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1 CE HOURMedical Specialities

Specimen Transportation Methods

Key Terms: 
  1. Alkaline Peptone Water – Specialized growth medium used in microbiology for the cultivation of various microorganisms 
  2. Anticoagulant – An additive added to a tube that does not allow the blood sample to clot
  3. Aerobic – refers to an environment that has oxygen molecules
  4. Anaerobic – refers to an environment that is non-oxygenated
  5. Buffers – a solution that maintains the stability of a system’s PH level when adding small quantities of acids or bases
  6. Cellulose Wadding – An ecological and recyclable material used for cushioning and insulation purposes in packaging products
  7. Excisional – Refers to the surgical removal of an entire growth, tissue, or organ
  8. Hemolysis – Refers to the destruction of red blood cells 
  9. Hypothermic – a condition involving a low body temperature, usually below 95˚F or 35˚C
  10. IATA – International Air Transport Association
  11. ICAO – International Civil Aviation Organization
  12. ICD-10 Code – International Classification of Diseases, Tenth Revision
  13. Incisional – refers to the surgical removal of a portion of a growth, tissue, or organ
  14. ISO 15189 – International standard for medical laboratories specifying quality management system requirements
  15. Medium – solution used to preserve and transport specimens for examination
  16. Oragene – collection kit specific to saliva samples testing DNA, 95% accuracy
  17. Permeable – membrane that allows liquids or gases to pass through it
  18. Photosensitive – sensitivity to light sources and reactions upon receiving photons
  19. Quantity Not Sufficient (QNS) – inadequate sample volume for testing
  20. Suprapubic Aspiration – a sterile and precise procedure used to collect uncontaminated urine samples
  21. Swab Applicator – sterile polyester tipped applicator used in specimen collection from various locations throughout the human body 
  22. Transport Vial – A holding medium to maintain the viability of microorganisms, both anaerobic and aerobic, through the collection, transportation, and shipment of clinical specimens
  23. Urethral Catheterization – The standard method of accessing the urinary bladder involves inserting a flexible tube through the urethra into the bladder, allowing urine to drain freely for collection
  24. Vitrification – Process by which liquids solidify without crystallization and directly transform from a liquid state to a glass ice-free state 


 
Outline:
 
  • Introduction
  • Key Terms
  • Specimen Types
    • Blood specimens 
      • Whole Blood
      • RBC
      • Plasma
      • Platelets
      • Cryoprecipitate
      • Albumin
      • Immunoglobulins
  • Microbiological Specimens
    • Surgical Biopsies
    • Tissue
    • Wounds
    • Body Fluids
  • Chemical Specimens 
    • Hazardous Material
    • Chemical Exposure
    • Blood Collection
    • Urine Collection
  • Urine Specimens 
    • Random
    • Clean-Catch
    • Culture and Sensitivity
    • Suprapubic Aspiration
    • Urethral Catheterization
    • 24 Hour Collection
  • Saliva Specimens 
    • Free-flowing
    • FTA Card
    • DNA Kit
      • Oragene
    • Passive Drool
    • Whole Saliva
    • Swab
  • Tissue and Biopsy Specimens 
    • Renal
    • Liver
    • Bone
    • Bone Marrow
    • Endoscopic
    • Punch
    • Needle
      • FNA
      • Core Needle
      • Vacuum Assisted
    • Brush
    • Lymph Node
    • Ultrasound-Guided
    • Surgical
      • Incisional
      • Excisional
  • Additives, Mediums, Broth and Preservations
    • Blood Additives 
      • Anticoagulant 
        • Sodium Citrate
        • Lithium Heparin
        • Sodium Heparin
        • EDTA
        • Potassium Oxalate
      • Clot Activator 
        • Silica
      • Thixotropic Gel
      • Sodium Fluoride
      • SPS
  • Microbiological Transport Mediums
    • Meticulous Preservation
    • Classification of Physical State
      • Semi-solid
      • Liquid
    • Classification of Utility 
      • Bacterial
      • Viral
      • Parasites
    • Cary-Blair Medium
    • Amies Medium
      • With Charcoal
      • Without Charcoal
    • Stuart’s Medium
    • Venkatraman Ramakrishnan (VR) Medium
    • Alkaline Peptone Water
    • Sach’s Buffered Glycerol Saline
    • Viral Transport Medium (VTM)
    • Anaerobic Transport Medium (ATM)
    • Chlamydia Transport Medium
    • Mycoplasma Transport Medium
  • Chemical Additives
    • Anticoagulants 
      • EDTA
      • Sodium Heparin
      • Potassium Oxalate
    • Glucose Preservative 
      • Sodium Fluoride
    • Sterile Screw Cap Plastic Container
      • No Additives
    • Aliquoting into Tubes 
      • Contain Preservatives
    • Urine Preservatives
      • Certain Buffers
        • Boric Acid 
          • Most commonly used
        • Hydrochloric Acid 
          • Used commonly in urine specimens
        • Acetic Acid 
          • Used in 24-hour urine collection
        • Oxalic Acid
    • Saliva Additives
      • Sodium Dodecyl Sulfate (SDS)
      • Ethylenediaminetetraacetic Acid (EDTA)
      • Tris Buffer
    • Tissue and Biopsy Preservation 
      • Fixative, 10% Formal Saline
      • Normothermic
      • Dry State
      • Hypothermic
      • Vitrification
      • Slow Freezing
  • Choosing the Right Containers
    • Blood Collection Containers 
      • Blood Specimens
      • Culture Bottles
        • Anaerobic
        • Aerobic
      • Vacutainer Tubes
      • Microgard Closure 
      • Micro capillary Tubes
    • Microbiological Collection Containers
      • Swab
      • Transport Vial 
        • Sterile Screw Cap Container 
        • Sterile Screw Cap Container with Specified Medium
    • Urine Collection Containers
      • Sterile Screw Cap Container
      • Gray Top Urinalysis Tube with Preservative
      • UA Preservative Plus Plastic Conical Bottom
      • Microscopic slide 
        • Cover Slip
    • Saliva Collection Containers
      • Saliva Collection Tubes
        • Funnel Devices
        • Collection Cups
        • Sterilization Kits
        • FTA Cards 
          • Elute Cards
          • EasiCollect Devices
          • QIAcard Cards
      • Sterile Collection Swabs
        • Sample Punching Tools
        • Storage Pouches
        • Oragene Saliva Collection Tubes
        • Funnel Device
        • DNA Stabilization Solution
        • Sterile Caps and Packaging
        • SalivaBio Collection Aid
        • Cryovials
        • Cryogenic Tubes 
          • Wheaton
          • Nunc
        • Swab
    • Tissue and Biopsy Collection Containers
      • Glass Jar or Bottle with Screw Caps
      • Cryoprotectants
        • Low Molecular Weight Solutes 
          • Permeable
        • Sugars and High Molecular Weight Polymers 
          • Non-permeable
  • Specimen Handling
    • Blood Specimen Handling
      • Improper Time of Collection
      • Inadequate Fast 
      • Avoid Contamination
      • Use Correct Disinfectants
      • Extended Tourniquet Time
      • Avoid Hemolysis
      • Correct Gauge Needle
      • Use Correct Order of Draw
      • Proper Inversion Amounts
      • Avoid Quantity Not Sufficient (QNS)
      • Avoid Improper Storage Conditions
      • Photosensitive
      • Avoid Processing Delay
      • Failure to Separate Serum From Cells
      • Improper Use of Serum Separator
    • Microbiological Specimen Handling 
      • Expel Air, Needle Collections
      • Avoid Use of Cotton or Wood Handle Swabs, Ocular Specimens
      • Avoid Toilet Tissue, Stool Specimens
      • Avoid Cross Contamination, Urine Specimens
      • Avoid Lubricants, Genital Specimens
    • Chemical Specimen Handling
      • Left Whole
      • Unopened
      • Store at  1˚ - 10˚C
      • Dry Ice, Preferred
    •  Urine Specimen Handling 
      • Unpreserved Specimens, Refrigerated 
      • Wash Hands
      • Refrain From Touching the Inside of the Urine Container
      • Avoid Contamination of Feces, Water or Dirt
    • Saliva Specimen Handling
      • Choose Correct Tools
      • Patient Preparations
      • Choose Correct Storage Temperature
      • Limit Freeze / Thaw Cycles
      • Long Term Storage, Frozen
      • Long Term Storage, Room Temperature
    • Tissue and Biopsy Specimen Handling 
      • 10:1, Specimen Immersion
      • Large Specimens, Bucket
      • Amputated Specimens in a Rubber Sheet
      • Bulky Specimens Bisected
      • Stomach / Intestine Opened
      • Cotton Wool, Never Water or Normal Saline
  • Confirm Labeling
    • All Specimens 
      • Patient’s First and Last Name
      • Date of Birth
      • Sex
      • MRN
      • Physician’s Name
      • Physician Contact Information
      • Confirm Patient Followed Testing Guidelines
      • Identify Floor and Room Number, If Applicable
      • Bed Number, If Applicable
      • Type of Specimen Collected
      • Specimen Identification Barcodes
      • Any Special Handling Instructions
      • Test Codes (ICD-10)
      • Time Collected
      • Date Collected
      • Collector’s Name and Title
      • Any Notable Events During Collection
  • Transportation Temperature  and Packaging
    • Transportation Temperature 
      • Ambient
      • Room Temperature
      • Refrigerated
      • Frozen
    • Transportation Packaging
      • Primary Receptacle
      • Sterile leakproof with Tight Fitting  Lid
      • Cushioning Material
      • Secondary Container
      • Documentation
      • Styrofoam Cooler
      • Rigid, Outer Packaging
      • Spill-proof and Absorbent Materials
        • Cellulose Wadding
        • Cotton Balls
        • Super-absorbent Packs
        • Paper Towels
      • biohazard Envelope
      • Secure, Tamper-Evident
      • Monitoring Devices
      • Insulated Coolers
      • Dry Ice
      • Gel Packs
      • ISO 15189
      • Applicable Identifying Markings
      • Outer Packaging
      • Biohazard
      • Non-Pathogenic
      • Exempt Human Specimen
  • Method of Transportation 
    • Dangerous Goods Certificate
    • Three Classifications 
      • Category A
      • Category B
      • Exempt Specimen
      • Federal Transport Regulations and Standards
      • Biological Specimens
      • IATA
      • ICAO
      • U.S. DOT
      • USPS, Next Day Air
      • FedEx, Priority Overnight
  • Tracking and Special Markings
    • Tracking Devices
      • Barcodes
      • Specimen Barcodes
      • QR Codes
      • Laboratory Information Systems (LIS)
      • RDIF Technology 
        • Electromagnetic Fields
      • IoT-enabled 
        • Reports Any Temperature Fluctuations
    • Specific Markings on Shipping Container
      • Shipper and Consignee
      • Responsible Person
      • Emergency Contact
    • Documentation 
      • Shipper’s Declaration of Dangerous Goods
        • Required information:
          • UN number
          • Proper shipping name, followed by technical name 
          • Class or division
          • Quantity of substance and type of container
          • Packing instructions used
          • Authorization code, if applicable
      • UN Numbers
        • Proper Shipping Names 
          • Common Shipping Names – UN2814
          • Common Shipping Names – UN3245
          • Common Shipping Names – UN3291
          • Common Shipping Names – UN3373
          • Common Shipping Names – UN1845
        • Classes of Clinical Lab Samples 
          • Class 6 - Infectious Substances
            • UN2814 – Category A
            • UN3373 – Category B
          • Class 9 
            • UN1845 – Dry Ice
            • UN3373 - Biological Substance
        • Examples of Category A Substances
          • Class  6 – UN2814
          • Process of Categorization
        • Examples of Category B Substances
          • UN3373 – Category B
          • Category B - Class 6 UN3373
          • Class 6 UN2814 Packaging Certification
  • Specimen Rejection Criteria
    • Rejection Criteria 
      • Delayed Delivery
      • Container Leakage
      • Inadequate Volume
      • Inappropriate Transportation Methods
      • Regulatory Non-Compliance
      • Contamination and Improper Collection
      • Incorrect Labeling
      • Hemolysis
      • Clotted Specimens
      • Specimen Age Out
  • Urgent Response Plan 
    • Immediate Notification
    • Sample Isolation
    • Assessment and Action
    • Documentation and Review 
  • Conclusion