Remote Primary Health Care Manuals

Collecting swabs

Well lit area.
Wear gloves.
Wear safety glasses.jpg
Pathology collected.
Sharps disposal.

       

Making slides

Attention

  • Take slides out of holders, make sure they are ‘frosted side up’
  • Write on frosted end of glass slide in pencil — pen ink will rub off or smear, fixative spray will wash ink off
  • Be gentle — pressing too hard or rubbing backward and forward can destroy microscopic cells
  • Make sure slides are dry before putting back into holders and snapping them shut — use rubber band or tape if catch won’t hold

What you need

  • Clean glass slide with frosted end
  • Sharp pencil, pen
  • Cardboard or plastic slide holder
  • Swab

What you do

  • Label frosted end of slide with pencil, label slide holder with pen
  • Take specimen, gently roll swab once only along glass slide — Figure 5.20 and Figure 5.21. Don’t press down or rub backward and forward
  • Always leave to air dry
  • When dry, put slide into holder, secure catch. Make sure slide correctly labelled

Figure 5.20  

Roll swab along slide.

Figure 5.21  

Single layer of specimen.

Wound swabs

What you need

  • Sharp pencil, pen

MC&S

  • Transport medium swab
  • 0.5mL sterile normal saline
  • Glass slide with frosted end, slide holder

NAAT

  • Aptima or sterile dry swab

What you do

  • Label frosted end of slide with pencil, label slide holder and swab container with pen

MC&S

  • If wound dry (no pus) — wet tip of swab with sterile normal saline
  • Starting at centre of wound, roll dry swab gently to edges, collecting any discharge on the way
  • Gently roll swab once along glass slide — Figure 5.20 and leave to air dry
  • Put swab into transport medium container, close firmly
  • When slide dry, put into holder and secure. Make sure slide correctly labelled
  • Store and transport at room temperature

NAAT

  • Start at centre of wound, roll dry swab gently to edges. Collect any discharge
  • Put swab back into container
    • If using Aptima swab — remove lid, put swab in tube — Figure 5.22. Break off handle at groove — Figure 5.23, leaving swab in tube

Figure 5.22  

Aptima tube for collected swab.

Figure 5.23  

Aptima swab has groove indicating point where handle is broken off to fit into tube.

  • Make sure swab container correctly labelled, closed tightly
  • Store and transport at room temperature

Collecting eye, ear, nose, throat swabs

Attention

  • Do throat swabs as quickly as you can so person doesn’t gag
  • If swabbing both eyes, ears or nostrils — need separate swabs and clearly labelled slide for each side (eg ‘left eye’ and ‘right eye’)

What you need

MC&S

  • Wooden spatula/tongue depressor (for throat)
  • Transport medium swab
  • 0.5mL sterile normal saline
  • Pencil and pen
  • Glass slide with frosted end, slide holder
  • Penlight torch

NAAT for eye, nose or throat

  • Wooden spatula/tongue depressor (for throat)
  • Penlight torch (for throat)
  • Aptima or dry swab (flocked if available)

Nasal NAAT for influenza and other respiratory viruses

  • Dry swab (flocked if available)

What you do

  • Label frosted end of slide with pencil, label slide holder and swab container with pen

MC&S

  • Wet tip of swab with sterile normal saline

For eye

  • Tilt head back
  • Hold lower eyelid down, ask person to look upward
  • Run swab tip very gently along inside of bottom eyelid, from inner to outer corner of eye — Figure 5.24

Figure 5.24  

Swabbing eye.

For ear

  • Tilt head to one side
  • Straighten ear canal
  • Put swab about 0.5–1cm into ear canal
  • Gently turn it around (rotate), take it out

For nose

  • Push nose upward as shown — Figure 5.25
  • Put swab up into nostril about 3cm, parallel to roof of mouth not to outside of the nose
  • Gently turn swab around twice, take it out

Figure 5.25  

Push tip of nose up to improve visibility.

For throat

  • Tilt head back a little
  • Hold down tongue with spatula/tongue depressor
  • Look at throat with penlight to pick site/s — pus or red area
  • Ask them to say ‘aaghhh’
  • Quickly rub swab over any pus or red areas on back of throat — Figure 5.26

Figure 5.26  

Swabbing throat.

For all

  • Gently roll swab once along glass slide — Figure 5.20, leave to air dry
  • Put swab into transport medium container, close firmly
  • When slide dry put into holder and secure
  • Make sure all labelling is correct, store and transport swab and slide at room temperature

NAAT

  • Roll swab for eye, nose or throat on slide as above
  • Put swab back into container
    • If using Aptima swab — remove lid, put swab in tube — Figure 5.22. Break off handle at groove — Figure 5.23, leaving swab in tube
  • Make sure swab containers correctly labelled, closed tightly
  • Store and transport at room temperature

Vaginal and cervical swabs

Collecting penile swabs

What you do

Genital sore (ulcer) swabs

What you need

  • Aptima or dry swab
  • Sterile needle (for herpes-like sores)

What you do

  • Swab base of sore or scab
  • For herpes-like sores (blisters) gently burst with sterile needle, swab fluid
  • Put swab back into container
    • If using Aptima swab — remove lid, put swab in tube —  Figure 5.22. Break off handle at groove — Figure 5.23, leaving swab in tube
  • Make sure swab container correctly labelled, closed tightly
  • Request 'Genital ulcer — herpes, syphilis, donovanosis NAAT

Collecting anal swabs for STIs

What you need

  • 2 swabs
    • NAAT — Aptima or dry swab
    • MC&S — Amies transport medium swab
  • Clean paper sheet or bluey

What you do

Both swabs

  • Put clean paper sheet or bluey on bed
  • Ask person to lie on left side with knees drawn up
  • Gently put end of swab 1–2cm inside anus just past anal ring
  • Run swab once around inside of anus
  • Avoid faecal contamination as much as possible
  • Put swab back into container
    • If using Aptima swab — remove lid, put swab in tube — Figure 5.22. Break off handle at groove — Figure 5.23, leaving swab in tube
  • Make sure swab containers correctly labelled, closed tightly

Self-collected swabs

  • For swab with transport medium (eg Aptima, Amies)
    • Remove container, leave swab in original packet
    • Do not give container to person
  • For dry swab — leave swab in original container, break seal
  • Give swabs to person and explain
    • Wash hands
    • Squat down, stand with one leg up on toilet seat or chair or sit on toilet with legs apart and lean forward
    • Take first swab from container or packet — do not touch swab tip with hands or any other object
    • Put tip of swab 1–2cm inside anus just past anal ring
    • Run swab once around inside of anus
    • Remove swab, put back into container or packet
    • Repeat specimen collection with second swab, put swab back into container
    • Wash hands, return swabs
  • When person returns swabs
    • If swab in packet — put into transport tube
    • Make sure swab containers correctly labelled, closed tightly