Collecting body fluids, viral cultures, skin specimens
Collecting sputum specimens
Attention
- Remember, fresh is best — send to town within 3 days (72 hours)
- Sputum is thick and slimy — coughed from deep in throat and lungs
- If specimen thin and watery or contains bits of food — throw away
- Take 3 samples over 24 hours (8 hours apart)
- Cytology for cancer testing
- AFB for tuberculosis (TB) testing
- Collect sputum for TB outside, away from other people — do not collect in toilet or communal space
What you need
- Sterile specimen jars
What you do
For MC&S (1 sample)
- Label specimen jar ‘MC&S’
- Ask person to take several deep breaths, cough hard and spit into specimen jar. Do first thing in morning, or at time of consultation if urgent
- Store and transport under refrigeration within 3 days (72 hours)
For AFB or cytology (3 samples)
Collect samples at least 8 hours apart. Important to include early morning sample
- Give person 3 specimen jars labelled (AFB or cytology)
- Day 1 — Morning
- Day 1 — Afternoon
- Day 2 — Morning
- OR can collect 1 straight away, 1 early next morning, 1 afternoon of second day (label with date and time collected)
- Ask person to take several deep breaths, cough hard, and spit into specimen jar
- AFB
- Keep specimens out of sunlight. If room bright — put in brown paper bag then in biohazard bag
- Keep cool and store in fridge if delay in transport — transport within 3 days (72 hours)
- Cytology
- Store and transport under refrigeration within 3 days (72 hours)
Viral culture/smear
Attention
- Contact your local laboratory as viral kit types used differ across jurisdictions
- Store and use according to manufacturers instructions
- Check use-by dates — do not use out of date kits
What you need
- Viral collection kit — cotton swab, glass slide and holder, viral transport medium (VTM), sterile No. 23 scalpel blade
- Pencil and pen
What you do
- Label glass slide with pencil, label transport medium container with pen
- Lift top off blisters, pustules or scabs with point of scalpel blade
- Rub base of sore (lesion) with cotton swab, then roll swab onto 2 wells (indents) on glass slide
- Let swab air dry, put into VTM
- Check slide is correctly labelled
- Store and transport VTM at room temperature
- Store and transport slide under refrigeration
Skin scrapings
Scabies
Attention
- To find scabies mite you need to find burrows and track marks
- Sores usually called scabies don’t contain mite or its eggs — they are part of the allergic reaction
What you need
- Pencil and pen
- Glass slide and holder
- Blunt blade or wooden spatula
- Paraffin oil
- Magnifying glass
What you do
- Label glass slide with pencil, label holder with pen
- Do not scrape sore/pustule
- Use magnifying glass to find burrow and track mark sites
- Using blunt blade or wooden spatula, scrape firmly from edge of site, collect as much skin as possible
- May have to scrape hard to take off top of lump
- Keep scraping until tiny flecks of blood are seen
- Repeat in at least 3 different places
- Put scrapings onto slide, leave to air dry, cover with a few drops of paraffin oil
- Check slide is correctly labelled
- On pathology request form — 'Scabies microscopy'
- Store and transport at room temperature
Fungal lesions
What you need
- Yellow top (urine) container or appropriate container, labelled
- Pen
- Sterile scalpel blade — do not send any sharp scraping object with the specimen
What you do
- With blade at right angles to skin, scrape scaly edge of sore/lesion
- Hold open container underneath to catch flakes
- For large or multiple sores/lesions scrape in several places
- Put lid on container, check it is correctly labelled
- Store and transport at room temperature
- On pathology request form put ‘Fungal M&C on skin scrapings’ and also request 'Scabies microscopy' if suspected