Container Information and Courses from MediaLab, Inc.

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.

The reagent strips must be handled and stored properly in order to ensure that results are accurate. The following precautions should be observed: Store strips according to the manufacturer's recommendation. DO NOT expose strips to moisture, direct sunlight or volatile fumes. Remove only enough strips for immediate use and immediately recap the bottle. Avoid contamination of test strips. Do not touch the test areas with fingers or do not lay the test strips directly on the workbench. DO NOT use discolored strips. Compare the color of the unused strip to the negative area on the color chart provided by the company. The color should be similar. Check the expiration date. Re-label the container with a revised expiration date if the manufacturer states a shortened usage period once the container has been opened. Reagent strips must be tested periodically (frequency defined by the laboratory) for clinical reactivity with normal and abnormal urine controls. Urine controls are available commercially or may be prepared and preserved in-house.

Perform quality control procedures. Use a fresh, well-mixed uncentrifuged urine. Hold the reagent strip by the opposite end from the test areas and dip the stick into the specimen so that all test areas are immersed in the specimen. Remove the stick immediately. Prolonged immersion in the sample may wash out the test reagents. Hold strip in a horizontal position and run the edge of the strip against the rim of the urine container or touch the long edge of the strip to absorbent toweling to remove excess urine (do not blot the strip). Maintain the strip in a horizontal position to prevent mixing of reagent chemicals. Observe the reagent pads at the specified time periods. Color changes that occur after the stated maximum read time are not valid. Hold the strip close to the chart and compare the colors to read the results. A good light source facilitates accurate reading.

A false positive result may occur in the presence of strong oxidizing agents in the collection container. In random urine specimens from women, a positive result for leukocyte esterase may be due to a source external to the urinary tract. Other urine sediment findings such as bacteria, squamous or renal epithelial cells, lymphocytes or red blood cells do not contain esterases, and would not produce a positive leukocyte esterase test.

Urine to be screened for ketone bodies should be tested immediately or refrigerated in a closed container since acetone is lost to the air if the sample is left standing at room temperature for any length of time. The Acetest® can be used for the semiquantitation of ketones in urine, serum, or whole blood, however the reaction times differ depending on the type of specimen tested. The same substances which interfere with the dipstick tests for ketones will also interfere with Acetest® because the same reaction is involved.

The last type of collection is the observed collection. In this type of collection both the donor and "observer" enter the collection stall. Observed collections afford less privacy in order to guard against the donor using items which are designed specifically to beat the testing process. After entering the stall the observer requests the donor to: Raise shirt, blouse, dress / skirt as appropriate, above the waist, just above the navel, Lower clothing and underwear to mid-thigh, and, Then turn around to show the observer that the donor does not have a prosthetic device. After the observer has determined that the donor does not have a prosthetic device, the donor is permitted to return clothing to proper position. The observer must personally watch the urine go from the donor's body into the collection container.

The term "shy bladder" refers to a situation where the donor is unable to provide the sufficient amount of urine required for a drug screen.If the donor indicates upon arrival at the collection site that he or she cannot provide a specimen, the collector should begin the collection process anyway and have the donor make an attempt to provide a specimen. If after an attempt the donor cannot provide a specimen or can only provide a specimen of insufficient volume, the donor must be instructed not to leave the collection site and to do so will be considered a refusal to test. The donor should be monitored either by the collector or by another member of the collection site staff. The donor should be encouraged to drink up to 40 ounces of fluid reasonably distributed over a period of up to three (3) hours, or until the donor can provide a sufficient amount of urine, which ever comes first. If no specimen is provided on the first attempt, the same collection container may be used for the next attempt. The donor may keep possession of the container during the waiting period. The same CCF is used.

In an observed collection, the observer must be the same gender as the donor. If an observed collection must be made, and the collector is not the same gender as the donor, it is the responsibility of the collector to locate someone who is the same gender as the donor to act as the observer. If the collector is not the observer, the donor can not hand the specimen to the observer. It is, however, the responsibility of the observer to make sure the donor directly hands the specimen to the collector.In an observed collection, the donor must raise and lower clothing and turn around to permit the observer to determine if a prosthetic or other device is present. The observer must physically watch the donor urinate into the collection container.The collector must mark on the CCF that the collection was observed and state why in the Remarks section.If the collector learns that a directly observed collection should have taken place, but did not, the collector must inform the employer that the donor must be directed to return for an immediate recollection under direct observation.

A chemical attack involves poisonous vapors, aerosols, liquids, or compounds. A terrorist might spread harmful chemicals with a bomb; spray from aircraft, boats, or vehicles; pour the chemicals into water or onto food; or leave a container of poisonous chemical in a confined public space.

Do not leave test orders or test results in areas where they can be viewed by patients.Do not discuss test results or any patient information in areas where patients can overhear the conversation. Be careful not to discuss confidential information on the telephone where patients can overhear the conversation.Do not provide supplies to physician offices other than those usually provided by the laboratory. Document any supplies given to an office.Do not supply items that the office can use for testing (e.g. urine dipsticks). Do not allow offices to dispose of biohazard waste or sharps in the waste containers paid for by the laboratory.

Engineering Controls are devices which isolate the worker from the hazard of exposure.Examples: Self-sheathing needles Sharps disposal containers Disposable resuscitation bags Microbiological safety cabinets Proper use of engineering controls in your workplace will help protect you from bloodborne pathogens.

Place blood and other infectious specimens ... first in an appropriate sealed container and then in a secondary red or biohazard labeled bag. Or place them in a compartmentalized tray for transport within the institution.

Contaminated sharps must be placed in puncture resistant, leak-proof, closable, biohazard labeled containers.These must be closed when only three quarters full, to prevent sharps from sticking out of the opening, and must be disposed of properly.

The following do not require biohazard labeling: Blood products in clinical use Individual specimen containers However, they are subject to Standard Precautions.

There was no guarantee that workers would be told about the chemical hazards they might face on the job. Container labels and warning sheets did not always give enough information on potential hazards, what to do in an emergency, or where to turn for help.

Every chemical container is labeled by the manufacturer. The format of the label will differ from company to company. The label must contain similar types of information to meet the OSHA and DOT regulations. The label makes it easy for you to find a chemical's possible hazards. The basic steps to protect yourself against the chemical's hazards are listed on the label.

Formaldehyde has a manufacturer's label on its container indicating the hazards associated with it.Read this label carefully!

All biohazard needle disposal containers are marked with a “full” line at about ¾ of the box’s volume. Therefore, needles should never be sticking out of the top of the container. Julie should never have attempted to put the needle into an overly full container. The needlestick safety and prevention act requires the use of butterflies with built in safety devices. However, they are only effective if properly activated. When disposing of a butterfly needle, hold its “wings” with one hand, and the hub at the opposite end of the tubing with your other hand to prevent the needle from recoiling. Butterflies should be used with extra caution since they are the number one cause of needle stick injuries.Relevant topics:Needle disposal, Sharps disposal containers, Butterfly needles with safety 1, Butterfly needles with safety 2, Needle-stick injuries, Built-in safety features, Angel Wing™ safety butterfly, Punctur-Guard™ safety butterfly

All sharps must be disposed in appropriate sharps disposal containers. These are usually available in patient rooms, but may also be available on the phlebotomy tray depending on your institution’s policies and procedures.

After collecting the blood specimen into a syringe, properly activate the appropriate safety device, and dispose of the needle in a sharps container.Attach the syringe to a blood transfer device by twisting the needle tip into the hub of the device.Push a vacuum blood collection tube into the holder of the transfer device, and let the tube fill to the appropriate level.

All needles & other sharps must be disposed of in approved sharps disposal containers. Other contaminated waste must be discarded in an appropriate red biohazard bag or waste receptacle.

Label the tubes appropriately and seal their tops with tamper-evident strips.Complete the chain of custody form and other paperwork as directed. Place paperwork and specimens in the appropriate container, and apply the required seals in the presence of the donor.

Other aspects of specimen collection that must be considered are the temperature of the specimen and the time needed to transport it to the laboratory.Ideally, the specimen should be collected in a room at the testing site.If on-site collection is not possible, the specimen should be kept at body temperature (37°C) from the time of collection until it arrives at the laboratory. This can be facilitated by holding the container close to the body, for example by carrying it in an inside pocket.Semen should arrive at the laboratory as soon as possible after collection, preferably within one hour.Lubricants should not be used for collection unless absolutely necessary as most lubricants are toxic to sperm. If lubricant must be used then non-toxic forms such as KY jelly or cooking oil should be the only options.

In order to test collection containers for sperm collection, the sperm must be held in the container for several hours to ensure that neither the numbers nor motility are adversely affected. Numbers will decline if the sperm adhere to the container. Motility will decline if the container is toxic. One method of testing involves removing sperm from semen. The specimen would be centrifuged and the sperm pellet diluted in a small volume of culture medium containing an energy source and at least 0.5% of a protein, such as serum albumin. The processed sperm specimen would be placed in the container to be tested. Total count and motility of the sperm would be tested at the start of incubation and 24 hours later. The container is non-toxic if the motility at the end of 24 hours is no less than 50% of the original value.

Urine specimens should be collected in a clean, dry, disposable container. If the sample is to be cultured, the container must be sterile. The preferred method is the "clean catch" collection. The external genitalia are cleansed with a mild antiseptic solution. The first part of the urine stream is discarded while collecting only the midstream portion of the urine.