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  • Check use-by dates — do not use out of date kits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