly, activate the puncture device, wipe away the first drop of blood, and begin collection of the specimen.Allow the blood to wick onto the card. Completely saturate the circle with one continuous drop of blood. Avoid touching the card to the skin. Apply the blood only to one side of the card. Do not layer the blood by applying a second drop on top of the first. Repeat the procedure to completely fill each circle on the card. Each circle should be completely and uniformly saturated as shown in the bottom image on the right. Follow the policy of your institution or state to determine how many circles must be completely filled. Apply pressure to the puncture site using a sterile gauze Gently raising the infant's leg above the level of the heart will also aid in clotting the puncture site. Bandage according to site-specific policy.

View Page
Lead: An Important Public Health Concern

Lead may be found on surfaces touched by children and adults. Lead may be present in the paint that was used in older homes or apartments, and it has even been detected in the paint used on some toys.Elevated lead levels in children can cause developmental delays. Many state governments closely monitor the presence of lead in children. To accomplish this, government agencies require official forms be completed and submitted for each patient at the time of specimen collection for lead testing. It is the responsibility of both the phlebotomist and healthcare provider to submit the completed form with the specimen. If an elevated lead level is obtained, the government authority can then track and monitor follow-up treatment for the patient. When the phlebotomist determines that a capillary puncture on the finger will be used to collect a specimen for lead testing, it is imperative that the patient's hands be washed with soap and water prior to the start of the collection to ensure the skin is free of any contaminant that could falsely elevate the test result. The patient should thoroughly wash his or her hands or if the patient is a child, the parent or guardian could be asked to assist the child. If necessary, wash the patient's hands yourself.It is important to note that washing hands with soap and water aids in removing surface lead but is not a substitute for the cleaning step in the blood collection procedure. The finger must still be cleansed with alcohol and allowed to dry before a dermal puncture is made.

View Page

Emerging Cardiovascular Risk Markers (retired 12/6/2013)
Risk Markers

We have listed the 'classic' cardiovascular risk markers as LDL-C, HDL-C and triglycerides. But there are many more cardiovascular risk markers as well as cardiovascular risk factors. A cardiovascular risk factor is a condition (not a laboratory analyte) that is associated with an increased risk of developing cardiovascular disease. Examples include: Age Gender (males are at increased risk) Heredity Hypertension Cigarette Smoking Obesity Diabetes StressThere are also negative risk factors, factors which decrease a person's risk of cardiovascular disease. Examples include: Optimal HDL-C concentration Exercise Estrogen Moderate alcohol intakeThis course will not focus on cardiovascular risk factors. Instead we will focus on newer, emerging cardiovascular risk markers. There are well over twenty well-studied cardiovascular risk markers; in this course we will focus on some of the more established markers and the ones which are becoming more commonly measured in the clinical laboratory. These include apolipoprotein A1/apolipoprotein B100, Lp(a), oxidized LDL, LpPLA2, hsCRP and lipoprotein particle size and concentration.It is important to remember that the association between a cardiovascular risk marker and actually having or developing cardiovascular disease is a statistical one. The fact that a patient has a particular risk marker which is abnormal simply increases the probability of developing cardiovascular disease, it does not mean that he or she is certain to develop cardiovascular disease. Conversely, if an individual does not have a particular cardiovascular risk marker present it does not guarantee protection against cardiovascular disease. We must always remember that some percentage of individuals who have heart attacks or strokes will not have abnormal risk markers present.

View Page

General Laboratory Question Bank - Review Mode (no CE)
What is the preferred solution for general disinfection of work surfaces in the clinical laboratory:View Page
What is the purpose of using acetone/alcohol in the Gram stain procedure?View Page

Hereditary Hemochromatosis (retired 2/13/2014)
Other Treatments

Deferoxamine (DFO), an iron chelating agent, may be used to reduce iron overload in patients for whom phlebotomy is contraindicated or not well tolerated. Examples include patients with sickle cell disease or thalassemia whose anemia would be exacerbated by phlebotomies. DFO is seldom used to treat hereditary hemochromatosis (HH) due to the low cost and efficacy of phlebotomy therapy. DFO is typically administered by intravenous or subcutaneous infusion.Patients with HH may be counseled to avoid alcohol use in order to avoid liver damage. With the exception of iron supplements, dietary restrictions on iron ingestion are rarely advised.

View Page

Histology Special Stains: Carbohydrates
Mucicarmine: Staining Protocol

Sample Type Required: Deparaffinized and re-hydrated tissue sections on positively charged slides. Fixative: 10% Neutral Buffered FormalinStepReagentTimeTechnical Notes1Weigert's Iron Hematoxylin Working Solution½ Solution A (Hematoxylin and 95% Alcohol) and ½ Solution B (Distilled Water, Hydrochloric Acid and 29% Ferric Chloride Solution)7 MinutesBe careful not to overstain with Hematoxylin as this can obscure the carminophilic tissue elements.If Gills hematoxylin is used in place of Weigert's Iron Hematoxylin the mucin may have a bluish cast.2Running Tap Water10 Minutes3Working Mucicarmine Solution10mL Mucicarmine Stock Solution and 40mL Distilled Water60 MinutesStock Mucicarmine should be stored refrigerated to slow down deterioration of the solution. Expiration of the solution should be closely monitored. Do not freeze solution to avoid frequent freeze-thaw cycles that may cause deterioration.4Distilled Water1-2 Changes5Metanil Yellow0.25% Solution30 Seconds to 1 MinuteBe careful no to overstain with Metanil Yellow as this can obscure carminophilic tissue elements. Tartrazine can be used in place of Metanil Yellow. Expected ResultsMucin = Deep Rose Red Capsule of Cryptococcus = Deep Rose Red Nuclei = Black Other tissue elements = Blue or yellowPost Staining Procedure: Tissue sections should be rinsed well in distilled water, dehydrated with 95% and absolute alcohols, cleared and cover-slipped. Mucicarmine stock solution should be stored refrigerated Room temperature storage will accelerate the chemical breakdown of the solution. Frozen storage is not recommended to avoid repeated freeze-thaw cycles that may also affect the chemical reactivity of the stain.

View Page

Histology Special Stains: Connective Tissue
Phosphotungstic Acid-Hematoxylin (PTAH) Staining - Chemistry

The PTAH staining method relies on acid-base chemistry to stain collagen and muscle fibers. These fibers are demonstrated using a tungsten mordant provided by the phosphotungstic acid. This mordant binds hematein and stains selective tissue components blue, while the phosphotungstic acid is believed to stain other tissue components a red-brown color. Tissue should preferably be fixed in Zenkers, which is believed to intensify staining reactions. However, tissues fixed in formalin are commonly post-fixed in Zenker’s solution for this purpose. A section of skeletal muscle tissue can be used for quality control.The amount of phosphotungstic acid in the staining solution is far greater than the amount of hematein and it is believed that tungsten binds all available components blue, while the phosphotungstic acid is thought to stain the red-brown components. This stain has been referred to as a polychrome stain because one solution gives two major colors. The components colored red-brown will lose this color with water or prolonged alcohol washes. Therefore, dehydration of the tissue section following staining MUST be rapid. (Ref4)

View Page
Phosphotungstic Acid-Hematoxylin (PTAH) Staining - Staining Protocol

Sample type required: Deparaffinized and rehydrated tissue section (3-5 microns) on positively (+) charged slidesPreferred fixative: Zenkers; however 10% neutral buffered formalin (NBF) may be used as wellControl: Skeletal or cardiac muscleReagentTimeTechnical NotesZenker's fixative5 minutes (in heated solution)Used as both a fixative and mordant.Microwave solution for 45 seconds on high power before placing slides inside.Running water wash5 minutesEnsure that ALL traces of the reagent have been removed.Lugol's iodine 5 minutesRunning water wash5 minutesEnsure that ALL traces of the reagent have been removed. 5% hypo solution (sodium thiosulfate)1 to 2 minutesRunning water wash 10 minutes0.25% potassium permanganate5 minutesOxidizesRunning water wash 5 minutes5% oxalic acid Bleach until tissue is colorlessRunning water wash5 minutesDistilled water 3 changesDiscard solution after use.PTAH staining solutionOvernight at room temperaturePost staining procedure: Dehydrate quickly through two changes each of 95% and 100% alcohol, along with two changes of xylene, then cover-slip. Expected results:Cross striations - BlueNuclei - BlueCollagen - Red-brownElastic fibers - Purplish

View Page

Introduction to Bone Marrow
Ring Sideroblasts

This slide shows a marrow aspiration smear with numerous ring sideroblasts. Normal red cell precursors have only one or at most two granules of iron in their cytoplasm. These abnormal red cell precursors have numerous iron containing granules in their cytoplasm indicating abnormal iron incorporation. This iron is actually incorporated into mitochondria. Ring sideroblasts can be seen in idiopathic sideroblastic anemia, and in sideroblastic anemia induced by drugs, lead poisoning, and alcohol abuse.

View Page
Alcohol is considered a:View Page

Laws and Rules of the Florida Board of Clinical Laboratory Personnel (retired 9/1/2010)
License on probation

An individual whose license that has been put on probation for violating the laws of the Board may be subject to any or all of the following requirements, as assigned by the Board: Practice only under direct supervision of a licensed clinical laboratory personBe reviewed on a quarterly basis by his / her supervisor, with reports submitted to the BoardSubmit a personal quarterly report to the Board describing the individual's progressComplete additional continuing education requirementsConsult a psychiatristNot consume alcohol or use any controlled or illegal substancesAttend AA or NA meetings weeklyUndergo and pay for random drug testingPay an administrative fineFailure to comply with all conditions of the probation will mean that the individual's license will be suspended or revoked.

View Page
Capability Violations

The accuracy and safety of patient testing depends on the capability and honesty of clinical laboratory personnel. If an individual's ability to perform testing is influenced by illness, injury, drug use (legal and illegal), or alcohol use, he or she may no longer practice. The Board can order a doctor's exam to determine if illness, injury, drugs, or alcohol is a factor. The individual can get his / her license back after recovery and proving that the condition is no longer a problem. If an individual commits a crime in any state relating to matters of honesty (such as filing false reports or advertising false services), that individual's Florida license may be suspended. Other licensed personnel who know that an individual is practicing despite being under the influence of drugs or alcohol, is physically or mentally incapable, has been convicted of a lab-related crime, or is not competent to perform his / her duties are required to report the individual to the Board. The following are violations of Board rules:Continuing to practice after becoming unable to safely perform testing because of illness or use of alcohol or drugs, or another mental or physical condition. Continuing to practice after being judged mentally or physically incapable.Being convicted of any crime relating to activities of clinical laboratory science or involving dishonesty or lack of morals. Failing to report to the Board that one has been convicted of a crime (as listed above), been judged mentally or physically incapable, or had a licensed revoked in another state. Knowingly allow an unqualified person to perform clinical laboratory duties.

View Page
Which of the following are violations of Board rules?View Page

Medical Error Prevention (retired)
Avoiding Systems Failure

Standardized systems should be used in virtually every circumstance to reduce errors. For example, medical errors can be avoided by using the standardizing procedure for preparing a venipunture site before drawing a blood alcohol specimen. A standardized system for this procedure is developed, published, trained, and posted. Everyone learns one protocol. Encouraging them to review and use the procedure for drawing blood alcohol tests avoids the error of using alcohol wipes to prepare the venipuncture site.

View Page

Microbiology / Serology Question Bank - Review Mode (no CE)
What is the purpose of using alcohol in the gram stain procedure:View Page

Mycology: Yeasts and Dimorphic Pathogens (retired 2/12/2013)
Oral candidiasis may be directly exasperated by the habitual ingestion of:View Page

OSHA Bloodborne Pathogens
Antiseptic Hand Cleanser

Alcohol-based antiseptic hand cleanser can be used in place of soap and water. Place a dose of the antiseptic hand cleanser into the palm of your hand and rub your hands together, spreading the solution thoroughly over both hands, particularly around nail beds and under jewelry, until the hands are dry.

View Page

OSHA Hazard Communication and Chemical Hygiene Updated to the Globally Harmonized System
Sections

The intent of the safety data sheet (SDS) is to answer these questions:What is the material?What information needs to be known immediately?What should be done in cases of emergency situations?How can hazardous situations be prevented from occurring?What other useful information is there on this material?As of June 1, 2015, new SDSs supplied by the chemical manufacturers must be in a uniform format that includes 16 specific sections. The SDS will include the section numbers, the headings, and associated information under each heading. The 16 section headings are:IdentificationHazard identificationComposition/information on ingredientsFirst-aid measuresFire-fighting measuresAccidental release measuresHandling and storageExposure controls/personal protectionPhysical and chemical propertiesStability and reactivityToxicological informationEcological informationDisposal considerationsTransport informationRegulatory informationOther information (includes the date of preparation or last revision)

View Page

Packaging and Shipping Infectious Materials (retired July 2013)
IATA and US Postal Service Exempt Specimens

Laboratory specimens that are unlikely to cause disease and do not meet the criteria for category A or B substances are not subject to Division 6.2 regulations. Specimens for which the hazardous materials regulation (HMR) does not apply include human or animal samples (including, but not limited to, secreta, excreta, blood and its components, tissue and tissue fluids, and body parts) being transported for routine testing not related to the diagnosis of an infectious disease. This includes specimens that are being sent for:drug or alcohol testing cholesterol testing blood glucose level testing prostate specific antibody (PSA) testing testing to monitor kidney or liver function pregnancy testing tests for diagnosis of non-infectious diseases such as cancer biopsies The US Department of Transportation (DOT) has no "Exempt Specimen" classification and there are no DOT guidelines for packaging non-regulated specimens.* According to the DOT, in the U.S., if a package is marked as "Exempt Human/Animal Specimen" the understanding is that it contains no infectious substance. However, both IATA and the US Postal Service (USPS) have these requirements for packaging exempt specimens: Packaging IssueIATAUSPSType of packaging requiredTriple packagingTriple packagingOuter containerOne dimension must be a minimum of 100 mm X 100 mm (approximately 4 x 4 inches) Must be able to survive a drop test of 4 feet One dimension must be a minimum of 100 mm X 100 mm (approximately 4 x 4 inches) Must be able to survive a drop test of 4 feet Quantity limits: outer containerNone NoneQuantity limits: Primary receptacleNone500 mLQuantity limits: secondary packagingNone500 mL* Non-regulated specimens may become regulated because of preservatives, such as 10% formaldehyde (class 9) or 25% formaldehyde (class 8); or 25% ethanol (class 3).

View Page
Additional Packaging Requirements for Category A and Category B Substances

If multiple primary receptacles are placed in a single secondary packaging, they must be either individually wrapped or separated so as to prevent contact between them.The primary receptacle or the secondary packaging must be capable of withstanding, without leakage, an internal pressure producing a pressure differential of not less than 95 kPa (13.8 lbs/in2) because the package may be placed into an unpressurized storage compartment in a cargo aircraft. This must be verified when choosing packaging for shipping either category A or category B substances by aircraft. It is also recommended if shipping by ground. An evacuated blood collection tube that has remained unopened qualifies as a 95 kPa container. The smallest surface of the outer packaging must be at least 100 mm X 100mm (4 inches x 4 inches).Other dangerous goods must not be packed in the same packaging as Division 6.2 infectious substances unless they are necessary for preservation of the specimen (e.g., formalin). A quantity of 30 mL or less of formalin or other dangerous goods included in hazard Classes 3, 8, or 9 (flammable liquids such as alcohol; corrosives such as acids or bases; or miscellaneous hazardous materials) may be packed in each primary receptacle containing infectious substances. A quantity greater than 30 mL will require appropriate hazard labels on the package.OverpackWhen packages are placed in an overpack, the overpack must be marked with the word "Overpack" and the package markings must be reproduced on the outside of the overpack.

View Page

Parasitology Question Bank - Review Mode (no CE)
Amebas stained with this substance may be readily distinguished since this it enhances nuclear and structural detail:View Page
Which of the following is considered as the best fixative for maintaining specimen integrity during and following permanent staining?View Page
Arrange the following major trichrome stain reagents in order of their use in the procedure:View Page

Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics (retired 10/15/2012)
Enzyme Abnormalities and Drugs

The following is a list of enzymes for which known mutations have been associated with clinical effects. Enzymes Substrates (Drugs) Acetylaldehyde dehydrogenase Alcohol Acetylcholinesterase Succinylcholine Alcohol dehydrogenase Alcohol Dihydropyrimidine dehydrogenase Fluorouracil CYP2C9 Warfarin, phenytoin, losartan CYP2C19 Diazepam, omeprazole (Prilosec) CYP2D6 Many antidepressants, opioids, antiarrhythmics Glucose-6-phosphate dehydrogenase Aspirin, quinidine N-acetyltransferase Procainamide, isoniazid Thioprine methyltransferase 6-mercaptopurine UDP-glucuronosyl transferase Acetaminophen, tolbutamide, irinotecan

View Page

Phlebotomy
Case

Marcie Moore was a phlebotomist at a community hospital in Atlanta. It was her week to collect the pediatric unit and she was on her way to the room of a newborn for which she had just received orders to draw a STAT BMP (chem-7) and bilirubin. After informing the mother of the baby about the test she needed to perform, Marcie set up to perform a heel stick on the baby. Marcie chose a site on the outer edge of the heel on the bottom of the baby's foot ( the correct area for a heel stick) and made a small incision with a Tenderfoot lancet after cleaning the site well with alcohol.She immediately began collecting the blood in the correct tube for the BMP and bilirubin. Blood flow was not strong so Marcie squeezed the baby's foot a little to help the blood come out faster – the newborn was screaming and Marcie could tell it was making the mother uncomfortable. She wanted to hurry and get done so the mother could hold the baby.After the chemistry tech ran the blood tests on the tube, she informed Marcie that the newborn had a panic potassium level which did not coincide with the previous blood work on the newborn. Also the chemistry instrument could not perform the bilirubin due to hemolysis. Marcie was asked to recollect the specimen.

View Page
Discussion

Hemolysis can easily be caused by improper phlebotomy techniques. Hemolysis occurs when RBCs are broken up and hemoglobin is released into the plasma, causing it to become pink rather than its natural straw color. Hemolysis can occur by using too small a needle, pulling a syringe plunger too rapidly, expelling blood vigorously into a tube, or shaking a tube of blood too hard. Hemolysis can cause falsely increased potassium, magnesium, iron, and ammonia levels, and other aberrant lab results.In this case, Marcie did not properly wipe the site with gauze after cleaning it with alcohol, and alcohol contacting the blood could have caused RBCs to break up or hemolyze. Marcie also squeezed the baby's foot too hard, causing hemolysis.Relevant topics:Site selection and preparation, Heelstick: Puncture, Hemolysis, Causes of hemolysis

View Page
What had Marcie done to hemolyze the specimen?View Page
Case

Bobby Jones, a phlebotomist at Georgetown Hospital, was called to the pre-op area to perform a bleeding time. Bleeding times may be requested on selected preoperative patients to help assure that they will not bleed excessively during surgery. Bobby gathered the appropriate equipment, then placed the blood pressure cuff of the patient's upper arm, and pumped it to 40 mm Hg. After finding the appropriate site (a few inches below the elbow on the inside of the forearm), Bobby cleaned the site with an alcohol pad and immediately made the incision with a Surgicutt parallel to the bend of the elbow. Bobby then wiped away the first drop of blood with an alcohol pad, and blotted the incision every 30 seconds thereafter. Fifteen minutes later the patient was still bleeding.

View Page
What did Bobby do that could have falsely prolonged the bleeding time?View Page
Discussion

The blood pressure cuff was correctly inflated to 40 mmHg. The site for the incision is indeed the inside of the forearm a few inches below the bend of the elbow, and the cut was correctly made parallel to the bend of the elbow. However, the phlebotomist did not allow the alcohol to dry, and then made the additional mistake of wiping the incision with alcohol. Alcohol will retard blood coagulation, resulting in a falsely elevated bleeding time. It is also important to ask the patient about medications taken within the past week. Certain medications, particularly aspirin, will result in an elevated bleeding time.Relevant topics:Bleeding time: introduction 1, Bleeding time: introduction 2, Bleeding time: performance, Bleeding time, Apply blood pressure cuff, Bleeding time: prepare the site

View Page
Discussion

During a finger stick procedure it is important that the lancet be positioned on the finger so that the incision is perpendicular to the fingerprint. This allows a larger amount of blood to flow. It is also important to wipe away the first drop of blood that emerges form the incision with clean gauze, since it may contain tissue fluids that can cause incorrect test results. The first drop of blood may also contain traces of alcohol remaining from the cleaning step. Alcohol may break up or hemolyze blood cells, causing incorrect results.Relevant topics:Finger-stick collections, Finger-stick: site preparation, Finger-stick: puncture, Wipe away the first drop, Finger-stick specimen collection

View Page
Case

A phlebotomist at Memorial Hills Hospital entered the room of a 6 year old patient. The only test ordered was a CBC, so the phlebotomist decided to do a finger stick. After gathering proper supplies for the finger stick, the phlebotomist began the procedure by putting on gloves and wiping the tip and side of the patient's ring finger with alcohol. He positioned the safety lancet between the ball and the side of the finger and made a small incision. The child cried as the blood was collected.

View Page
Case

A phlebotomist from the laboratory at Midtown Memorial Hospital was working evening shift. Her shift ended at 11 PM and it was 10:30 PM. She suddenly got orders for a STAT blood culture on the second floor. The order specified blood culture times two, 30 minutes apart. The phlebotomist went to the patient's room and decided to collect both blood cultures at the same time form the same site so she would be able to leave on time without having to come back in thirty minutes to collect the second set. She also wanted to "save" the patient from an extra stick. While the phlebotomist was preparing for the collection, she realized she didn't have any Betadine on her tray, and decided she would just clean the site twice with alcohol. She finished the blood culture collections and was able to leave by 11 PM.

View Page
Discussion

This phlebotomist violated hospital procedures in several ways that could adversely impact patient care: Cleaning the site only with alcohol, not iodine, could result in a false-positive contaminated blood culture. This might result in the patient receiving unnecessary intravenous antibiotics, and could prolong the patients hospital stay unnecessarily. Drawing both cultures at the same time lessens the chance of recovering a bloodstream organism.Drawing both cultures from the same site might result in both of them being contaminated, making it very difficult for the physician to distinguish contamination from a "real" bloodstream infection.Relevant topics:Blood cultures: introduction, Avoid skin contamination, Blood culture site preparation 1, Blood culture site preparation 2

View Page
What did the phlebotomist do wrong?View Page
Sterilization materials for phlebotomy

Sterilization materials generally contain either: Isopropyl alcohol (rubbing alcohol), usually in the form of prep pads, or Iodine as povidone-iodine solution ( Betadine™, Purdue Frederick) in the form of solutions , swabs, or swab sticks.

View Page
Routine Venipuncture equipment continued

Basic equipment includes: Alcohol swab, Bandage, Tube(s), Needle, Needle holderDo not remove the needle cover until you are ready to perform the venipuncture.

View Page
Cleaning the site

Use an isopropyl alcohol swab to clean the site.Move the swab in an outward expanding spiral starting with the actual venipuncture site.

View Page
Cleaning the site continued

Allow the alcohol to dry prior to performing the venipunctureDrying gives the alcohol time to disinfect the site.It also tends to prevent a burning sensation from occurring during venipuncture.

View Page
Heelstick - Site selection and preparation

Firmly grasp the infants foot. Do not use a tourniquet. The heel may be warmed with a cloth to help increase blood flow. Wipe the collection site with an alcohol prep pad, and allow the alcohol to dry. Wipe the site with sterile cotton or gauze, to be sure all the alcohol has been removed.

View Page
Heelstick - Puncture

Puncture the left or right side (outskirt) of the heel, not the bottom of the foot.Wipe away the first drop of blood since it may contain excess tissue fluid or alcohol which could alter test results.

View Page
Heelstick - specimen collection

Collect the blood into the appropriate tube.Do not: Squeeze the infant's foot too tightly and wipe with alcohol during the collection.These actions could result in hemolysis (breakdown of the red blood cells), invalidating the test results.

View Page
Prepare the site

Clean the site with an alcohol prep pad and allow it to dry.

View Page
Remove iodine

Clean the venipuncture site with alcohol to remove all the iodine from the patients arm, then apply a bandage.

View Page
Equipment

These items are needed to obtain a blood culture specimen :Gloves (sterile if available)Alcohol pads and sterile gauze padsTourniquet and iodine swabsBlood culture bottlesSyringes, needles, and/or evacuated tube system.

View Page
Site preparation

Clean the site thoroughly with alcohol, then with iodine, to rid the skin of contaminating bacteria.Next, clean the site again with alcohol, and allow it to dry.

View Page
Clean the bottle tops

Clean blood culture bottles while the iodine on the venipuncture site is drying. Wipe the tops of the blood culture bottles, first with a new iodine swab, then with a clean alcohol pad.

View Page
Additional tips continued

Good sterilization is the key to avoiding contaminates:Let the iodine dry before drawing the blood.Be sure to wipe your gloved finger with iodine if palpation is necessary after cleaning. Always remove iodine from blood culture bottle with alcohol to prevent iodine from "sterilizing" the culture, and causing a false negative result.

View Page
Blood

Collect the blood specimen next, if required.Be sure to use the iodine swab provided in the collection kit to disinfect the venipuncture site.Do not use an alcohol swab, as this might lead to suspicion of a falsely elevated blood alcohol result.

View Page

Routine Venipuncture
Preanalytic Errors

Preanalytical ErrorWhat is it?How does it happen?What is the result?HemolysisRed blood cells (RBCs) break and release contents of cell into plasma.Needle incorrectly positioned in vein; cells forced to squeeze through opening. Needle gauge too small; slow blood return into tube. Vigorous mixing or shaking of tube. Alcohol on skin that has not had sufficient time to dry. Some test results may be falsely elevated. (Potassium is especially affected by hemolysis.) Patient may have to be re-drawn. Clotted specimenClumped or clotted cells in specimen that requires anticoagulated or whole bloodInsufficient mixing of blood with anticoagulant in tube. Delay in mixing tube. Slow filling tube. Inaccurate test results for cell counts and clotting studies. Patient may have to be re-drawn. Tube filled to incorrect volumeToo little or too much blood in tube.Tube removed from needle too quickly. Vacuum in tube has been compromised due to use of tube past the expiration date (Results in a short fill). Manual fill of tube may lead to over-fill. Test results may be unreliable due to dilution errors. Patient may have to be re-drawn.

View Page
Blood Collection Tubes

Most blood collection tubes contain an additive that either accelerates clotting of the blood (clot activator) or prevents the blood from clotting (anticoagulant). A tube that contains a clot activator will produce a serum sample when the blood is separated by centrifugation and a tube that contains an anticoagulant will produce a plasma sample after centrifugation. Some tests require the use of serum, some require plasma, and other tests require anticoagulated whole blood. The table below lists the most commonly used blood collection tubes.Tube cap colorAdditiveFunction of AdditiveCommon laboratory testsLight-blue3.2% Sodium citratePrevents blood from clotting by binding calciumCoagulationRed or gold (mottled or "tiger" top used with some tubes is not shown)Serum tube with or without clot activator or gelClot activator promotes blood clotting with glass or silica particles. Gel separates serum from cells.Chemistry, serology, immunologyGreenSodium or lithium heparin with or without gelPrevents clotting by inhibiting thrombin and thromboplastinStat and routine chemistryLavender or pinkPotassium EDTAPrevents clotting by binding calciumHematology and blood bank GraySodium fluoride, and sodium or potassium oxalateFluoride inhibits glycolysis, and oxalate prevents clotting by precipitating calcium.Glucose (especially when testing will be delayed), blood alcohol, lactic acid

View Page
Tourniquets, Alcohol, and Gauze

A tourniquet is used by the phlebotomist to assess and determine the location of a suitable vein for venipuncture. Single-use, latex-free tourniquets are preferred but reusable tourniquets are acceptable. However, if the reusable tourniquet becomes contaminated with blood or body fluid, it must be discarded immediately to avoid the spread of harmful contaminants to other patients. Follow the guidelines established by your facility for cleaning reusable tourniquets.Proper application of a tourniquet will partially impede venous blood flow back toward the heart and cause the blood to temporarily pool in the vein so the vein is more prominent and the blood is more easily obtained. The tourniquet is applied three to four inches above the needle insertion point and should remain in place no longer than one minute to prevent hemoconcentration. If the tourniquet is used during preliminary vein selection, it is best to release the tourniquet after assessing the vein and while you are assembling your supplies. Reapply the tourniquet just before starting the venipuncture; it should then be released soon after the needle has been inserted into the vein and the blood flows into the first tube. If collecting multiple tubes, the tourniquet may remain in place until blood enters the last tube.

View Page
Cleansing the Venipuncture Site

The product used most often to cleanse and disinfect the site prior to venipuncture is 70% isopropyl alcohol in towelette form. Alternative cleansing agents available are chlorhexadine gluconate (chloraprep) and povidone-iodine which are used mainly for collection of blood cultures, blood alcohol specimens, or when the patient is sensitive to alcohol.The alcohol should be applied using a circular target motion, as demonstrated in the image. This technique pushes the bacteria away from the inside of the venipuncture site to the outside. The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid discomfort for the patient. Gauze should be used when applying pressure to the venipuncture site immediately after the needle is withdrawn. Adequate pressure to stop bleeding is crucial to avoid formation of a hematoma or bruise. Cotton balls should not be used to apply pressure to stop bleeding because the clot formed may be dislodged by residual cotton fibers as the cotton ball is pulled away from the site.Paper tape or a bandage is used to cover the wound after bleeding has stopped to prevent disruption of the clot.

View Page

Semen Analysis
Safety Precautions

Safety precautions should be observed when handling seminal fluid. The following guidelines should be followed:If non-disposable items are used, soak contaminated items(e.g., hemocytometers and coverslips) in 70% alcohol or other appropriate decontaminate.All disposable items should be placed in a biohazard bag.Non-latex or powder-free latex disposable gloves must be worn and hands thoroughly washed when the examination is completed.Seminal fluids that are to be discarded should be placed in biohazard bags.

View Page

Special Topics in Phlebotomy
Clean Up Your Act

During a blood collection, bacteria that is present on the skin surface may adhere to the outside of the needle as it enters into the vein. This can allow bacteria to infect the puncture site. A serious infection of the blood (septicemia) or of the tissue (cellulitis) may result. To avoid an infection, it is imperative that the phlebotomist uses a technique that thoroughly cleanses the skin at the site prior to venipuncture.Once the phlebotomist locates a suitable vein for venipuncture, the site of the vein that will be punctured is cleaned with a pre-packaged wipe saturated with 70% isopropyl alcohol.The site is cleansed using a "target" motion beginning at the center of the site and moving outward in concentric circles applying enough pressure to move surface bacteria away from the puncture point. (This is demonstrated in the image on the right). It is not recommended to use a scrubbing back and forth motion to clean the site since you may drag bacteria from a dirty area back into the clean area. Allow alcohol to air dry for effective disinfection of the site. Never use non-sterile gauze to wipe dry the alcohol as this will contaminate the site.During the remainder of the procedure, the site must NOT be touched by anything that has not been cleaned in an identical manner. The phlebotomist should avoid retouching the site after cleaning. If it is absolutely necessary to re-palpate, the phlebotomist MUST clean the gloved finger in a manner identical to the above procedure. Make certain that no other piece of equipment touches the site. This includes ends of the tourniquet and gauze. If you suspect that your needle has touched the site before entry, dispose of the needle, re-clean the site and repeat the procedure using a new needle. If a patient complains that there is redness or pain at the puncture site, even hours or days after the procedure, immediately refer the patient to his/her physician for evaluation.

View Page
Which of the following blood culture collection techniques could cause a false-positive blood culture result?View Page

The Influenza A Virus: 2009 H1N1 Subtype
Survival of the Influenza A 2009 H1N1 Virus

Influenza A viruses, including the 2009 H1N1 strain, are able to survive and maintain infectivity on surfaces for extended lengths of time. Influenza A viruses typically remain infectious for 12 - 48 hours on non-porous surfaces, for 8 - 12 hours on cloth or paper, and for 5 minutes on hands.To reduce spread of the virus from person to person, it is important to discard contaminated items such as tissues and laboratory testing supplies and to wash hands frequently. To eliminate viruses from contaminated surfaces, a number of disinfectants can be used, such as chlorine, hydrogen peroxide, detergents, iodophores, and alcohols. Influenza viruses also can be rapidly inactivated with heat from 167 - 212°F.

View Page

The Urine Microscopic: Microscopic Analysis of Urine Sediment
Leucine Crystals

Leucine crystals indicate a problem with the metabolism of the amino acid leucine. These crystals are round to oval with radiating bands going from a center point out to the periphery, often referred to as a "wagon wheel." These crystals are soluble in hot alcohol and alkali.

View Page

Theoretical and Practical Aspects of Routine H&E Staining
Differentiating

As mentioned earlier, differentiation is used with regressive staining techniques and is used to remove the excess dye that has been taken up into the tissue until a crisp delineation of the desired parts is achieved.Basic dyes are differentiated using a weakly acidic solution prepared with alcohol.Acid dyes are differentiated using a weakly basic solution prepared with alcohol.Aqueous based differentiating solutions are not recommended as the dyes will diffuse more rapidly and over-differentiating becomes a problem.

View Page
Match the following solutions with its' appropriate use.View Page
Types of Eosin

Eosin is any one of a class of rose-colored stains or dyes and many types can be obtained commercially. Some of the more common ones are: Eosin Eosin Y (most widely used and is soluble in both alcohol and water) Alcoholic eosin Y Eosin B Eosin- phloxine Picro-eosin

View Page
Paraffin Sections

The following steps are performed after sectioning tissue samples that have been processed in the routine manner (paraffin) and placing them on the microscope slides:1. Deparaffinization (usually a two step process): First, the slides are placed in a drying oven to remove the water from the tissue, help adhere the section to the slide, and start removing the wax from around the tissue. Then, the slides are brought through 2-3 changes of a clearing agent such as xylene which removes the remaining paraffin from the slides and tissue so that the dyes can then penetrate into the cells.2. Hydration: This is accomplished by using a series of graded alcohols to reintroduce water to the tissue. It begins as the slides go through absolute alcohol which removes the clearing agent. Then they go through several changes of lower percentage alcohols until they reach water. This is a necessary process which prepares the tissue to stain with the aqueous staining solution.

View Page
Frozen Sections

When there is a need to bypass the lengthy routine processing steps for tissue, as in cases where an urgent diagnosis is needed, frozen sections can be prepared. The tissue is cut on a cryostat, which is basically a microtome enclosed in a deep-freeze compartment. The ice surrounding the tissue takes the place of paraffin as the embedding medium; therefore, the and hydration step can be eliminated when staining the slides. Sample rapid H&E stain for frozen sections:1. Formol-acetic alcohol (quick fixative) for 20 seconds2. Water rinse3. Harris's Hematoxylin for 1 1/2 minutes4. Water rinse5. Ammonia water - dip until section turns blue6. Water rinse7. Eosin for 10 seconds8. Water rinse 9. Dehydrate, clear, coverslip

View Page
White Patches on Slides After Deparaffinization Step

Sections should appear clear after the deparaffinization step. If white patches are present, this in an indication that the slides were not completely dried and/or deparaffinized. Possible Causes: Insufficient drying time Insufficient time in xyleneRemedy: Return the slides to the oven or place them in 100% alcohol 2-3 changes of xylene over a period of 10 minutes should be sufficient time to remove all of the paraffin

View Page
Clear Patches on Tissue After Hydrating

When the slides go from the xylene in the deparaffinizing step to the first alcohol in the hydration sequence, the sections should turn slightly opaque. If there are clear patches present then the deparaffinization was incomplete. Possible Causes: Water still on the slides after the drying oven Xylene contaminated with waterRemedies: Remove excess water by putting the slides back in the oven or into 100% alcohol Change reagents regularly to ensure that the xylenes stay water-free Drain slides well before transferring them to the next reagent

View Page
Which of the following observations would indicate that tissue sections have not been sufficiently deparaffinized? (Choose all that apply.)View Page
What is the function of the hydration alcohols? (Choose all that apply.)View Page
Contaminated Clearing Agent

The last dehydrating alcohol must be 100% to ensure that absolutely no water will be carried into the following clearing agent. If the clearing xylene is contaminated with water it will appear milky-white and the slides will not clear. Remedy:Once the slides have gone into a contaminated clearing agent the only remedy is to bring them backwards to water and then dehydrate and clear them again in fresh solutions. The xylene in the coplin jar on the left side of the image is contaminated with water. Note how cloudy it is compared to the one on the right which is not contaminated.

View Page
Poor Eosin Differentiation

Differentiation of the eosin occurs best in 70% alcohol and to a lesser extent in the higher grade alcohols; therefore, adding a 70% alcohol to the dehydration series or adjusting the time in the 70% alcohol will aid in obtaining the desirable three distinct shades of eosin. The pH of the eosin is another possible cause of poor differentiation. Carry-over of the alkaline bluing solution into the eosin can occur if the slides are not rinsed adequately prior to the eosin. This increase in pH will interfere with the uptake of the dye into the tissue. Proper rinse time, adjusting the pH with the addition of acetic acid, and/or regular changes of fresh eosin will resolve this problem.The image on the left is one shade of pale pink as opposed to three shades of pink in the image to the right. This was probably due to being over-differentiated in the alcohols.

View Page
Poor Contrast Between the Hematoxylin and the Eosin

If the hematoxylin or the eosin is too dark or too pale the contrast between the nuclear staining and the cytoplasmic staining will be poor.Decreasing the time in the hematoxylin and/or eosin solution will decrease the intensity of the stain. Conversely, increasing the time will increase the intensity. The time in the differentiating solutions can be adjusted as well. Increasing the time in the acid alcohol or the dehydrating alcohols will decrease the intensity of the hematoxylin and eosin respectively. Whereas decreasing the times in these will increase the intensity of the hematoxylin and eosin. With these factors in mind, the optimal times in both the dyes and the differentiators need to be determined to achieve the proper balance between the nuclear and cytoplasmic staining.Keeping the reagents fresh by exchanging them with new reagents at regular intervals is also important to ensure good results.The top image shows a very poorly stained slide with very little contrast between the hematoxylin and the eosin. A well-stained slide is shown in the bottom image.

View Page
What is the indication that the tissue did not go through the bluing step?View Page


MediaLab, Inc.

http://www.MediaLabInc.net    |    (877) 776-8460 (tollfree)    |    sales@medialabinc.net