Contaminated 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.

Low JC. Donachie W.: A review of Listeria monocytogenes and listeriosis. Veterinary Journal. 153:9-29, 1997Following the initial isolation and description in 1926, Listeria monocytogenes has been shown to be of world-wide prevalence and is associated with serious disease in a wide variety of animals, including man.Our knowledge of this bacterial pathogen and the various forms of listeriosis that it causes has until recently been extremely limited, but recent advances in taxonomy, isolation methods, bacterial typing, molecular biology and cell biology have extended our knowledge. It is an exquisitely adaptable environmental bacterium capable of existing both as an animal pathogen and plant saprophyte with a powerful array of regulated virulence factors.Most cases of listeriosis arise from the ingestion of contaminated food and in the UK the disease is particularly common in ruminants fed on silage.Although a number of forms of listeriosis are easily recognized, such as encephalitis, abortion and septicaemia, the epidemiological aspects and pathogenesis of infection in ruminants remain poorly understood. The invasion of peripheral nerve cells and rapid entry into the brain is postulated as a unique characteristic of its virulence, but relevant and practical disease models are still required to investigate this phenomenon.

If the chemical is a dry powder, first brush it off from the victim, taking care not to contaminate yourself, especially your eyes.Immediately flush exposed skin with large amounts of water.Remove contaminated clothing while continuing to flush the affected area with water.Continue flushing with water for 15 minutes or longer.Seek emergency medical attention.

Face shields, masks, and safety glasses protect your eyes and the mucous membranes of your nose and mouth.They must be worn whenever it is reasonably anticipated that splashing or spraying of blood or other contaminated materials may occur.Employees who wear prescription eyewear may be protected with a face shield, goggles, or with side shields attached to their glasses.

Most likely means of dissemination: Aerosol (eating contaminated food)Primary route of entry: Inhalation (oral)General signs and symptoms: Difficulty with speaking, swallowing, or blurred or double vision, drooping eyelids (ptosis), dilated pupils, dry mouth, decreased gag reflex, weakening of the reflexes (hyporeflexia), abnormal sensations such as numbness, prickling, tingling, and arm or leg weakness.Botulism is caused by a neurotoxin and technically could be classified as a chemical WMD. For our discussion it is placed under biological agents because the toxin is derived from a bacterium. Botulism is potentially life-threatening, producing a characteristic clinical picture of muscular paralysis leading to respiratory failure.                Photo courtesy of the CDC archives.    

Stay inside or get inside quickly. Find a “Shelter-in-place”. To “shelter in” is a way to make the building you are in safe as possible to protect yourself until help arrives. You should not try to “shelter in” in a vehicle unless you have no other choice. The best room to use is one with as few windows and doors as possible. Be sure to close all windows and doors, and turn off the furnace, air conditioners, and exhaust systems. As best as possible, seal all openings in windows and doors. Monitor your radio for instructions from authorities. If you believe you’ve been exposed and you can’t get to a hospital, shed all your clothes as quickly as possible. Don’t take the clothes inside because you may spread contamination. Go straight to the shower and thoroughly wash all body parts with a coarse soap. It is important not to ingest radiation by eating contaminated food or even chewing on contaminated fingernails. Also, certain types of radioactivity can be flushed from the body by drinking large amounts of water. After an attack don’t travel through heavily contaminated areas. If you can get out of the general area through an uncontaminated route, do so—otherwise, stay indoors until assistance arrives.               

Technologists are primarily responsible for performing testing and reporting results. Other duties include:Performing only those tests authorized by the director and for which the technologist is licensed by specialty.Following the laboratory's procedure for specimen handling, running tests, reporting results, and maintaining recordsParticipating in proficiency testing and demonstrating that proficiency samples are tested in the same manner as patient samplesFollowing quality control and instrument calibration policiesDocumenting corrective action taken when results exceed the laboratory's acceptable performance valuesUsing professional judgment to ensure test validity, including recollecting and retesting samples that may be flawed or contaminated

Hepatitis B most often spreads when certain body fluids from an infected individual come in direct contact with another person.Contact may occur through: a break or sore in the skin a contaminated sharp contact with mucous membranes that line the insides of the mouth, nose, eyes, and the genital organs. HBV is not spread through casual contact, such as handshake, or through sweat.

HBV is spread in the community through: Sexual contact Drug abusers sharing contaminated needles An infant's exposure to its mother's body fluids

If the outside of a sealed specimen container is contaminated, the standard requires that the specimen be placed in a secondary red/orange or biohazard labeled container.

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.

Remove contaminated personal garments as soon as possible.Do not take your contaminated garments home.Your employer will launder them and provide you with clean clothes to wear.Handle contaminated laundry as little as possible.

Gloves must be worn: when there is a reasonable chance of exposure to blood, other infectious body fluids, mucous membranes, or nonintact skin, during vascular access procedures, including phlebotomy, or when handling contaminated items or surfaces.

Even after taking all the proper precautions there is still a small chance of an exposure incident.Exposure incident: Blood or another potentially infectious body fluid coming into direct contact with mucous membranes or nonintact skin.Parenteral exposure: Needle stick or being cut by a contaminated sharp.

Should you become contaminated with formaldehyde, a quick drench shower and an eye wash station are available in your area.Ask your supervisor for their exact location and how they work.

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

Bloodborne pathogens are infectious micro-organisms which live in the bloodstream.You can be exposed to bloodborne pathogens if you are injured with a contaminated needle.You can also be exposed if your mucous membranes, including eyes, mouth, or the inside of your nose come into contact with contaminated body fluids.

Epithelial cells in large numbers within sputum smears means that the specimen is predominantly oral saliva, rather than true sputum from the lung. Epithelial cells in urine smears indicate that the sample has been contaminated by organisms found on the vulva or distal urethra. Bacteria found near or on epithelial cells are usually normal contaminating bacterial flora.White blood cells indicate inflammation and possible infection. The direct smear examination should focus within and around these cells.Red blood cells in a direct smear are not usually significant.Yeast may be present as normal flora in upper respiratory tract or genital tract. They may be significant if they predominate, or if budding yeast forms are seen.Hyphae are more likely to indicate the presence of fungal infection, but this determination requires correlation with clinical findings.Bacteria found in spinal fluid, blood, tissue and specimens from other sterile sites are always significant.Body fluids which are normally sterile must be examined carefully. If only one organism per oil immersion field is identified, then there are about 105 organisms per mL present in the sample! Bacteria observed in specimens from the throat, genital tract and other areas containing normal flora suggest infection only if their composition and type varies significantly from the norm.

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.hemacytometers and coverslips) in 70% alcohol or Wexide®.All disposable items should be placed in a biohazard bag for autoclaving.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 for autoclaving.