Principles of Medical Laboratory Science 1 (LEC)
LESSON 1: HISTORY OF MEDICAL TECHNOLOGY PROFESSION
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Mid-1900s
o Technical laboratories regulated by center for disease
control and prevention (CDC) began to be used for
medical diagnostics in the US
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1969
o 80%of medical professionals were non-physicians
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20th century
o Improvements in basic sciences and integration of
scientific and technological discoveries marked the
advances of medical technology
o Electron microscope—gave way to the visualization of
small cells including tumor cells
o The adaption of computers in medical researches led to
the development of tomography and magnetic
resonance imaging (MRI).
o Prosthesis such as artificial heart valves, artificial blood
vessels, functional electromechanical limbs, and
reconstructive skeletal joints were also developed
History of medical technology in a global context
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300 BC-180 AD
o Hippocrates—father of medicine
 author of Hippocratic oath
 advocated the tasting of urine, listening to the
lungs, and observing outward appearances in
the diagnosis of disease
 he concluded that appearance of bubbles,
blood and pus in urine indicated kidney
disease and chronic illnesses
o Galen—Greek physician and philosopher
 Described diabetes as “diarrhea of urine”
 Established the relationship between fluid
intake and urine volume
o Both instigated a rudimentary and qualitative
assessment of disorder through measurement of body
fluids in relation to season
o
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Four humors of man (body fluids):
 Blood
 Phlegm
 Yellow bile
 Black bile
In medieval Europe, diagnosis by water casting
(uroscopy) was widely practiced
Physicians who failed to examine the urine were
subjected to public beatings
900 AD
o First book detailing the characteristics of urine (e.g.,
color, density, quality) was written
11th century
o Medical practitioners were not allowed to conduct
physical examinations
o They rely solely on the patient’s description of
symptoms and their observations
18th century
o Mechanical techniques and cadaver dissection were
used to provide more objective and accurate diagnosis
and to understand the insides of the body
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Mid-1800s
o Laboratories designed for analyzing medical specimens
were organized by chemical experts
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19th century
o Physicians began using machines for diagnosis or
therapeutics
o John Hutchinson—invented spirometer for measuring
the vital capacity of lungs
o Jules Herisson—invented sphygmomanometer for
measuring blood pressure
o The use of chemistry was pivotal in the diagnosis of
diabetes, anemia, diphtheria, and syphilis during this
period
1
Breakthrough in medical technology
1816—stethoscope—first diagnostic medical breakthrough
invented by Rene Laennec
 used to acquire information about the lungs and heartbeats
1840—microscope—developed for medical purposes due to
advances in lenses and lower costs
 the first practical microscope was devised by Antonie van
Leeuwenhoek
1850—opthalmoscope—first visual technology invented by
Hermann von Helmholz
1855—laryngoscope—devised by manuelgarcia using two mirrors
to observe the throat and larynx
1859—x-ray—invented by Wilhelm Roentgen when he discovered
by accident that radiation could penetrate solid objects of low
density
 allowed physicians to view the inside of the body without
surgery
 used to diagnose pneumonia, pleurisy and tuberculosis since
world war II
1903—electrocardiograph—developed by William Einthoven to
measure electrical changes during the beating of the heart
1910—kenny method—served as the pioneering work for modern
physical therapy
 devised by Elizabeth Kenny in the treatment of polio (then
called infantile paralysis) using hot packs and muscle
manipulation
 prompted the invention of a new stretcher (called Sylvia
stretcher in 1927) intended for transporting patients in shock
1927—drinker respirator—invented by Philip Drinker to help
patients with paralytic anterior poliomyelitis recover normal
respiration with the assistance of artificial respirator
1939—heart-lung machine—first visual technology invented by
Hermann von Helmholz
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
1941—cardiac catheterization and angiography—first operated by
forsmann in 1929
 developed by moniz, reboul, rousthoibetween 1930 and
1940
 discovered as safe method in humans by Cournand in
1941
 made seeing the heart, lung vessels, and valves possible
through inserting a cannula in an arm vein and into the
heart with an injection of radiopaque dye for x-ray
visualization
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1895
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1918
o
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1920
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1922
o
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1565
o
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The university of Pennsylvania’s William
Pepper Laboratory of Clinical Medicine was
opened to highlight the service role of clinical
laboratories
John Kolmer called for the development of a
method
that
would
clarify
medical
technologists on a national scale
Kolmer published “the Demand for and
Training of Laboratory Technicians” that
included a description of the first formal
training course in medical technology
The state legislature of Pennsylvania enacted a
law requiring all hospitals and institutions to
have fully-equipped laboratory fit for routine
testing and to employ a full rime laboratory
technician
The administrative units of clinical laboratories
in large hospital were directed by a chief
physician
Clinical laboratories consisted 4-5 divisions
including clinical pathology, bacteriology,
microbiology, serology and radiology
American Society for Clinical Pathology was
founded
Objective: to encourage cooperation between
physicians and clinical pathologists as well as
maintaining the status of clinical pathologists
ASCP also established the code of ethics for
technicians and technologists stating that
these allied health professionals should work
under the supervision of a physician and
refrain from making oral or written diagnosis
and advising physicians on how patients
should be treated
American Society for Clinical Laboratory
Science
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Former American society form
medical technologists
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Originally formed as subgroup of
ASCP which helped in
the
recognition of non-physician clinical
laboratory scientists as autonomous
professionals
Medical technologists in the united states sought
professional recognition from the government of
their educational qualifications through licensure
laws
History of Medical Technologists in the Philippines
History of medical technology in the United States
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1950
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1578
o
1596
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1611
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1641
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1871
o
Spaniards established the first hospital which is
hospital real in Cebu
It was moved to manila to cater to military patients
Members of the religious orders who came to the
country alongside the occupiers established health
institutions for the poor and educational
institutions for the elite
Franciscans build San Lazaro hospital for the poor
and lepers
The Hospital de San Juan de Dios was founded for
poor Spaniards
The Dominicans founded the University of Santo
Tomas
Hospital de San Jose was founded in Cavite
University of Santo Tomas established the first
faculties of pharmacy and medicine
Published journals of science and medicine
o Boletinde Medicina de Manila (1886)
o RevisitaFarmaceutica de Filipinas (1893)
o Cronicas de CienciasMedicas (1895)
1806
o The central board of vaccination started producing
vaccine lymph
o Had 122 regular vaccinators (vacunadores) in
manila and other major towns by 1898
1876
o Provincial medical officers were appointed to
provide health care services throughout the
country
1883
o Establishment of the Board of health and Charity
1886
o
1887
o
o
“They made it hard on purpose”
Meredith Grey
Expanded board of health and charity
Laboratorio Municipal de Manila was established
by the Spanish authorities for laboratory
examinations of food, water and clinical samples
although the laboratory was not adequately used in
the study of outbreaks
General Antonio Luna—Philippine war hero who
has employed as a chemical expert in this
laboratory
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Pioneered water testing, forensics
and environmental studies
Principles of Medical Laboratory Science 1 (LEC)
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1898
o
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1901
o
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1905
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After the fall of manila, the Spanish Military
hospital was converted into the First Reserved
Hospitals
Lt. Col. Henry Lipincott—chief surgeon of the
division of the pacific and eight army corps
This hospital has diagnostic laboratory but was not
fully maximized when it first became operational
due to its director contracting typhoid fever
Richard P. Srong—the successor, utilized the
laboratory to perform autopsies and to examine
blood, feces, and urine along with other laboratory
services
The US government, through the Philippine
Commission, established a bureau of government
laboratories under the Philippine commission act
no. 156
The bureau was located in Calle Herran (Pedro Gil),
Ermita, Manila
It has a science library, chemical section, and serum
laboratory for the production of vaccines
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Biological laboratory—designed to
address and develop methods in the
diagnosis, treatment and prevention of
human and animal diseases
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Chemical Laboratory—food, plant
compositions and minerals were
investigated
Paul Ferrer—bureau’s first director
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Ensured that the biological laboratory
would be equipped with adequate
supplies and equipment such as
incubators, sterilizers, microscopes,
microtome, stains, glassware, and
chemicals
The main laboratory was composed of 2 stories and
divided into 2 wings with rooms in the biological
wing having microscope tables by window
The building was destroyed during world war II
Presently, the National Institutes of Health of
University of the Philippines-Manila occupies the
area
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Reorganization of the bureau of government
laboratories
Bureau of science was established for medical
officers who sought a career vin laboratory
research
The bureau worked with the army board for the
study of the tropical diseases until the latter was
disbanded in 1914
Bureau focused on pathology; board focused on
studying white foreigners’ physiology in tropical
climates
1909
o
The laboratory received over 7000 fecal
specimens, 900 urine specimens and 700
blood specimens
3
The bureau’s medical research and laboratory
investigations were mainly focused on
microbiology in connection with the onslaught
of different diseases such as cholera, malaria,
leprosy, tuberculosis and dysentery
End of Philippine-American war
o Board of health established by the Americans was
changed into bureau of health
1915
o The board of health was reorganized into the
Philippine Health Service
1933
o From Philippine Health Service, it was reverted to
Bureau of Health
June 1927
o The University of the Philippines’ College of Public
Health formally opened its Certificate in Public
Health program
o Aim: to provide proper training to the Philippine
Health Service’s medical officers
December 8, 1941
o Japan attacked the whole of manila through aerial
assault and deployment of troops just ten hours
after bombing the Pearl Harbor
o Beginning of the second world war that resulted to
massive casualties
o The Medical Laboratory unit of US army provided
medical services with the available laboratory
supplies, supplemental laboratory examinations,
and epidemiological and sanitary investigations
o It was also tasked to perform routine water
analyses, examination of food supplies, distribution
of special reagents and solutions, culture media,
and investigation of epidemics and epizootics
o It also performed special serological,
bacteriological, pathological and chemical
examinations, post mortem examinations, and
preservation of pathological specimens of value to
the US army medical department
June 18, 1942
o The 3d Medical Laboratory was the first laboratory
unit to be assigned in the South West Pacific Area
(SWPA)
1944
o The US forces landed in Leyte
o The laboratories including the 3rd, 5th, and 8th
Medical Laboratories and the 19th medical general
laboratory were relocated to the west pacific area
o Added to the list were the 26th and 27th medical
laboratories and the 363rd medical composite
detachment
o These medical units were not merged but deployed
separately as small detachments or mobile
laboratory sections to military bases in different
islands
Leyte:
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19th Medical General Laboratory
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3rd Medical Laboratory
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363rd Medical Composite Detachment
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
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Tacloban:
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27th medical laboratory
Lingayen gulf:

26th medical laboratory
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The only laboratory unit in Luzon
First clinical laboratory in the Philippines
o Established during world war II by the 6th infantry
division of the US army at Quiricada St., Sta. Cruz,
Manila
o Known as the manila public health laboratory
June 1945
o The US army left
o The laboratory was endorsed to the National
Department of Health and was non-operational
October 1945
o The laboratory was reopened by Dr. Pio de
Rodawith the help of manila city health officer Dr.
Mariano Icasiano
After instituting the public health laboratory in Manila, Dr.
Pio de Roda along with Dr. PrudenciaSta Ana, conducted a
training program for aspiring laboratory workers
Later on, Dr. Sta. Ana was asked to prepare a six-month
syllabus for the training program with certificate for the
trainees upon completion
Dr. Tirso Briones joined the two later on
1954
o The training program ended
o The bureau of private education approved a fouryear course in Bachelor of Science in Medical
Technology
o The Manila Sanitarium Hospital (MSH) opened its
first School of Medical Technology in the
Philippines under the leadership of Mrs. Willa
Hedrick, wife of Dr. Elvin Hedrick
o Soon after, MSH started its medical internship and
residency training program which was affiliated
with Loma Linda University in California
o Philippine Union College (PUC) in Baesa, Caloocan
City (now Adventist University of the Philippines)
absorbed MSH’s school of medical technology
o Dr. Jesse Umali—was the first graduate of the
medical technology program
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He graduated as Doctor of Medicine in
FEU and became successful OBgynecologist in the US
1957
o The University of Santo Tomas offered the Medical
Technology course as an elective for pharmacy
students
1961
o Medical Technology was recognized as an official
program in UST
4
1880—Marie Francois Xavier Bichat—identified organs by their
types of tissues; impact of contribution: histology
1835—Agostino Bassi—produced disease in worms by injection of
organic material—the beginning of bacteriology
1857—Louis Pasteur—successfully produced immunity to rabies
1866—Gregor Mendel—Enunciated his law of inherited
characteristics from studies on plants
1870—Joseph Lister—Demonstrated that surgical infections are
cause by airborne organisms
1877—Robert Koch—presented the first pictures of bacilli
(anthrax), and later tubercle bacilli
1886—Elie Metchnikoff—described phagocytes in blood and their
role in fighting infection
1886—Ernst von Bergmann—introduced steam sterilization in
surgery
1902—Karl Landsteiner—distinguished blood groups through the
development of the ABO blood group system
1906—August von Wassermann—developed immunologic tests
for syphilis
1906—Howard Ricketts—discovered microorganisms whose range
lies between bacteria and viruses called rickettsiae
1929—Hans Fischer—worked out the structure of hemoglobin
1954—Jonas Salk—developed poliomyelitis vaccine
1973—James Westgard—introduced the westgard rules for
quality control in clinical laboratory
1980—Baruch Samuel Blumberg—introduced the hepatitis B
vaccine
1985—Kary Mullis—developed the polymerase chain reaction
(PCR)
1992—Andre van Steirteghem—introduced the intracytoplasmic
sperm injection (IVF)
1998—James Thomson—derived the first human stem cell line
Inventions and innovations in the Field of Medical Laboratory
1660—Antonie van Leeuwenhoek—the father of microbiology;
known for his work on the improvement of microscope
1796—Edward Jenner—discovered vaccination to establish
immunity to small pox; impact of contribution: immunology
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
o
LESSON 2: DEFINING THE PRACTICE OF THE MEDICAL
TECHNOLOGY/CLINICAL LABORATORY SCIENCE PROFESSION
Nature of Medical Technology
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Science—primarily concerned with the study of the
natural world and the interrelationship among
biological, psychological, and even the social world
Many principles of medical technology are highly
dependent on developments in the scientific disciplines
and areas such as chemistry, electronics, optics and
mechanics, among others in order to develop a
utilizable biotechnology that will aid in the diagnosis of
disease
Technology—is the application of science in ways that
are considered beneficial to society
Technology can be defined in three ways:
1. Physical artifact, machine, or instrument
2. An activity or a means to accomplish a goal
3. Knowledge
Rogers (1983)—asserts that “technology is a design for
instrumental action that reduces the uncertainty in the
cause-effect relationships involved in achieving a
desired outcome.”
Medical Technology—is designed to improve the
detection, diagnosis, and treatment and monitoring of
diseases
o it has linkages with many other disciplines for
specific diagnostic or therapeutic purposes
o nature:
contextual,
interdisciplinary,
interdependent, and systems-based
Clinical laboratory testing—plays an important role in
the detection, diagnosis, and treatment of diseases
Clinical laboratory scientists—are involved in the
examination and sis of body fluids, tissues and cells
o Usually look for the presence of bacteria,
parasites, and other microorganisms in the
body
o They analyze the chemical constituents of
fluids, match blood for transfusions, and test
for drug levels in the blood to show the
patient’s response to a specific treatment
o They also prepare specimens for examination,
to count cells, and look for abnormal cells in
the blood and other body fluids
Medical Technology Practice Defined
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The medical technology profession is governed and
defined in section two (2) of R.A. 5527, also known as
medical technology act of 1969
Dr. Nardito Moraleta—made the original version
Prof. Rodolfo Rabor—made the revised version
Roles and responsibilities of Medical Technology Profession
1.
Perform clinical laboratory testing
o A medical technologist must be capable of
performing the most basic to the most advance
laboratory tests
2.
3.
4.
5.
6.
5
A graduate of Bachelor of Science in Medical
Technology/Medical Laboratory Science is expected to
show competency in [performing routine laboratory
tests including urinalysis and stool examination
o Capable of performing hematologic, microbiologic,
serologic, chemical and other procedures in different
areas of laboratory science
Perform special procedures
o Medical technologists are also expected to perform
procedures in diagnosing disease
o These may include operation of advanced diagnostic
equipment
o Special procedures: molecular and nuclear diagnostics
Ensure accuracy and precision of results
o A medical technologists should always be conscious of
the accuracy and precision of both the testing process
and its results
o Accuracy and precision impacts the interpretation of
results by the physician to provide proper medication in
the treatment of disease
Be honest in practice
o It is important that a medical technologist value honesty,
particularly in conveying or reporting the results of any
laboratory procedure
o He or she should act according to the Medical
Technology professions code of ethics and his/her
pledged oath of practice
Ensure timely delivery of results
o A medical technologist must be aware of the urgency of
delivering results on time especially cases that require
urgent treatment
o One should take notations on “STAT” or even observe
the source of the requests (e.g. from OR or ER)
o Medical Technologists should be fully alert to fully
address the needs of the patient
Demonstrate professionalism
o Medical technologist must be able to perform his/her
functions according to the professional code of ethics for
medical technology professionals
o Should be aware of the laws and regulations and should
not exploit its function beyond its boundaries
Other governing regulations:
1. Clinical laboratory act 1966 (R.A. 4688)
2. Blood banking acts of 1956 (R.A. 1517)
and 1995 (R.A. 7719)
o National organizations such as the Philippine
Association of Medical Technologists, Inc. (PAMET)
and the Philippine Association of Schools of Medical
Technology and Public Health, Inc. (PASMETH) also
have their own constitutions and by-laws in
accordance with the governing laws and code of
ethics
7. Uphold confidentiality
o Ensuring
confidentiality
of
patient’s
information is one of the core duties within
the medical practice
o Confidentiality requires health care providers
to keep a patient’s personal health
information private unless the patient
consents to release the information
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
o
8.
9.
10.
It is expected that these records containing
very important information are protected
and made available only when necessary
Collaborate with other health care professionals
o A medical technology professional is required
to collaborate with other health care
practitioners in o0rder to build a wellfunctioning team
o Collaboration—is an act of working together
in order to achieve the desired outcome
o Success in health care setting is achieved not
because of the availability of highly
sophisticated
hospital
or
laboratory
equipment, but because of teamwork
Conduct research
o Practicing medical technologists must also be
engaged in research activities to update their
skills
o Research work, whether experimental or
descriptive can contribute significantly to the
discovery of new knowledge in the field of
medical technology and in assessing and
revisiting already known ones.
Involvement in health promotion programs
o Medical technologists d\should not be
confined only to the four corners of their
clinical laboratories
o Medical technology is a multi-disciplinary
field which consistently ventures into other
areas of health care including health
promotion
o A medical technology professional must be
actively involved in reaching out to the
community
The following are some ways that medical
technology professionals can help the
community:
1. Cooperate with other health
care professionals in health
promotion campaigns such as
promoting the ideal attitudes
on
hygiene,
community
sanitation, waste segregation,
and disease prevention
2. Implement
pre-planned
programs of health promotion
campaigns
3. Offer free laboratory testing
such as blood typing, urinalysis,
fecalysis, blood sugar testing,
cholesterol testing and other
tests beneficial to the entire
community
4. Collaborate with other health
care
professionals
once
diagnoses are done
6
Defining the practice of other laboratory personnel
1.
Pathologist
o As defined by R.A. 5527: a pathologist is a duly
registered physician who is specially trained in methods
of laboratory medicine, or the gross and microscopic
study and interpretation of tissues, secretions and
excretions of the human body and its functions in order
to diagnose disease, follow its course, determine the
effectivity of treatment, ascertain cause of death, and
advance medicine by means of research
o A pathologist is always considered to head a clinical
laboratory and monitor all laboratory result
o A laboratory result without the signature of a
pathologist may not be considered valid
2.
Medical Laboratory Technicians
o As defined by R.A. 5527: is a person certified by and
registered with the Board of Medical Technology and
qualified to assist a medical technologist and/or
qualified pathologist in the practice of medical
technology as defined in the aforementioned act
Qualifications to become a medical technician:
 Failed to pass the medical technology
licensure examination given by the board of
medical technology but obtained a general
rating of at least 70% and provided finally that
a registered medical laboratory technician
when employed in the government shall have
the equivalent civil service eligibility not lower
than second grade
 Passed the civil service examination for
medical technicians given on March 21, 1969;
or
 Finished a two-year course and has at least
one (1) year experience of working as a
medical laboratory technician; provided that
for every year of experience in college, two (2)
year of work experience may be substituted;
and provided further, that the applicant has at
least ten (10) years of experience as medical
laboratory technician as of the date of
approval of this decree
3. Phlebotomist
o An individual trained to draw blood either for
laboratory tests or for blood donations
o Small amount of blood: skin puncture
o Larger volume of blood: venipuncture or
arterial puncture
o Arterial puncture can only be performed by
specially trained phlebotomist
o In the Philippines, a medical technologist is
required to be skilled in phlebotomy
o ASCP—American Society for Clinical Pathology
o AMT—American Medical Technologist
o NHA—National Health career Association
Cytotechnologist
o A laboratory personnel who works with the
pathologist to detect changes in body cells which
may be important in the early diagnosis of disease
4.
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
o
5.
6.
7.
The test is primarily done by examining microscope
slides of body cells for abnormalities or anomalies
in structure, indicating either benign or malignant
conditions
o A cytotechnologist selects and sections minute
particles of human tissue for microscopic study,
using microtomes and other equipment and
employs stain techniques to make cell structures
visible or to differentiate its parts
Most commonly employed staining techniques:
 Papanicolaou (pap) test
 H&E
Histotechnologist
o Also referred to as histotechnician
o Is a laboratory personnel responsible for the
routine preparation, processing and staining of
biopsies and tissue specimens for microscopic
examination by pathologist
o NAACLS—National Accrediting Agency for Clinical
Laboratory Science
Nuclear Medical Technologist
o A healthcare professional who works alongside
nuclear physicians
o Nuclear medical technologist apply their knowledge
of radiation physics and safety regulations to limit
radiation exposure, prepare and administer
radiopharmaceuticals, and use radiation detection
devices and other kinds of laboratory equipment
that measure the quantity and distribution of
radionuclides deposited on the patient or in the
patient’ specimen
Toxicologist
o Studies the effects of toxic substances on the
physiological functions of human beings, animals,
and plants to develop data for use in consumer
protection and industry safety programs
o He/she also designs and conducts studies to
determine physiological effects of various
substances on laboratory animals, plants and
human tissue using biological and biomedical
techniques
LESSON 3: ETHICS
Schools of Ethics
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Theoretical
prescriptions/critiques
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The nature of good
The nature of human
person
Criteria of judgment
Morality
Based on principles practiced
by a particular community
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Fundamental
convictions of human
agent
Character of moral
agent
Use of norms
Situational analysis
Ethical Relativism
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Also known as moral relativism
Is a school of ethics anchored on the principle that
morality is relative to the norms of particular culture
It is a theory based on norms relative to a particular
culture or society
Acknowledges societal diversity, that every society has a
unique moral design and culture; and people’s beliefs
are greatly influenced by culture
Challenge: preservation of its cultural uniqueness and
acknowledgement of cultural differences
Ethical Pragmatism
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Moral code that guides how an individual should behave
As a branch of knowledge, it deals with moral principle
Individual’s search for meaning while dealing with
human problems which may be
o Logical—problems of reasoning
o Epistemological—problems of the truth
o Cosmological—problems of universe
o Ethical—problems of morality
o Aesthetical—problems of art and beauty
o Scientific problems—problem of science
Human being are logical beings but human existence is
inexplicable
Ethics deals with a diverse prescription of universal
concepts and principles that serve as foundation of
moral beliefs
Ethics can be connected with morality
Donnal Harrington—morality can be viewed from
different perspectives—as a law, as an inner conviction,
as love, as personal growth, and as social transformation
James Gustafson—illustrated the nuances between
ethics and morality
Ethics
Ethics
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Pragmatism—is a philosophical approach or movement
that began in 1870s
o The term was coined by Charles Sanders
Peirce and further developed by William
James
It is considered as America’s most distinctive and major
contribution to the field of philosophy
It is more of a theory on knowledge, truth, and meaning
rather than morality
Pragmatic conception of good and truth can be applied
in medical context especially in terms of decision
making and moral reasoning
Ethical Utilitarianism
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Founded by two English philosophers Jeremy Bentham
and John Stuart Mill
States that the rightness or wrongness of actions is
determined by their consequences
“Actions are good insofar as they tend to promote
happiness, bad as they tend to produce unhappiness””.
The utility or usefulness of an action is determined by
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)

the extent to which it promotes happiness rather than
its reverse.”
Moral Issues
o
Abortion



Abortion is considered illegal in the Philippines
Article II, Section 12 of the 1987 Philippine Constitution
states that:
The state recognizes the sanctity of life and shall protect
and strengthen the family as a basic autonomous social
institution. It shall equally protect the life of the mother
and the life of the unborn from conception
Abortion can be:
o Direct
o Induced
o Caused by natural cases/accidents
8
o
Ciabal stated that people can now
“intervene” in the biological process and
“control” bad or defective genes
Stem-cell therapy—is a form of genetic engineering
that makes use of stem cells to treat or prevent
diseases
In vitro fertilization (IVF)—is popularly known as
laboratory fertilization
Professional Ethics



Covers the morally accepted behavior of individuals in the
workplace
The code of ethics of a particular profession serves as the
guiding principle in the ethical practice of a profession
Guide individuals in dealing with issues and conflicts in the
workplace in order for them to remain functional
Euthanasia (Mercy Killing)
LESSON 4: MEDICAL TERMINOLOGIES AND ABBREVIATIONS



is a practice of ending the life intentionally, usually in
situations when the individual is terminally ill, to
retrieve him or her pain and suffering
regarded as a merciful release of an individual from an
incurable sickness
Herbert Hendin—described euthanasia as the process
of inducing the painless death of a person who is
severely debilitated for reasons assumed to be merciful,
either through voluntary, non-voluntary or involuntary
means.
o Voluntary euthanasia—when an individual
gives consent to subject himself or herself to a
painless death
o Non-voluntary euthanasia—conducted when
the permission of the patient to perform the
process is unavailable, like in the case of
patient in a deep comatose, or neonates born
with significant and major birth defects
o Involuntary euthanasia—when the individual
does not give his or her consent
Medical Terminologies

3 basic parts:
1.
Genetic Engineering
2.


Involves genetic manipulations that are perceived to be
against moral standards set by the society
Through genetic engineering, humans are seen to be acting
as their own gods because of procedures that enable them to
manipulate the genetic make-up of organisms
Following procedures that is involved in genetic engineering:
o Genetic Screening—is a procedure whose main
purpose is to screen, choose, and select the genes
for proper detection of any genetic disease and
other chromosomal malformations

Usually done for the early diagnosis of
disease
o Genetic interventions—are techniques such as
genetic control, therapy, and surgery
Most medical terms are derived from Greek and Latin words
3.
Root word—main part of the medical term that denotes the
meaning of the word
Examples:
o Colo—colon
o Phlebo—vein
o Hemat—blood
o Aero—air
o Cardio—heart
o Myo—muscle
o Arterio—artery
o Cyto—cell
o Arthro—joint
o Heap/hepato—liver
o Pyo—pus
o Cranio—skull
o Thrombo—clot
o Pyro—fever
o Nephro—kidney
o Osteo—bone
Prefix—found at the beginning of the term and it shows how
meaning is assigned to word
Examples:
o A-/an- —without, absence
o Hyper-—increased, above
o Poly-—many
o Pre-—before
o Iso-—same
o Pseudo-—false
o Nano-—billionth
o Anaero-—without oxygen
o Cryo-—cold
Suffix—found at the terminal portion or at the end of the
term. It also denotes the meaning of the root word
Examples:
o –megaly—enlargement
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
o
o
o
o
o
o
o
o
o
o
o
–uria—urine
–emia—blood
–ostomy—to make an opening or mouth
–blast—young
–poiesis—formation
–ectomy—surgical removal
–emia—blood condition
–pathy—disease
–penia—deficiency
–oma—tumour, growth
–tome—cutting instrument
Definition of Curriculum from some sources:


Rule: if suffix starts with a consonant, a combining vowel needs to
be used (usually letter O)
Singular
Plural
Bacterium
Bacteria
Nucleus
Nuclei
Thrombus
Thrombi
Bacillus
Bacilli
Ovum
Ova
Spermatozoon
Spermatozoa
9


Curriculum refers to the means and materials with
which students interact for the purpose of achieving
identified educational outcomes.
Curriculum refers to the knowledge and skills students
are expected to learn, which include learning standards
or learning objectives they are expected to meet; units
and lessons the teacher teach; the assignments and
projects given to students; the books materials,
presentation and reading used in a course; and the
tests, assessments and other method used to evaluate
student learning. – According to Glossary of Educational
Reforms
“Continuous reconstruction, moving from the child’s
present experience out into that represented by
organized bodies of truth that we call studies… the
various studies are themselves experience—they are
that of the race” – According to John Dewey
Refers to planned interaction of students with
instructional content, materials, resources, and
processes for evaluating the attainment of educational
objectives.
Looking in these definitions, curriculum:
Abbreviations



















DOH—Department of Health
CHED—Commission on Higher Education
VDRL—Venereal Disease Research Laboratories
AIDS—Acquired Immunodeficiency Syndrome
AIDs—Autoimmune disorders/disease
AMI—Acute Myocardial Infarction
BUN—Blood Urea Nitrogen
2PPBS—2 Hours Postprandial Blood Sugar
AFS—Acid Fast Stain
PCQACL—Philippine Council for Quality Assurance in the
Clinical Laboratories
FBS—Fasting Blood Sugar
IV—Intravenous
HIV—Human Immunodeficiency Syndrome
IU—International Unit
ICU—Intensive Care Unit
K—Potassium
Na—Sodium
NPO—Noting Per Orem
BAP—Blood Agar Plate




Medical Technology Curriculum
Commission on Higher Education or CHED




LESSON 5: Medical Technology/ Clinical Laboratory Science
Education
Definition of Curriculum
Curriculum –from Latin word “currere” which means to run.

A student enrolled in a program has to work hard and
run with all his or her might in order to finish the race
on time.
Is systematic and organized;
Explicitly states outcomes the learners have to achieve
and learn through the use of planned instructional
processes and other learning implements in a specific
period;
Consist of a planned process of measurement,
assessment, and evaluation to gauge student learning ;
Is designed for students.
Established on May 18, 1994 through Republic Act No.
7722, the Higher Education Act of 1992.
It is a government agency that covers institutions of
higher education both public and private.
It is tasked to organize and appoint members of the
technical panel for each discipline/program area.
Under CHED is the TCMTE or Technical Committee for
Medical Technology Education.
TCMTE- composed of leading practitioners and
academicians responsible assisting the
Commission in setting standards, monitoring
and
evaluating
institutions
offering
BSMT/BSMLS program.
BSMT/BSMLS

Four year program consisting of general education and
professional courses that student expected to complete
within the first three years. The fourth year is dedicated
to student’s internship training in CHED-accredited
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
training
laboratories
affiliated
with
their
college/department.
CMO No. 13, series of 2017 (Policies, Standards and Guidelines for
Bachelor of Science in Medical Technology/ Bachelor of Science in
Medical Laboratory Science program)







Guide for institutions offering the program
Contains goals, outcomes, performance indicators and
the minimum course offerings (GE core courses and
professional courses with allotted units)
This new CMO is compliant with the K-12 program.
Prescribed minimum number of units per course and
whether laboratory or lecture component has are also
indicated.
One unit of lecture is equivalent to one hour of class
meeting per week
One unit of laboratory is equivalent to 3 hours of class
meeting per week.
In this curriculum, the policies of taking prerequisites for
some courses are followed.
General Education Courses
GE courses aim to develop humane individuals that have a deeper
sense of self and acceptance of others. GE courses included in the
new CMO are:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Understanding the Self
Readings in the Philippine History
The Contemporary World
Mathematics in the Modern World
Purposive Communication
The Life and Works of Rizal
Science, Technology and Society
Art Appreciation
Ethics
Professional Courses
Professional Courses are taken for learners to develop the
knowledge, technical competence, professional attitude, and
values necessary to practice and meet the demands of the
profession. Some of the professional courses are:
1.
PMLS 1: Introduction to Medical Laboratory Science,
Laboratory Safety, and Waste Management

Deals with the basic concept and principles
related to the profession. Its emphasis is on
the curriculum, practice of the profession l,
clinical laboratories, continuing professional
education, biosafety practices and waste
management.
2.
PMLS 2: Clinical Laboratory Assistance and Phlebotomy

Clinical Laboratory Assistance–concepts and
principles of different assays performed in the
clinical laboratory

Phlebotomy- deals with the basic
concepts, principles and standard
procedures in blood collection,
3.
10
transports and processing. Also
includes pre-analytic, analytic and
post- analytic variables that affect
reliability of test results.
Community and Public Health for MT/MLS

Study of the foundation of community health
that include human ecology, demography, and
epidemiology.

Emphasizes the promotion of community,
public, environmental health and interaction
of students with the people in the community.
4.
Cytogenetics

Focused on the study of concepts and
principles of heredity and inheritance which
include
generic
phenomena,
sex
determination and genetic defects rooted in
inheritance.

Also discusses abnormalities and genetic
disorders involving the chromosomes and
nucleic acids.
5. Human Histology

Deals with the fundamentals of cells, tissues
and organs.

The laboratory component of this courses
deals with microscopic identification and
differentiation of cells that makes up the
systems of the body.
6. Histopathologic Techniques with Cytology

Deals with the techniques necessary for the
preparation of tissue samples collected for
macroscopic and microscopic examinations for
diagnostic purposes.

Covers the basic concept and principles of
disease processes, etiology and the
development of anatomic and microscopic
changes brought by the disease process.
7. Clinical Bacteriology

Deals with study of physiology and
morphology of bacteria and their role in
infection and immunity.

Emphasis is on the collection of specimen and
isolation and identification of bacteria.
8. Clinical Parasitology

Concerned with the study of animal parasites
in humans and their medical significance in
the country.

Emphasis
is
on
pathophysiology,
epidemiology, life cycle, prevention and
control, and the identification of ova/ adult
worms and other forms seen in specimens for
diagnostic purposes.
9. Immunohematology and Blood Bank

Tackles the concepts of inheritance,
characterization, and laboratory identification
of red cells antigens and their corresponding
antibodies.
10. Mycology and Virology

Deals with the study of fungi and viruses as
agents of diseases with emphasis on
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
11.
12.
13.
14.
15.
16.
17.
epidemiology, laboratory identification and
characterization, and prevention and control.
Laboratory Management

Looks into the concepts of laboratory
management which are planning, organizing,
staffing, directing, and controlling as applied in
clinical laboratory.

It also tackles the process of solving problems,
quality assurance and quality control and
other activities necessary to maintain a wellfunctioning laboratory.
Medical Technology Laws and Bioethics

Encompasses various laws, administrative
orders, and other approved legal documents
related to the practice of MT/MLS in the
Philippines

Bioethics looks into the study of ethics as
applied to health and health care delivery to
human life in general.
Hematology 1

Deals with the study of the concepts of
blood as tissue. Formations, metabolism
of cells, laboratory assays, correlation
with pathologic conditions, special
hematology evaluation are given
emphasis.

Bone marrow studies are also discussed.
Hematology 2

Deals with the concepts and principles of
hemostasis, and abnormalities involving RBC,
WBC, and platelets.

Laboratory identification of blood cell
abnormalities, quantitative measurement
coagulation factors, and disease correlation
are emphasized.
Clinical Microscopy

Focuses on the study of urine and other body
fluids (excluding blood). It includes their
formation, laboratory analyses, disease
processes, and clinical correlation of
laboratory results.
Clinical Chemistry 1

Encompasses the concepts and principles of
physiologically active soluble substances and
waste materials present in body fluids,
particularly in the blood.

Includes information, laboratory analyses,
reference values and clinical correlation with
pathologic conditions.

Also looks into instrumentation and
automation, quality assurance, and quality
control
Clinical Chemistry 2

Continuation of Clinical Chemistry 1

Covers the study of endocrine glands and
hormones and their formation and clinical
correlation.

Therapeutic drug monitoring and laboratory
analyses of drugs and substances of abuse as
well as toxic substances are also emphasized.
11
18. Seminars 1 and 2

Taken during fourth year in the program
together with internship training

Deals with the current laboratory analyses
used in the practice of medical technology.
19. Molecular Biology and Diagnostics

Deals with the nucleic acid and protein
molecule interaction within the cell.

Covers the molecular mechanisms of DNA
replication, repair, transcription, translation,
and protein synthesis and gene regulation.

Focused on concepts, principles and
application of molecular biology in clinical
laboratory.
Research Courses
Research 1: Introduction to Laboratory Science Research

Basic concepts and principles of research
applied in Medical Technology/Clinical
Laboratory Science.
Research 2: Research Paper Writing and Presentation

Covers the methodology of the research
approved in research 1, writing the paper in
the format prescribed by the institution and
research agencies, and presentation of the
finished research in a formal forum.
Clinical Internship Training





“They made it hard on purpose”
Meredith Grey
Taken during student’s fourth year
Only those who have completed and passed all the
academic and institutional requirement for the first
three years of the program are qualified for
internship.
Before proceeding with the training, students are
required to undergo physical and laboratory
examinations
Examinations included;
o CBC
o Urinalysis
o Chest X-ray and/or sputum microscopy
o HBsAg and HBsAb screening
o Drug testing (for methamphetamines and
cannabinoids)
6-month or one-year rotation. This rotation ensures
that all students experience to work in the different
sections of clinical laboratory.
The intern is required to render 32 hours of duty
per week not exceeding a total of 1,664 hours in
one year. This is broken down per section as
follows (based on CMO 13 s. 2017):
Principles of Medical Laboratory Science 1 (LEC)

Licensure Examination
Serves as foundation of curriculum
development
and
teaching
methodologies that shape a program.

Learning outcomes of MT/MLS programstates the knowledge, skills, values, and
ethics
that
graduates
should
demonstrate.
The program outcomes of BSMT/BSMLS degree expect
students to;
Professional Regulation Commission (PRC)

Tasked to administer licensure examination to
different professional.
Professional Regulatory Board (PRB) for MT/MLS




Tasked to prepare and administer the written
licensure examination for the qualified graduates.
PRB must composed of:
 Chairperson- must be a licensed
Pathologist
 Two members- should be RMT
All PRB members should have PRC licenses.
MT Licensure Examination is given twice a year, on
the months of March and August.
1.
2.
List of some provisions included in RA 5527 (The Medical
Technology Act of 1969)
1.
2.
3.
4.
5.
3.
Courses included

Clinical Chemistry – 20%

Microbiology and Parasitology- 20%

Hematology – 20%

Blood Banking and Immunology and Serology
–20%

Clinical Microscopy – 10%

Histopathologic Techniques – 10%
To pass the exam, the examinee must:

Receive general average of 75%

Have no rating below 50% in major
courses

Pass at least 60% of the courses
computed according to their relative
weights
If the examinee is passed and is 21 years old and
above, he/she will issued a certificate of
registration and PRC card. If younger than 21,
he/she will register as professional on his/her 21st
birthday.
If the examinee failed three times, he/she need to
enroll in a refresher course before taking the
examination.
If the examinee failed to pass the exam but
garnered 70%-74% general weighted average,
he/she may apply as medical laboratory technician.
4.
5.
6.
7.
All higher educational institutions offering any graduate or
undergraduate programs must have a written document stating
the program goals, vision and mission, objectives and learning
outcomes based on the institutions philosophy.
Demonstrate knowledge and technical
skills needed to correctly perform
laboratory testing and ensure reliability
of test results
Be endowed with the professional
attitude and values enabling them to
work with their colleagues and other
members of the health care delivery
system
Demonstrate critical thinking and
problem solving skills when confronted
with situations, problems and conflict in
the practice of their profession.
Actively participate in self-directed lifelong learning activities to be updated
with the current trends in the profession.
Actively participate in research and
community-oriented activities
Be endowed in leadership skills
Demonstrate collaboration, teamwork,
integrity and respect when working in a
multicultural environment.
Assessment

Involves a planned, systematic and organized way of testing,
measuring, collecting, and obtaining necessary information
to gain feedback on student’s progress.

Ensuring that students are on the right track toward attaining
their goals, as well as gauging their strengths and
weaknesses.
Types of Assessment
1.
2.
Program Goals and Learning Outcomes
3.
Formative assessment –this is done during and/or within
the instructional process of a course. Determine
whether a student is achieving the outcomes of topic
being discussed. Ex. Quizzes, short-answer question and
reflection papers.
Summative Assessment –this is done at the end of
instruction, grading period or examination. It is used to
know how well the students attained the learning
outcomes. Ex. End-of-term exams, research/term
papers, and final projects.
Diagnostic Assessment – this is given prior to
instruction. This is used to gauge what student already
know and do not know about the topic at hand.
Assessment Tools
Learning Outcomes

12
define what learner has to achieve
“They made it hard on purpose”
Meredith Grey
1.
2.
3.
4.
Teacher-made written test
Reflection papers
Portfolios
Performance task
Principles of Medical Laboratory Science 1 (LEC)
5. Oral examinations and presentations
6. Rubrics
Job Opportunities for the Graduate of the Program

A BSMT/BSMLS graduate can practice as a /an
1. MT/Clinical Laboratory Scientist in a hospital-based or
non-hospital-based Laboratory.

2. Histotechnologist in an anatomical laboratory
3. Researcher/ research scientist

4. Member of academe
5. Perfusionist

6. Molecular scientist

7. Diagnostic product specialist
8. Public health practitioner

9. Health care leader
A graduate may also practice in the ff. fields:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Molecular Biology
Public Health and Epidemiology
Veterinary Laboratory Science
Food and Industrial Microbiology
Veterinary Science
Forensic Science
Nuclear Medicine/ Science
Health Facility Administration and Management
Quality Management
LESSON6: Basic Concepts on Laboratory Biosafety and
Biosecurity


Biosafety


The containment principles, technologies, and practices
that are implemented to prevent unintentional
exposure to pathogens and toxins, or their accidental
release. (WHO Laboratory Biosafety Manual)
biosafety protects people from germs

Biosecurity


The protection, control, and accountability for valuable
biological materials within laboratories, in order to
prevent their unauthorized access, loss, theft, misuse,
diversion, or intentional release. (WHO Laboratory
Biosafety Manual)
protects germs from people


13
for defensive purposes to enable to respond if attacked
by such weapons.
Newell A. Johnson designed modifications for biosafety
at Camp Detrick. He developed specific technical
solutions such as Class III biosafety cabinets and laminar
flow hoods to address specific risk.
1984 - Consequent meetings eventually led to the
formation of the American Biological Safety Association
(ABSA) in 1984. The association held annual meetings
that soon became the ABSA annual conferences.
1907 and 1908 – Arnold Wedum – described the use of
mechanical pipettors to prevent laboratory-acquired
infections in 1907 and 1908.
1909 – A pharmaceutical company in Pennsylvania
developed a ventilated cabinet to prevent infection
from mycobacterium tuberculosis.
1967 – Height of increasing mortality and morbidity due
to smallpox. WHO aggressively pursued eradication of
the virus.
During this time, serious concerns about biosafety
practices worldwide were raised, contributing directly to
the decision of the World Health Assembly to
consolidate the remaining virus stocks into two
locations:
o Center for Disease Control and Prevention
(CDC) – United States
o State Research Center of Virology and
Biotechnology VECTOR (SRCVB VECTOR) –
Russia
1974 - The CDC published the Classification of Etiological
Agents on the Basis of Hazard that introduced the
concept of establishing ascending levels of containment
associated with risks in handling groups of infectious
microorganism that present similar characteristics.
1978 – The National Institutes of Health (NIH) of the
United States published the NIH Guidelines for Research
Involving Recombinant DNA Molecules. It explained in
detail the microbiological practices, equipment, and
facility necessarily corresponding to four ascending
levels of physical containment.
These Guidelines along with WHO’s first edition of
Laboratory Biosafety Manual (1983) and NIH’s jointly
published first edition of Biosafety in Microbiological
and Biomedical Laboratories (1984), marked the
development of the practice of laboratory biosafety.
Arnold Wedum, director of the Industrial Health and
Safety at the US Army Biological Research Laboratories
in 1944, recognized as one of the pioneers of biosafety.
Wedum and microbiologist Morton Reitman, analyzed
multiple epidemiological studies of laboratory-based
outbreaks.
Brief History of Laboratory Biosafety


Brief History of Laboratory Biosecurity
1943 – The origins of biosafety is rooted in the US
biological weapons program which began in 1943, as
ordered by the US president Franklin Roosevelt
Ira L. Baldwin became the first scientific director of
Camp Detrick (eventually became Fort Detrick), and was
tasked with establishing the biological weapons program


1996 – The US government enacted the Select Agents
Regulations to monitor the transfer of select list of
biological agents from one facility to another.
2001 – after the terrorist attacks and anthraxs attack of
2001 (aka. Amerithrax), they revised Select Agents
Regulation then required specific security measures for
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)




any facility in US that used or stored one or more agents
on the new, longer list of agents.
2012 – The revision of the Select Agent Regulations in
2012 sought to address the creation of two tiers of
select agents from one facility to another. Tier 1 agents
are materials pose the greatest risk of deliberate
misuse, and the remaining select agents.
This change was intended to make the regulations more
risk-based, mandating additional security measure for
Tier 1 agents.
Other countries also relatively implemented and
prescribed biosecurity regulation for bioscience facilities
o Singapore, 2005–Biological Agents and Toxins
Act – similar scope as the US but with more
severe penalties for noncompliance
o South Korea, 2005 – Act on Prevention of
Infectious Diseases – require institutions that
work with listed “highly dangerous pathogens”
to implement laboratory biosafety and
biosecurity requirements.
o Japan – Infectious Disease Control Law –
established four schedule of select agents that
are subject to different reporting and handling
requirements for possession, transport and
other activities.
o Canada – Canadian containment level (CL) 3
and CL4 facilities that work with risk group 3
and 4 are required to undergo certification.
o 2008 – The Danish Parliament passed a law
that gives the Minister of Health and
Prevention the authority to regulate the
possession, manufacture, use, storage,
transport and disposal of listed biological
agents.
Around the world, biosecurity implementation has
become a purely administrative activity based on
government-developed checklist.
Local and International Guidelines on Laboratory Biosafety and
Biosecurity



Comité Européen de Normalisation (CEN) – a European
Committee for Standardization
CEN Workshop Agreement 15793 (CWA 15793)
o Published by CEN. It focuses on laboratory
biorisk management
o It was updated in 2011 and intended to
maintain a biorisk management system among
diverse organizations and set out
performance-based requirements for
implementing a national biosafety system.
o Since it originated from Europe, confusion
from countries outside Europe arose in terms
of applicability. Nevertheless, the agreement
was used until it officially expired in 2014.
1983 – WHO published 3rd edition of the Laboratory
Biosafety Manual.
o Includes information in the different levels of
containment laboratories (Biosafety Levels 14), different types of biosafety cabinets, good






14
microbiological techniques, and how to
disinfect and sterilize equipment.
o The manual puts emphasis on the continuous
monitoring and Improvement directed by a
biosafety officer and the biosafety committee.
2003 –The Cartagena Protocol on Biosafety (CPB), made
effective in 2003
o The regulations primarily tackle the safe
transfer, handling, and use of Living Modified
Organisms (LMOs) that may have adverse
effects on the conservation of biological
diversity.
The National Committee on Biosafety of the Philippines
was established under E.O. 430 series of 1990. NCPB
focuses on organizational structure for biosafety
March 27, 2006 – the office of the president
promulgated E.O. 514 establishing National Biosafety
Framework (NBF)
NBF is a combination of policy, legal, administrative, and
technical instruments developed to attain the objective
of the Cartagena Protocol on Biosafety which the
Philippines signed on May 24, 2000.
DA Administrative Order No. 8 – issued by the
Department of Agriculture to set in place policies on the
importation and release of plants and its product
derived from modern biotechnology.
DOH Administrative Order No.2007-0027 – requires
clinical laboratories to ensure policy guidelines on
laboratory biosafety and biosecurity.
Different Organizations in the Field of Biosafety
1.
2.
3.
4.
5.
American Biological Safety Association (ABSA) –
founded in 1984. It promotes biosafety as a scientific
discipline and provides guidance to its members on the
regulatory regimen present in North America.
Asia-Pacific Biosafety Association (A-PBA) – founded in
2005. Acts as a professional society for biosafety
professionals in Asia-Pacific region.
European Biological Safety Association (EBSA) –
founded in June 199. Focuses on encouraging and
communicating among its member’s information and
issues on biosafety and biosecurity as well as emerging
legislation and standards.
Philippine Biosafety and Biosecurity Association
(PhBBA) – the goal of the association is to assist DA and
DOH in their efforts to create a national policy and
implement plan for laboratory biosafety and biosecurity.
Biological Risk Association Philippines (BRAP) – works
to serve the emergent concerns of biological risk
management in various professional fields such as
health, agriculture and technology sectors throughout
the country. BRAP goes with the tagline, “assess,
mitigate, monitor.”
Classifications of Microorganisms According to Risk Groups
Risk group classification is based on the agent’s pathogenicity,
mode of transmission, host range, and the availability of
preventative measures and effective treatment.
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
1.
2.
3.
4.
Risk Group 1

Includes microorganisms that are unlikely to cause
human or animal disease.

These microorganisms bring about lo individual and
community risk.
Risk Group 2

Includes microorganisms that are unlikely to be a
significant risk to laboratory workers and the
community or the environment.

Lab exposure may cause infection

Effective treatment and preventive measures are
available.

This risk group bring about moderate individual risk
and limited community risk.
Risk Group 3

Includes microorganisms that are known to cause
serious diseases to humans or animals and may
present a significant risk to laboratory workers.

Could present limited to moderate risk if spread in
the community.

Effective preventive measure and treatment are
available.

This risk group bring about high individual risk and
limited to moderate community risk.
Risk Group 4

Include microorganisms that are known to cause
life-threatening diseases.

Represents a significant risk to laboratory workers
and may be readily transmissible from one
individual to another.

Effective preventive measure and treatment are
not available.

Bring about high individual and community risk.

15
All procedures where infectious aerosols or
splashes may be created are conducted in biosafety
cabinets or other physical containment equipment.
3.
Biosafety Level 3 (BSL-3)

Puts emphasis on primary and secondary barriers in
the protection of the personnel, community, and
environment from infectious aerosol exposure.

Work with indigenous or exotic agents with a
potential for respiratory transmission, and that may
cause serious and potentially lethal infection are
being conducted here.

All laboratory activities are required to be
performed in a biosafety cabinet or other
containment equipment like gas tight aerosol
generation chamber.

Secondary barriers for this level are highly required
including controlled access to the laboratory and
ventilation requirements to minimize the release of
aerosols from the laboratory.
4.
Biosafety Level 4 (BSL-4)

Required for work with dangerous and exotic
agents that pose a high risk of life-threatening
diseases that may be transmitted via aerosol route,
for which there are no available vaccines of
treatment.

The laboratory worker’s complete isolation from
aerosolized infectious materials is accomplished by
working in a Class III biosafety cabinet or in a full
body, air-supplied positive pressure personnel suit.

A BSL-4 laboratory is generally a separate building
or completely isolated zone with specialized
ventilation requirements and waste management
systems.
Categories of Laboratory Biosafety According to Levels
Examples of microorganism being handled
CDC categorized laboratories into four biosafety levels. Biosafety
level designations are based on a composite of the design
features, construction, containment facilities, equipment,
practices, and operational procedures required for working with
agents from various risk groups.
1.
2.
Biosafety Level 1 (BSL-1)

Is suitable for work involving microorganisms that
are defined and well characterized strains known
not to cause disease.

Require basic laboratory safety practices, safety
equipment, and facility design that requires basic
level of containment.
Biosafety Level 2 (BSL-2)

Designed for laboratories that dealt with moderaterisk agents present in the community.

Observes practices, equipment and facility design
that are applicable to clinical, diagnostic, and
teaching laboratories consequently observing good
microbiological techniques.

Appropriate when work is done with human blood,
body fluids, tissues or human cell lines where there
is uncertain presence of infectious agents.
BSL-1




Bacillus subtilis
Naegleria gruberi
infectious canine hepatitis virus
And exempt organisms under the NIH
Guidelines.
BSL-2



Hepatitis B virus
HIV
Salmonellae and Toxoplasma species.
BSL-3



Mycobacterium tuberculosis
St. Louis encephalitis virus
And Coxiella.
BSL-4

Marburg
or
the
Crimean-Congo
hemorrhagic fever
Any other agents known to pose a high risk
of exposure and infection.
“They made it hard on purpose”
Meredith Grey

Principles of Medical Laboratory Science 1 (LEC)

LESSON 7: Biorisk Management
Biorisk Management and the AMP Model
Personal Protective Equipment – devices worn by
workers to protect them against chemicals, toxins and
pathologic hazards in the laboratory.
Hazard – refers to anything in the environment that has the
potential to cause harm
Risk – possibility that something bad or unpleasant will happen.
Biorisk – risk associated to biological toxins or infectious agents.
Biorisk Management–integration of biosafety and biosecurity to
manage risks when working with biological toxins and infectious
agents.
-a system or process to control safety and security risks associated
with the handling or storage and disposal of biological agents or
toxins in laboratories and facilities. (CEN Workshop Agreement
(CWA) 15793:2011)
The effectivity of mitigating risks relies on the combination of all
different measures and proper utilization of each.
Key Components
LESSON 8: Nature of Clinical Laboratory



16
Performance of Evaluation – involves a systematic process
intended to achieve organizational objectives and goals. The model
ensures that the implemented mitigation procedures are indeed
reducing or eliminating risks. It also helps to highlight biorisk
strategies that are not working effectively and measures that are
ineffective or unnecessary.
Performance management is simply a reevaluation of the
overall mitigation strategy.
Clinical Laboratory –main task is to provide accurate and reliable
information to medical doctors for diagnosis, prognosis,
treatment, and management of diseases.
Assessment
Mitigation
Performance
Risk Assessment – initial step in implementing a biorisk
management process. Includes the identification of hazards and
risk that are possibly present in the laboratory.
Consist of the following steps:
1. Define the situation
2. Define the risks
3. Characterize the risks
4. Determine if risks are acceptable or not
Mitigation Procedures – actions and control measures that are put
into place to reduce or eliminate the risks associated with biological
agents and toxins. There are five major areas of controls and
measures that can be employed in mitigating the risks.
Heirarchy of Controls
Most Effective (most difficult to implement)
- It is the place where specimens collected from individuals are
processed, analyzed, preserved, and properly disposed.
Classifications of Clinical Laboratories
According to Function
1.
Clinical Pathology–concerned with the diagnosis
and treatment of diseases performed through
laboratory testing of blood and other body fluids.
(Clinical chemistry, immunohematology and blood
banking, medical microbiology, immunology and
serology, hematology, parasitology, clinical
microscopy).
2. Anatomic Pathology–concerned with diagnosis of
diseases through microscopic examination of tissue
and
organs.
(Histopathology,
immunohistopathology, cytology, autopsy, and
forensic pathology.)
According to Institutional Characteristics
1.
Clinical laboratories that operates within the
premises or part of an institution such as hospital,
school and medical clinic.
2. A free-standing clinical laboratory is not part of an
established institution.
According to ownership
Least Effective (easiest to implement)
1.




Elimination–provides the highest degree of risk
reduction. Involves the total decision not to work with a
specific biological agent or even not doing the intended
work.
Substitution – replacement of procedure or biological
agent with a similar entity in order to reduce risks.
Engineering Controls – includes physical changes in work
stations, equipment, production facilities, or any other
relevant aspect of the work environment that can reduce
or prevent exposure to hazards.
Administrative Controls – refers to the policies,
standards, and guidelines used to control risks.
Government-owned – clinical laboratories owned
wholly or partially by national or local government
unit.
2. Privately-owned – clinical laboratories owned,
established and operated by an individual,
corporation,
institutions,
association,
or
organization.
According to Service Capability
1.
“They made it hard on purpose”
Meredith Grey
Primary category–licensed to perform basic,
routine laboratory testing ( routine urinalysis,
routine stool examination, routine hematology or
complete blood count that includes hemoglobin,
hematocrit, WBC and RBC count, WBC with
Principles of Medical Laboratory Science 1 (LEC)
2.
-
-

differential count and qualitative platelet count,
blood typing, and gram staining.
Equipment required but not limited to, microscope,
centrifuge, hematocrit centrifuge.
Space requirement is at least 10 sq.m.
Administrative Order No. 59 s. 2001
o Rules and Regulations governing the
establishment,
operation
and
maintenance of Clinical Laboratories in
the Philippines.
Sections of the Clinical Laboratory
Secondary category– licensed to perform the tests
being done by the primary category clinical
laboratories along with routine clinical chemistry
tests like blood glucose concentration, blood urea
nitrogen, blood uric acid, blood creatinine,
cholesterol determination, qualitative platelet
count, and if hospital based, gram stain, KOH
mount, and cross matching.
Minimum equipment requirement are microscope,
centrifuge, hematocrit centrifuge, semi-automated
chemistry analyzers, autoclave, incubator and
oven.
Minimum requirement of 20 sq.m.
Clinical Chemistry
Tertiary category – licensed to perform all the
laboratory test performed in the secondary
category laboratory plus the following:

Immunology and serology – NS1-Ag for
dengue, rapid plasma reagin, treponema
pallidum particle agglutination tests)

Microbiology, bacteriology and mycology
– differential staining techniques culture
and identification of bacteria and fungi
from
specimen,
antimicrobial
susceptibility testing

Special clinical chemistry – clinical
enzymology,
therapeutic
drug
monitoring, markers for certain disease.

Special hematology –bone marrow
studies, special staining for abnormal
blood cells, red cell morphology

Immunohematology and blood banking –
blood donation program, antibody
screening and identification, preparation
of blood components
Minimum floor area requirement of at least 60
sq.m
Equipment required include those in the secondary
category laboratory along with automated
chemistry analyzer, biosafety cabinet class II,
serofuge.
4. National Reference Laboratory- Laboratory in a
government hospital designated by the DOH to
provide special diagnostic functions and services
for certain diseases.
Laws on the Operation, Maintenance, and Registration, of
Clinical Laboratories in the Philippines
-This section is intended for the testing of blood and other body
fluids to quantify essential soluble chemicals including waste
products useful for diagnosis of certain diseases
-Ex. of test performed











3.

17
Republic Act No. 4688
o An act regulating the regulation and
maintenance of clinical laboratories and
requiring the registration of the same
with the DOH, providing penalty for the
violation thereof, and for other purposes.
FBS
HbA1c for diagnosis of diabetes
Total cholesterol including HDL and LDL
TAG for diagnosis of cardiovascular diseases
BUA
BUN
Creatinine for diagnosis of kidney diseases
Total protein
Albumin
Electrolytes (ex. sodium, potassium chloride)
Clinical enzymology
Microbiology
– This section is subdivided into four sections: bacteriology,
mycobacteriology, mycology, and virology.
-
-
-
At present, the work on this section is more focused on the
identification of bacteria and fungi on specimens received.
Specimens usually submitted are blood and other body fluids,
stool, tissues, and swabs from different sites in the body.
Test includes:
o Microscopic visualization of microorganisms after
staining, isolation, and identification of bacteria
and fungi using varied culture media
o Antigen typing
o Antibacterial susceptibility testing
Other activities:
o Preparation of cultured media and stains, quality
assurance and control, infection control.
Hematology and Coagulation Studies
- This section deals with the enumeration of cells in the blood and
other body fluids.
- Examinations done:
-
“They made it hard on purpose”
Meredith Grey
CBC
Hemoglobin
Hematocrit
WBC differential count
Red cell morphology and cell indices
Quantitative platelet count
Total cell count and differential count
Blood smear preparation and staining for other
body fluids
Coagulation studies focus on blood testing for the
determination of various coagulation factors.
Principles of Medical Laboratory Science 1 (LEC)
18

Clinical Microscopy
Proper transport and processing of specimen
to the clinical laboratory.
Analytic Phase- deals with the actual testing of the
submitted/collected specimen.
– There are two major areas in this section of the laboratory. The
first area is allotted to routine and other special examinations of
urine such as macroscopic examinations to determine color,
transparency, specific gravity l, and pH level, and microscopic
examinations to detect presence of abnormal cells and/or
parasites as well as to quantify red cells and WBC and other
chemicals found in the urine.
Post-Analytic phase – includes the transmission of test
result to the medical doctor for the interpretation, TAT,
and application of doctor’s recommendations.
LESSON9: Professional Organizations
-
-
-
-
Examination of other body fluids are performed in this area.
The second area is assigned to the examination of stool or
routine fecalysis. Detection and identification of parasitic
worms and ova are the primary activities in this area.
Blood Bank/Immunohematology
Blood typing and compatibility testing are two main activities
performed in this section.
Screening for all antibodies and identification of antibodies as
well as the blood components used for transfusion are also
conducted in this section.
Immunology and Serology
Analyses of serum antibodies in certain infectious agents
(primarily viral agents) are performed in this section.
Hepatitis B profile tests, Serological test for syphilis, Hepatitis
C and dengue fever are some examples of antibody screening
tests.
Similar to Clinical Chemistry and hematology sections,
automated analyzers are commonly used in this section hen
performing different serological test
Professional Organizations




Professional
organization
that
cater
to
Medical
Technology/Medical Laboratory Science professionals in the
Philippines

Anatomic Pathology
Section of Histopathology/Cytology
-

Activities performed in this section includes tissue (removed
surgically as in biopsy and autopsy) processing, cutting into
sections, staining and preparation for microscopic
examination by a pathologist.
Professional Organizations
- assemblages of
professionals that come together for the purpose of
collaboration,
networking,
and
professional
development.
it provides opportunities for professional growth and
continuing education by offering workshops, trainings
and seminars and by publishing research journals
In the Philippines, membership to an accredited
professional organization (APO) or accredited
integrated professional organization (AIPO) is a
requirement for hiring, retention, and renewal of
professional licenses.
APO or AIPO – a professional society duly accredited by
PRC and PRB.
Philippine Association of Medical Technologists, Inc.
(PAMET) – accredited professional organization and the
leading national organization for RMTs in the country.
Philippine Association of Schools of Medical
Technologists and Public Health, Inc. (PASMETH) – the
only professional organization of schools of MT/MLS.
Benefits of Membership in Professional Organizations
Specialized Sections of the Laboratory
Immunohistochemistry- it combines anatomical, clinical
and biochemical techniques where antibodies are
bounded to enzymes and fluorescent dyes are used to
detect presence of antigens in tissue.
Molecular Biology and Biotechnology – primarily using
different enzymes and other reagents, DNA and RNA are
identified and sequenced to detect any pathologic
conditions/disease processes.
Laboratory Testing Cycle
This cycle has three phases, namely, pre-analytic,
analytic, and post-analytic.
Pre-Analytic phase includes:



Receipt of the laboratory request
Patient preparation
Specimen collection
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)






Professionalism – Professionals must adhere to the set
of rules or code of ethics prescribed by the professional
society.
Education - Professional organizations organize
continuing professional development (CPD) activities for
their members through conventions, seminar, for a,
workshops, and other activities of similar nature.
Perks – usually comes in the forms of monetary discount
on registration fees for professional development
activities of the organization.
Networking – activities conducted by professional
organizations provide opportunities for building
networks and connection in the field.
Profile – Membership in a professional organization can
also build the career portfolio of a professional.
Recognition – Professional organizations recognize their
outstanding members and leaders in the practice and
special fields such as research, public service and
community engagements through awards.
Types of Professional Organizations
1.
19
3.
Professional Societies – organizations that
contribute to the continued development of a
specific group of professionals.
Examples of Local Professional Societies for Medical
Technologists
Abbreviation
PAMET
PASMETH
Credentialing/Certifying Organizations
Philippine Association of Medical
Technologists, Inc.
Philippine Association of Schools of Medical
Technology and Public Health, Inc.
BRAP
Bio Risk Association of the Philippines
PBCC
Philippine Blood Coordinating Council
PCQACL
Philippine Council for Quality Assurance in
Clinical Laboratories
PSM
Philippine Society of Microbiologists
PhBBA
Philippine Biosafety and Biosecurity
Association
Accrediting Organizations – accredit curricular programs in
educational institutions. Membership is limited and usually
institutional.
Examples of International Professional Societies for Medical
Technologists
Examples of Local Accrediting Organizations for Medical
Technology Schools
Abbreviation
PAASCU
Accrediting Organizations
Philippine Accrediting Association of Schools,
Colleges, and Universities
Abbreviation
Credentialing/Certifying Organizations
ASCP
American Society of Clinical Pathology
AMT
American Medical Technologists
AACLS
ASEAN Association for Clinical Laboratory
Sciences
AAMLS
Asia Association of Medical Laboratory
Scientist
AAMLT
ASEAN Association of Medical Laboratory
Technologists
ASCLS
American Association for Clinical Laboratory
Science
IAMLT
International Association of Medical
Laboratory Technologists
Examples of International Credentialing/Certifying Organizations
for Medical Technologists
IFBLS
International Federation of Biomedical
Laboratory Science
Abbreviation
ISCLT
International Society for Clinical Laboratory
Technologists
PACUCOA
2.
Philippine Association of Colleges and
Universities Commission Accreditation
Credentialing/Certifying
Organizations
–
provide
certification examinations for professionals. In the
Philippines, credentialing professional organizations are not
common due to the presence of a government professional
regulatory body, the Professional Regulation Commission
(PRC).
Credentialing/Certifying Organizations
AMT
American Medical Technologists
ASCP
American Society of Clinical Pathology
ISCLT
International Society for Clinical Laboratory
Technology
NCA
National Certifying Agency for Medical
Laboratory Personnel
Professional Journals
Professional journals are publications containing
scholarly studies on specific professional fields. Sponsored by
professional organizations, these journals publish articles and
reviews of books and past articles and serve as a forum for new
articles. Professional journals are normally prepared by
professionals in the field and are peer-reviewed by experts.
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
Some of the available professional journals for laboratory
professionals are:









Philippine Journal of Medical Technology
Asia-Pacific Journal of Medical Laboratory
Science
International Journal of Science and Clinical
Laboratory
Laboratory Medicine
Medical Laboratory Observer
Clinical Laboratory Science
Advances for Medical Laboratory Professionals
American Journal for Clinical Pathology
Lab Medicine
Core Values










The Philippine Association of Medical Technologists,
Inc. (PAMET) is the national professional organization of
Registered Medical Technologists in the Philippines.
It is a national body with 46 provincial chapters
nationwide and four international chapters’ – PAMET
Singapore, PAMET Eastern Region Middle East, PAMET
Western Region Middle East, and PAMET USA.
Crisanto G. Almario – Father of PAMET
September 15, 1963 – date founded --through the
initiative of Crisanto G. Almario at the Public Health
Laboratory in Quiricada St., Sta. Cruz, Manila.
September 15, 1963 –first organizational meeting –
attended by 20 representatives. 11 from allied medical
professions and 9 from schools offering medical
technology.
September 20, 1964 – first national convention and
election of officers at the Far Eastern University
Integrity
Professionalism
Commitment
Excellence
Unity
PASMETH



PAMET

20


It is the national organization of recognized schools of
medical technology and public health in the Philippines.
Established in 1970
On May 13, 1970, Dr. Narciso Albarracin, then Secretary
of the Department of Education, designated Dr. Serafin
Juliano and Dr. Gustavo U. Reyes to organize an
association of deans/heads of schools of medical
technology and public health.
June 22, 1970 –first organizational meeting – UST
October 6, 1985 – The organization was formally
registered at SEC
President
Dr. Gustavo Reyes
Vice-President
Dr. Serafin Juliano
Secretary/Treasurer
Dr. Velia Trinidad
Press Relations Officer
Dr. Faustino Sunico
PASMETH Seal
PAMET Insignia
LOGO
Circle – represents the continuity of learning and the never ending
quest for excellence in the academic field.
Circle – symbolizes the continuous involvement where practice
and education must always be integrated.
Triangle – the trilogy of love, respect, and integrity.
Microscope and Snake – symbolize the science of Medical
Technology profession.
Green – the color of health
1964 – The year the first PAMET Board was elected.
Diamond – the four corners represent the four objectives of the
association.
Microscope - represents the field of Medical Technology and
Public Health.
1970 – The year the association was founded
PHISMETS

The Philippine Society of Medical Technology Students is
the
national
organization
of
all
Medical
Technology/Medical Laboratory Science students under
the supervision of PASMETH.
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)

It was organized in 2002 but became inactive due to
inevitable reasons, but was reorganized on November
25, 2006 at FEU-NRMF headed by Dir. Magdalena
Natividad and Dean Bernard Ebuen.
February 24, 2009 – first Medical Technology Student
Congress at Our Lady of Fatima University in Valenzuela
City
PHISMETS also conducts an annual Medical Technology
Student Leadership Training and Strategic Planning
usually during the month of May.


The Seal
3 Circle – symbolize the continuous active involvement of Luzon,
Visayas, and Mindanao in the national transforming venue of
medical laboratory science students.
changes
updating
skills
by
constantly
knowledge and
21
helps staff to continuously
apply learning to their role for
the
organization’s
development
Improves productivity and linking to appraisals; helps
efficiency by reflecting employees
focus
their
learning and highlighting achievements throughout the
the
gaps
between years
knowledge and experience

CPE and CPD
o Continuing Professional Education (CPE) –
refers to training which is linear and formal.
Training objectives in CPE usually are focused
on learning a particular skill or set of skills to
improve professional competence.
o CPD – refers to the development of one’s
knowledge, skills, and attitude relevant to
capability and competency in his or her
profession.

On July 21, 2016, Republic Act 10912 as passed into law
and took effect on August 16, 2016. The said law
mandated the strengthening of CPD programs for all
regulated professions

Implementation of R.A 10912 started on March 15,2017
upon the effectivity of the PRC Resolution No. 1032, also
known as the Implementing Rules and Regulations of
R.A 10912.
Laurel - symbolizes nature and continuation of life every year
The CPD Process
Green Letters – represent the color of health
Each profession has its own CPD council which is composed of the
following:
5 Bubbles in a Test Tube – represent the 5 objectives of the
organization
15 Interconnected Molecules Outside a Test Tube – signify the
unity of the 15 board schools exploring various possibilities and
aiming towards the integral growth and holistic development of
medical laboratory science students.
Microscope – represents medical laboratory science.
1.
2.
3.
A member from Professional Regulatory Board (PRB) as
chair
The president or officer of an APO as the first member –
president of PAMET
The president or officer of the national organization of
deans or department chairpersons of school, colleges, or
universities offering the course requiring the licensure
examination as second member - the president of
PASMETH.
LESSON10: Continuing Professional Development
Continuing Professional Development (CPD)



It is the maintenance, enhancement, and extension of
knowledge, expertise and competence of professionals
after attaining a bachelor’s degree.
It is the longest phase of professional education 
Benefits both the individual and the organization
Benefits to the Individual
Benefits to the Organization
Builds
confidence
credibility
and
Showcases
achievements
useful for appraisals
Achieves career goals by
focusing on training and
development
copes
positively
with
Maximize staff potential
Helps employees to set
SMART (specific, measurable,
attainable, realistic and timebound) objectives
Promotes staff development
Adds value for reflecting;
CPD providers need to apply their respective programs to the
CPD council at least 45 days prior to the conduct of CPD
activity. The CPD council will then evaluate the proposed
activity and designate the number of units to be assigned to
it. The current list of CPD providers for medical technologists
is as follows:
1.
2.
3.
4.
5.
6.
7.
8.
9.
“They made it hard on purpose”
Meredith Grey
PAMET
PASMETH
Research Institute for Tropical Medicine (RITM)
Philippine Blood Coordinating Council (PBCC)
Philippine Council for Quality Assurance in Clinical
Laboratories
National Reference Laboratory for HIV/AIDS and
other sexually transmitted diseases, San Lazaro
Hospital
UST Faculty of Pharmacy – Department of Medical
Technology
Far Eastern University – Nicanor Reyes Medical
Foundation School of Medical Technology
Centro Escolar University – College of Medical
Technology
Principles of Medical Laboratory Science 1 (LEC)
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Newborn Screening Society of the Philippines
Asian Hospital
Philippine Society of Echocardiography
Angeles University Foundation
University of Immaculate Conception
UP Manila – College of Public Health
Bicol Sanitarium
FEU Manila – Department of Medical Technology
DOH Regional Office III
DOH – Health Facility Department Bureau
Ilocos Training and Regional Medical Center –
Department of Laboratories
21. St. Luke’s Medical Center – Quezon City






CPD is a mandatory requirement in the renewal of the
professional identification card (PIC) under the
regulation of PRC.
Even professional s working abroad and senior citizens
are covered by the said requirement.
Every professionals are required to renew their PIC
every 3 years. For the said period, he or she must
acquire a stipulated number of CPD units.
For RMTs, the required is 45 units or an average of 15
units each year for three years.
Any excess number of CPD units cannot be carried over
the next three-year period except for the credit units
from doctorate or master’s degrees or specialty
trainings which are only credited once during the
compliance period.
“They made it hard on purpose”
Meredith Grey
22
Principles of Medical Laboratory Science 1 (LEC)
23
CPD programs consist of structured to non-structured activities
with definite learning processes and outcomes. There is specified
number of credit units for every type of CPD activity.


If a professional attended a training or seminar that as
not organized by a CPD provider or has no assigned CPD
units, he or she can apply the said training or seminar to
the CPD council then they will convert such activities
into CPD units.
The professional who cannot complete the required
number of CPD units can file an affidavit of undertaking
to allow him or her to renew PIC.
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
24
LESSON 11: Healthcare Waste Management
4.
Waste generated by healthcare industry may be hazardous to
nature and are detrimental to a person’s health and to the
environment. All health care facilities are responsible for the
proper segregation, collection, storage, transport, treatment, and
disposal of health care wastes. According to WHO 75-90% of
waste generated by health care are non-hazardous (69.63% in the
Philippines) and the remaining 10-25% is considered hazardous
(30.37% in Ph setting).
Chemical Waste – refers to the discarded chemicals
generated during disinfection, and sterilization
procedures. Also includes heavy metals and their
derivatives.

Chemicals are considered hazardous when
they are toxic, corrosive, flammable, and
reactive.
Ex.








Health care wastes refer to all solid or liquid waste generated by
any of the following activities:





Diagnosis, treatment, and immunization of humans;
Research pertaining to diagnosis, treatment, and
immunization of humans;
Research using laboratory animals
Production and testing of biological products;
Other activities performed by a health care facility that
generates wastes.
5.
Categories of Health Care Wastes
1.
Infectious Waste – all waste suspected to contain
pathogens or toxins that may cause disease to a
susceptible host
Pharmaceuticals Waste - refers to expired, split and
contaminated pharmaceutical products, drugs and
vaccine including discarded items used in handling
pharmaceuticals.
Ex.



Ex.




2.
Microbial cultures
Solid waste with infections—dressings,
sputum cups, urine containers, and
blood bags
Liquid waste with infections—blood,
urine, vomits, and other body
secretions
Food wastes from patients with
infectious diseases.
6.


7.
Empty drug vials
Medicine bottles
Containers for cytotoxic drug
Radioactive Waste – refers to waste exposed to
radionuclide including radioactive diagnostic materials
or radiotherapeutic materials
Ex.

Pathological and Anatomical Waste - Tissue secretions
and body fluids o organs derived from biopsies,
autopsies, or surgical procedures sent to the laboratory
for examination.
Laboratory reagents
X-ray film developing solution
Disinfectants and soaking solutions
used batteries
ammonia solutions
Concentrated hydrogen peroxide
Chlorine
Mercury from broken thermometers
and sphygmomanometers.
Cobalt (Co 90),Technetium (99
Tc),Iodine (131 I),Iridium (192 Ir)
Irradiated blood products and
contaminated waste. Patient’s
excretion
All materials used by patients exposed
to radionuclides within 48 hours
Non-Hazardous or General Waste – refers to waste that
have not been in contact with communicable or
infectious agents, hazardous chemicals or radioactive
substances, and do not pose a hazard.
Anatomical waste is a subgroup of pathological
waste that refers to recognizable body parts
usually from amputation procedures
Impact of Health Care Waste
3.
Sharps – waste items that can cause cuts, pricks, or
punctured wounds. Considered as the most dangerous
health care waste because of their potential to cause
both injury and infection.
Ex.




Syringes from phlebotomy
Blood lancets
Surgical knives
Broken glassware
All individuals exposed to health care waste such as the
medical staff, patients, garbage pickers, and the general public are
potentially at risk of being injured or infected.
Adverse health outcomes associated with health care waste
include:





Sharp-inflicted injuries
Toxic exposure to pharmaceutical products
Chemical burns
Release of particulate matter during medical waste
incineration.
Radiation burns
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
Treatment and disposal of health care waste may pose health
risk indirectly through the release of pathogens and toxic
pollutants into the environment.
National Laws and Policies
1.
Some guidelines in the treatment and disposal of health care
waste




Disposal of untreated waste in landfills may
contaminate drinking water, surface and the ground
water.
Treatment with the use of chemical disinfectants can
result in the release of chemical substances in the
environment if not properly handled, stored and
disposed.
Incineration of waste is widely practiced, but inadequate
incineration result in the release of pollutants in the air.
Incinerated materials containing chlorine can generate
dioxins and furans, which are human carcinogens.
Incineration of heavy metals (lead, mercury, and
cadmium) can lead to the spread of toxic metals in the
environment.
Only modern incinerators operating at 850OC to 1100OC
and fitted with special glass cleaning equipment are able
to comply with the international emission standards for
dioxins and furans.
Disposal of health care waste by incineration is not
allowed in the Philippines.

2.
3.
4.
Alternatives to incineration--autoclaving, microwaving
and steam treatment
Legislation, Policies, and Guidelines Governing Health Care
Waste
5.
International Agreements
1.
2.
3.
4.
5.
The Montreal Protocol on Substances that Deplete the
Ozone Layer (1987) – sets the final objective of the
protocol to eliminate ozone depleting substances in the
environment.
The Basel Convention on the Control of the
Transboundary Movements of Hazardous Wastes and
their Disposal (1989) – legitimates transboundary
shipments of hazardous wastes are exported from
countries that lack the facilities or expertise to safely
dispose certain waste to countries that have both
facilities and expertise.
The United Nations Framework Convention on Climate
Change (1992) - includes a legally non-binding pledge
that by the year 2000, major industrialized nations
would voluntarily reduce their greenhouse gas
emissions to 1990 levels.
The Stockholm Convention on Persistent Organic
Pollutants (2001) – a global treaty to protect human
health and the environment from persistent organic
pollutants.
The ASEAN Framework Agreement on the Facilitation
of Goods in Transit (1998) – is a core instrument that
provides nine high level protocols that set out generic
standards to be put into place for the implementation of
an international transit system.
25
6.
7.
Republic Act No. 4226 “Hospital Licensure Act (1965)

An act that require the registration and
licensure of all hospitals in the country and
mandates the DOH to provide guidelines for
hospital technical standards as to personnel,
equipment, and physical facilities.
Republic Act No. 6969 “An Act to Control Substances
and Hazardous and Nuclear Waste” (1990)

Requires the registration of waste generators,
waste transporters and operators of toxic and
hazardous waste treatment facilities with the
EMB. The waste generators are required to
ensure that their hazardous wastes are
properly collected, transported, treated, and
disposed in a sanitary landfill.
Republic Act No. 8749 “The Philippine Clean Air Act of
1999”

Prohibits the incineration of bio-medical
waste. It promotes the use of state-of-the-art,
environmentally sound, and safe non-burn
technologies for the handling, treatment,
thermal distraction, utilization, and disposal of
sorted, unrecycled, biomedical, and hazardous
wastes.
Republic Act No. 9003 “Ecological Solid Waste
Management Act of 2000”

Mandates the segregation of solid waste at
the sources including households and
institutions like hospitals by using a separate
container for each type of waste.
Republic Act 9275 “The Philippine Clean Water Act of
2004)

Pursues a policy of economic growth in a
manner consistent with the protection,
preservation, and revival of the quality of the
country’s fresh, brackish, and marine waters.
Presidential Decree 813 (1975) and Executive Oder 927
(1983) “Strengthening the Functions of Laguna Lake
Development Authority (LLDA)”

Further strengthens the powers and functions
of the LLDA to include environmental
protection and jurisdiction over surface waters
of Laguna Lake basin. Through E.O. 927, the
LLDa is empowered to issue permits for the
use of surface waters within Laguna de Bay.
Presidential Decree 856 “The Code of Sanitation of the
Philippines – Chapter XVII on Sewerage Collection and
Excreta Disposal” (1998)
a. Rules and Regulations Governing the Collection,
handling, Transport, Treatment and Disposal of
Domestic Sludge and Septage, (2004), a
“Supplement to the IRR of Chapter XVII on Sewage
Collection and Disposal and Excreta Disposal and
Drainage of 1998”

Require individuals, firms, public and
private
operators,
owners
and
administrators engaged in dislodging,
collection, handling and transport,
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
treatment, and disposal of domestic
sewage treatment plants/facilities and
septage from house septic tanks to
secure
environmental
sanitation
clearances from DOH.
b. Chapter XVII of Presidential Decree 856 “The Code
of Sanitation of the Philippines” on Refuse Disposal
(1998) – requires cities and municipalities to
provide an adequate and efficient system of
collecting, transporting and disposing refuse in
their areas of jurisdiction.
8. Presidential Decree No. 984 “Providing for the Revision
of Republic Act No. 3931, Commonly Known as the
Pollution Control Law , and for Other Purposes” (1976)

Governs the discharge of potentially polluting
substances to air and water. It provides the
basis for the DENR regulations on water
pollution through its IRR, DENR Administrative
Order No. 14, but was later replaced by the
Clean Air Act of 1999 (R.A 8749)
9. Presidential Decree No. 1586 “Environmental Impact
Statement (EIS) System” (1987)

Requires projects like construction of new
hospital buildings or expansion of existing
hospitals, to secure an Environmental
Compliance Commitment Certificate (ECC)
prior to the construction and operation of the
facility.
10. Executive Order No. 301 “Establishing a Green
Procurement Program for All Departments, Bureaus,
Offices and Agencies of the Executive Branch of the
Government” (2004)


Aims to (a) promotes the culture of making
environmentally informed decisions in the
government, especially on the purchase and
use of different products; (b) include
environmental criteria in public tenders,
whenever possible and practicable; (c)
establish the specifications and requirements
for products or services to be considered
environmentally advantageous; and (d)
develop incentive programs for suppliers of
environmentally advantageous products or
services.
11. DOH Administrative Order No. 2008-0021 dated July
30, 2008 “Gradual Phase-out of Mercury in all
Philippine Health Care Facilities and institutions”

Requires all HCF to gradually phase-out the
use of mercury-containing devices and
equipment.
12. DOH Administrative Order No. 2008-0023 dated July
30, 2008 “National Policy of Patient Safety”

Requires the establishment and maintenance
of a culture of patient safety in the HCF as the
responsibility of its leaders. The Key priority
areas in patient safety include, but are not
limited to, proper patient identification,
assurance of blood safety, safe clinical and
surgical procedures, provision and
26
maintenance of a safe quality drugs and
technology, strengthening infection control
standards, maintenance of the environment of
care standards, and energy and waste
management standards.
13. DOH “Manual on Health Care Waste Management: in
2011 (Revising the 2007 Health Care Waste
Management Manual)

Serves as reference for HCF administrators in
the implementation of an effective and
efficient waste management program. The
requirements for doing such are provided in
the manual by listing the standards of
performance, defining the mandatory
requirements, providing new concepts, and
citing examples and tools. The manual is
designed to be used by workers within the
HCF.
14. Philhealth Benchbook for Quality Assurance in health
care (2006)

Includes healthcare waste management as
one of its parameters in the quality assurance
of healthcare.
15. BFAD Memorandum Circular No. 22, Series of 1994,
“Inventory, Proper Disposal, and/or Destruction of
Used Vials or Bottles” and BFAD Bureau Circular No.
16, Series of 1999: “Amending BFAD MC No. 22dated
September 8, 1994, Regarding Inventory, Proper
Disposal, and/or Destruction of Used Vials or Bottles”

These circulars are released to prevent the
proliferation of adulterated, misbranded, and
counterfeit drugs brought about by the
recycling of used pharmaceutical bottles or
vials. It contains the guidelines on the proper
inventory and destruction of bottles and vials.
Health Care Waste Management System
Health care waste generated by HCF generally follows a
well-defined flow from the point of generation down to their
treatment and disposal.
Green Procurement
Resource
Development
End of Pipe


Green Procurement Policy – waste minimization- most
important step in the proper management of health
care wastes. This policy involves waste prevention and
reduction.
Reusing – refers to either finding a new application for a
used material or using the same product for the same
application repeatedly. Ex. Laboratory glassware
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)



Recycling – refers to the processing of a used materials
into new products. Ex. Printout from the hospitals can
be recycled into new paper products.
Recovery – defined in two ways. (1) Energy recovery,
whereby waste is converted to fuel by generating
electricity or for direct heating of premises and (2) as a
term used to encompass three subsets of waste
recovery: recycling, composting, and energy recovery.
End of pipe – approach needed for waste that cannot be
reused, recycled, or recovered.
BIN – Labeled “Chemical Waste”; For liquid
chemical waste, inside the bin is a disposal
bottled made of amber-colored glass with at
least 4 liters capacity that is strong, chemicalresistant and leak-proof.
Chemical Waste


Health care waste must be segregated, collected,
stored, and transported while considering risk and
occupational safety and compliance with existing laws,
policies and guidelines.
Hazardous waste must never be mixed with general
wastes and there must be a waste management officer
responsible for the management of the waste of the
facility.
Segregation is the process of separating different types
of waste at the point of generation until their final
disposal.
Pharmaceutical
Waste
Radioactive Waste
BIN - Strong-leak proof bin with cover
labeled “Infectious”
Infectious Waste
BIN - Strong-leak proof bin with cover
labeled
“Pathological/Anatomical
Waste”
Pathological/Anatomical
Waste
LINER - Yellow plastic that can
withstand autoclaving with 0.009 mm
thickness
and
labeled
“Pathological/Anatomical Waste” with
a tag indicating source and weight of
waste and date of collection.
Biohazard symbol is optional.
BIN – Punctured-proof container with
wide mouth and cover labeled
“Sharps” with biohazard symbol
LINER – Orange Plastic with 0.009 mm
thickness and labeled “Chemical Waste” with
a tag indicating name of radionuclide and date
of deposition
BIN – optional recycle symbol for recyclable
non-hazardous
wastes;
varying
sizes
depending on the volume of waste.
Specifications
LINER – Yellow plastic that can
withstand autoclaving with 0.009 mm
thickness and labeled “Infectious
Waste” with a tag indicating source
and weight of waste and date of
collection; may or may not have
biohazard symbol.
LINER - Yellow with black band plastic with
0.009 mm thickness and labeled “Chemical
Waste” with a tag indicating source and
weight of waste and date of collection.
BIN – Radiation proof repositories, leak-proof,
and lead-lined container labeled with name of
radionuclide and date of deposition with
radioactive symbol
Guidelines for the proper labeling, marking, and color
coding for waste segregation in HCF
Type of Waste
LINER – Yellow with black band plastic with
0.009 mm thickness and labeled “Chemical
Waste” with a tag indicating source and
weight of waste and date of collection
BIN - Strong-leak proof bin with cover labeled
“Pharmaceutical Waste” for expired drugs and
drug containers and “Cytotoxic Waste” for
cytotoxic, genotoxic, and antineoplastic
waste.
Segregation, Collection, Storage, and Transport of Health Care
Wastes

27
General Waste
LINER – Black or colorless plastic for nonbiodegradable and green for biodegradable
with 0.009 mm thickness and labeled
“Chemical Waste” with a tag indicating
source, weight of waste and date of
collection.
In the implementation of a color-coding system for health care
waste, the following practices should be observed;
1.
2.
3.
4.
5.
LINER – not applicable
Sharps
6.
Highly infectious waste must be disinfected at source.
Anatomical waste including recognizable body parts,
placenta waste, and organs should be disposed through
safe burial or cremation.
Pathological waste must be refrigerated if not collected
or treated within 24 hours.
Sharps must be shredded or crushed before they are
transported to the landfill.
- Chemical and pharmaceutical waste must be
segregated and collected separately.
- Wastes with high content of heavy metals, except
mercury, should be collected separately and send to the
waste treatment facility. Waste with mercury should be
collected separately.
- Hazardous chemical waste shall never be mixed or
dispose in a drain.
- Expired and discolored pharmaceuticals should be
returned to the pharmacy.
Radioactive waste has to be decayed to background
radiation levels. If it has reached the background
radiation level and is not mixed with infectious or
“They made it hard on purpose”
Meredith Grey
Principles of Medical Laboratory Science 1 (LEC)
7.
8.
chemical waste, the radioactive waste is considered as
non-infectious waste.
All waste bin must be properly covered to prevent cross
contamination.
Aerosol Containers can be collected with the general
waste.
Treatment and Disposal of Health Care Wastes
Health care waste can be decontaminated either by
Sterilization or Disinfection. Sterilization kills all microorganisms
while disinfection reduces the level of microorganisms present in
the material.
Accepted technologies and methods used in the treatment of
Health Care Wastes
1.
2.
3.
4.
5.
6.
Pyrolysis

Thermal decomposition of HCW in the absence of
supplied molecular oxygen in the destruction
chamber where waste is converted into gaseous,
liquid, or solid form.

Can handle full range of HCW

Waste residues may be in form of greasy
aggregates or slugs, recoverable metals, or carbon
black. These residues are disposed in a landfill.
Autoclave

Use to steam sterilization to render waste harmless
and is an efficient wet thermal disinfection process.

Widely used; usual setting is at 121 OC with
pressure of 15 psi for 15 to 30 minutes. Indicators
such as color-changing tapes and ampoules
containing bacterial spores can be used to check
the validity of the sterilization.
Microwave

Waste is exposed to microwaves that raise the
temperature to 100 OC for at least 30 minutes

Microorganisms are destroyed by moist heat which
irreversibly coagulates and denature enzymes and
structural proteins.
Chemical Disinfection

Chemicals like hypochlorite, hydrogen peroxide,
peroxyacetic acid, and heated alkali are added to
health care wastes to kill or inactivate present
pathogens.
Biological Process

Uses an enzymes mixture to decontaminate health
care wastes. The resulting by-product is put
through an extruder to remove water for waste
water disposal.
Encapsulation

Involves the filling of containers with waste, adding
and immobilizing material, and sealing the
containers. The process uses either cubic boxes
made of high-density polyethylene or metallic
drums that are three-quarters filled with sharps, or
chemicals or pharmaceutical residues. The
containers or boxes are then filled up with a
medium such as plastic foam, bituminous sand, and
cement mortar. After the medium has dried the
containers dried then disposed in a landfill.
7.
28
Inertization

Especially suitable for pharmaceutical waste that
involves the mixing of waste and cement and other
substances before disposal

The process is relatively inexpensive and can be
performed using relatively unsophisticated
equipment.
Landfills




“They made it hard on purpose”
Meredith Grey
After treatment, HCW are usually disposed in
landfills.
This site must secure proper permits from DENR
before it can accept wastes.
HCW mixed with general waste provided that the
organisms in waste products cannot regenerate
must be certified by the DOH.
For health care facilities with no access to landfills,
disposal usually through safe burial. Only allowed in
healthcare facilities located in remote areas
Principles of Medical Laboratory Science Practice I
OVERVIEW OF MEDICAL TECHNOLOGY
Pathologist
o Director of a clinical laboratory
o Licensed physician with a specialty in Pathology as
certified by the Philippine Board of Pathology
Definitions of Medical Technology
o
Heinemann
The application of the principles of natural, physical, and
biological sciences to the performance of laboratory
procedures which aid in the diagnosis and treatment of
diseases.
o Fagelson
Branch of medicine concerned with the performance of
laboratory determinations and analyses used in the
diagnosis and treatment of disease and the maintenance
of health.
o Walters
Health profession concerned with performing laboratory
analyses in view of obtaining information necessary in the
diagnosis and treatment of disease as well as in the
maintenance of good health.
o RA 5527 (Philippine Medical Technology Act of 1969)
An auxiliary branch of laboratory medicine which deals
with the examination of tissues, secretion and excretion
of the human body and body fluids by various electronic,
chemical, microscopic and other medical laboratory
procedures or techniques either manual or automated
which will aid the physician in the diagnosis study and
treatment of disease and in the promotion of health in
general.
Medical Technologist
–
Have a baccalaureate degree from a college or university
recognized by Commission on Higher Education (CHED);
Has completed a specified clinical internship in a training
laboratory accredited by the Bureau of Health Facilities and
Services (BHFS) of the Department of Health (DOH); and
Passed the licensure examination administered by the Board
of Medical Technology of the Professional Regulation
Commission.
Medical detectives
They work under pressure with speed, accuracy and
precision. They adhere to high ethical standards of
performance.
–
–
–
–
Employment Opportunities






Clinical Laboratories
–
–
Facilities that perform chemical and microscopic
examinations of various body fluids like blood and tissues.
Found in a variety of settings: government and private
hospitals or free standing (non-hospital) laboratories such as
those found in clinics, group practices, physician’s offices,
veterinary offices, government agencies and military
institutions.
 Small size hospitals: (<100 beds) perform only routine
procedures and that more complicated or infrequently
requested tests may be sent to reference laboratories.
 Medium size hospitals: (100-300 beds) contain
laboratory that can perform all routine tests including
more complicated procedures
 Large size hospitals: (>300 beds) can handle large
volumes of work and perform complex tests.





Employed in government and private hospitals, in clinical
laboratories and in blood banks as medical technology
generalists.
Medical technology specialists (in microbiology,
hematology, blood banking, clinical chemistry)
Clinical laboratory supervisors
Chief medical technologists
Laboratory owners
Sales and industry (sales representatives, public relations
representatives, or educational representatives for their
company)
Field of research (Industrial research - search for new
products and the necessary testing; Medical center
research – involve development or evaluation of new
laboratory methods, new clinical treatment method and
varying types of investigation.)
Academe – teach in high school or in college handling
Chemistry, Mathematics, and especially biological sciences
or medical sciences.
Veterinary medicine
Employment abroad
Stepping stone to a medical career
Personal Traits of a Medical Technologist

Pathology
- The practice of medicine which contributes to diagnosis,
prognosis, and treatment through knowledge gained by
laboratory applications of the biologic, chemical or physical
sciences to man or material obtained from a man.
Two areas of Pathology
1. Anatomic – diagnosis or confirmation of diseases through
autopsy examination and cellular differentiation of
autopsy and surgical tissues.
2. Clinical – specializes in chemical, microbiological, and
hematologic procedures.
30


To succeed, a person needs physical stamina, good eye
sight, a normal color vision, manual dexterity, good
intellect, and an aptitude for the biological sciences and a
caring attitude;
Communication skills and ability to relate well to fellow
workers and patients; and
Observant, motivated, able to perform precise
manipulations and calculations and must have good
organizational skills.
Special characteristics:
o Service oriented: self-satisfaction you feel of helping
the doctor diagnose a disease and of seeing the
patient rise up from his bed is certainly beyond
measure.
Principles of Medical Laboratory Science Practice I
o Patience is a must: MedTech deals with irritable
patients, especially children. A service with a smile is
of great help to the clientele.
o Honesty, accuracy, and skills are important. We deal
with human lives, any error, dishonesty and
negligence in the work endanger the life of the
patient.
o Dedication: we work devotedly and conscientiously
in fulfilling his duties and responsibilities.
o Emotional maturity: helps MedTechs deal with
colleagues in the profession harmoniously.
o ‘X’ factor: makes one likeable not only as a medical
technologist but as a total person.
THE DEVELOPMENT OF MEDICAL TECHNOLOGY

31
war were very grave, sickness and death due to illness
were rampant.
1944 – US bases were built in Leyte, making it possible for
Americans to bring in members of the healthcare team to
the Philippines.
The science was introduced in the Philippines by the 26th Medical
Laboratory at the end of World War II.
o
o
Established at 208 Quiricada St. Sta. Cruz Manila (where
Public Health Laboratory is presently located)
Training of high school graduates to work as laboratory
technicians started in February 1944
A year after, the United States Army left and endorsed the laboratory
to the National Department of Health
o
Early Beginning of Medical Technology
460 B.C – Hippocrates
o Father of Medicine
o Formulated the Hippocratic Oath (the code of ethics for
practicing physicians)
o Described four ‘humors’ or body fluids in man – blood,
phlegm, yellow bile and the black bile.
o These four humors were believed to be the source of
diseases in ancient times.
600 B.C – Polyuria of diabetes was noted in ancient times.
o Urinalysis is regarded as the oldest of laboratory
procedures today.
o Visual examination of urine at bedside could diagnose
illness.
o Hindu physician recorded the sweet taste of diabetic urine.
1500 B.C – Vivian Herrick
o Medical technologist who traces the beginning of medical
technology when intestinal parasites such as Taenia and
Ascaris were first identified.
o Ebers Papyrus - a book for the treatment of diseases was
published (three stages of hookworm infection and
diseases)
14th century – Anna Fagelson
o Medical technology started when a prominent Italian
doctor, Mondino de’ Liuzzi, employed Alessandra Giliani
to perform different tasks in the laboratory, unfortunately
she died due to laboratory acquired infection.

However, the Department of Health did not take interest
on it, maybe because the science was not very well known
and popular during those days.
Dr. Alfredo Pio de Roda
o A well-known bacteriologist and a staff of the 26th
Medical Laboratory;
o He wanted to preserve and save the remnants of the
laboratory; it was his idea that the laboratory could
better serve the residents of Manila and can solve the
problems in relation to their health.
o With the approval of the first city health officer of
Manila, Dr. Mariano Icasiano, a medical laboratory
under the city health department was established.
o October 1, 1945 – a medical laboratory now known as
the Public Health Laboratory was formally organized
under the leadership of Dr. Alfredo Pio de Roda.

The training of medical technicians started under Dr. Pio de Roda
and Dr. Prudencia Sta. Ana.
o The trainees were mostly high school and paramedical
graduates
o The course was free to all interested, however, no
specific /definite period of training nor a certificate of
completion was issued.

1954 – Dr. Pio de Roda instructed Dr. Sta Ana to prepare a
syllabus of training: formal 6 months training with a certificate of
completion. However, it did not last long

Manila Sanitarium and Hospital started to offer the Medical
Technology Course through the pioneering effort of Mrs. Willa
Hilgert Hedrick. (Founder of Medical Technology Education in
the Philippines.)
 Mrs. Hedrick formulated the Course curriculum and put
up the first Medical Technology School in the Philippines:
Philippine Union College (Adventist University of the
Philippines)
 March 1955 – PUC produced its first graduate named
Jesse Umali, followed by Avelino Oliva and Adoracion
Yutuc.

1957 – Dr. Antonio Gabriel and Dr. Gustavo Reyes of University
of Sto. Tomas, offered an elective course to Pharmacy graduates
leading to the medical technology course.
1632 – Anton van Leeuwenhoek
o Invented the first functional microscope
o He was the first to describe red blood cells, to see
protozoa, and to classify bacteria according to shape.
o His invention led to the rapid progress of microbiology and
pathology
History of Medical Technology in the Philippines


World War II is the most widespread war that occurred
from 1939 to 1945
December 7, 1941 – Pearl harbor was invaded by Japan
which led to Japan invading the Philippines. The effects of
Principles of Medical Laboratory Science Practice I
13th
ORGANIZATIONS OF MEDICAL TECHNOLOGY
12th
Shirley F. Cruzada
2003 - 2004
Interdisciplinary
Networking
14th
Leila M. Florento
2007 - 2013
Global
Perspectives
15th
Romeo Joseph J.
Ignacio
2013 - 2015
Golden
Celebration
16th
Rolando E. Puno
2015-Present
Empowerment
PAMET – Philippine Association of Medical Technologists, Inc.
o
o
o
o
o


National organization of all registered medical
technologists in the Philippines.
It was organized by Mr. Crisanto G. Almario (Father of
PAMET), a Pharmacy graduate of Manila Central
University, and worked as a laboratory technician at San
Lazaro Hospital.
It was at that point he noticed the very degraded
classification of workers performing this particular job. So
he felt the need to standardize the profession, and to
elevate its category into a more dignified one.
Without wasting time, he immediately grabbed the
opportunity and moved to organize the national
organization for the medical technology workers.
September 15, 1963, 10:00AM
o PAMET was born
September 20, 1964
o First national convention was held at the
conference hall of the Far Eastern University
Hospital
PAMET Logo
o The circle

symbolizes continuous involvement in
practice
o The triangle

represents the
trilogy of love,
respect, and
integrity
o The green text

symbolizes the color of health
o The microscope and the snake

represents the science of Medical
Technology profession
1st
Charlemagne T.
Tamondong
1963 - 1967
Emergence of the
Profession
2nd
Nardito D. Moraleta
1967 - 1970
Professional
Recognition
3rd &
6th
Felix E. Asprer
1970 – 1971;
1973 - 1977
Legislative Agenda
4th
Bernardo T.
Tabaosares
Sept. 1971 –
Jan. 1973
Celebration of the
Profession
5th
Angelina R. Jose
Jan. 1973 –
Sept. 1973
Career Advocacy
32
PASMETH – Philippine Association of Schools of Medical
Technology & Public Health

o
o
o
o
o
The national organization of all registered schools of
medical technology/public health in the Philippines

Organized in 1970 by some representatives of MedTech
schools in their desire to maintain the highest standard of
education and to foster closer relations among these
schools.
Objectives
To encourage a thorough study of the needs and problems of
MedTech education and to offer solution for them;
To work for the enhancement and continuous development of
MedTech education in order that the profession will be of maximum
service to the country;
To take a united stand in matters which affect the interest of
MedTech education; and
To seek advice, aid and assistance from any government or private
entity for the fulfilment of the association’s aims and purposes.Z
May 13, 1970
Dir. Narciso Albarracin appointed Dr. Serafin J. Juliano and Dr.
Gustavo U. Reyes to organize an association of Deans/Heads of
Schools of Medical Technology and Hygience (Public Health).
June 22, 1970
o First organizational meeting held at University of Santo tomas
o First set of officers:
 President: Dr. Gustavo Reyes (first President of PASMETH)
 Vice President: Dr. Serafin Juliano
 Secretary/Treasurer: Dr. Velia Trinidad
 PRO:
Dr. Faustino Sunico
May 7, 1971
o First annual meeting was held at the University of Santo Tomas,
Manila
April 30, 1972
o First set of officers were re-elected for a second term.
MEDICAL TECHNOLOGISTS: PROFESSIONALS WORTH REWARDING
7th
Venerable C.V Oca
1977 – Feb.
1982
Educational
Enhancement
8th
Carmencita P.
Acedera
1982 - 1992
Image Building
9th
Marilyn R. Atienza
1992 - 1996
Proactivism
10th
Norma N. Chang
1997 - 2001
International
Leadership
11th
&
Agnes B. Medenilla
2001-2002;
2005-2006
Organizational
Dynamism
HOW/WHY?
Multiple careers. Medical Technologists have a wide range of career
options. The demand for Med.Techs is continuously increasing
with the emergence of different job opportunities.
Job satisfaction. Making a real difference in patient’s lives
contributes to high levels of job satisfaction among medical
laboratory technologists.
Independence. Medical technologists often work independently
with minimal supervision – they have greater control over their
daily routine than many other healthcare professionals.
Principles of Medical Laboratory Science Practice I
Expanding Roles. The demands for faster testing and constant
monitoring of a patient’s illness may necessitate the
involvement of medical technologists in clinical practice.
Travelers and Explorers. A career in medical laboratory technology
may be one that is full of adventures because medical
technologists are required to explore new techniques and
technologies in laboratory medicine in different parts of the
world.









Achieving goals. Medical technologists are grounded in
their belief that the best way to achieve goals is through
motivation.
Gaining a Positive Perspective. The only way to gain a
positive perspective is to set the mission and elaborate on
the vision.
Creating the Power to Change. Each member of the
laboratory organization should be empowered to accept
and create changes in the organizational framework.
Building self-esteem and Capability. By building and
motivating a person to develop self-esteem, one can be
assured of improvement and professional growth.





Competence. A competent person has the capacity and
ability to work on a certain task; the fruit of labor would be
at stake if the person is not competent and eligible to do
it.
Relatedness. It refers to the universal need to interact, be
connected to, and experience caring for others.
Autonomy. It is simply regarded as the command of the
individual acting in a self-centered manner.
OPPORTUNITIES FOR AND CHALLENGES FACED BY MEDICAL
TECHNOLOGISTS
Problems




TRADITIONAL AND NON-TRADITIONAL ROLES OF MEDIAL
TECHNOLOGISTS
 Master the principles and theories of medicine
 Pass the American Society for Clinical Pathology
(ASCP)
Note: ASCP is an international certification that provides a
competitive advantage in the global market and is generally a
professional credential for pathologist’s assistants, laboratory
technicians and technologists
Demands





Microscopic analysis and examination
Identification of microscopic forms of life
Analysis of chemical content or chemical reaction of fluids
Determination of the concentrations of compounds in the
blood
Blood typing and cross-matching
Testing for drug levels in the blood in treatment
responsiveness
Philippines’ medical sector is booming in United
States
Emigration of professional manpower
Increase in enrolment in medical technology courses
OTHER ALLIED HEALTH PROFESSIONALS
Allied Health professionals are clinical and administrative health
care professionals who are distinct from professionals engaged in
medicine, dentistry and nursing.

Traditional Roles




High cost of college education
Wages are low
Work condition and environment
Health
Needs
Various Areas:
1. Laboratories
2. Clinical Areas
3. Business and Industrial Areas
4. Academic Areas
Challenges:
1. Future
2. Current
3. Past
Research including laboratory testing for innovations
(healthcare products or pharmaceutical agents)
Technical representatives for laboratory instrumentation
companies
Positions in the academe (education and teaching)
Diagnostic testing kits and laboratory equipment and
supplies
PROBLEMS, NEEDS, AND DEMANDS OF MEDICAL TECHNOLOGY
SERVICES
The self-determination theory identifies the following three
important innate needs:

Preparation of specimens for examination
Counting of blood cells
Checking for abnormal cells in blood and other body fluids
Evaluation of test results to develop and modify
procedures
Ensure accuracy and precision
Non-Traditional Roles

JOB MOTIVATION
33


ART THERAPISTS - they use music, art or drama as a
therapeutic intervention to help people with physical,
mental, social and emotional difficulties. Art and painting
can reduce problems and orient people to recognize the
harmony of colors.
CHIROPODISTS or PODIATRISTS - they specialize in the
health of feet, and play a particularly important role in
helping seniors retain their mobility and therefore remain
independent.
OPERATING DEPARTMENT PRACTITIONERS - they are an
important part of the operating department team working
Principles of Medical Laboratory Science Practice I







with surgeons, anesthetists, and theater nurses to help
ensure that every operation is conducted safely and
effectively. They are graduates in nursing with experience
in handling patients during surgeries.
DIETITIANS - they translate the science of nutrition into
practical information about food. They work with people
to promote nutritional well-being, prevent food-related
problems and treat disease. They understand how and
what nutritional foods are best administered to the
patients.
ORTHOPTISTS - they manage a wide range of eye
problems, mainly those conditions that affect eye
movement such as squint (strabismus) and lazy eye
(amblyopic)
OCCUPATIONAL THERAPISTS - they help people overcome
physical, psychological or social problem arising from
illness or disability by concentrating on what they are able
to achieve, rather than on their disabilities.
PHYSIOTHERAPISTS - they treat physical problems caused
by accidents, illness and ageing, particularly those that
affect the muscles, bones, heart, circulation and lungs.
PSYCHOLOGISTS - they use psychological theory and
practice to help solve problems or bring about
improvements for individuals, groups and organizations.
RADIOGRAPHERS - they are involved in the planning and
delivery of ionizing radiation treatment and in the
examination of patient by means of X-rays which are
interpreted to aid the identification of illnesses and
diseases. They work closely with radiology technologists.
SPEECH AND LANGUAGE THERAPISTS - they work with
people who have difficulties in communication including
those with speech defects or with chewing or swallowing.
PROFESSIONAL PRACTICE AND ORGANIZATION OF MEDICAL
TECHNOLOGY ABROAD
1.
AMERICAN MEDICAL TECHNOLOGISTS (AMT)
A non-profit certification agency and professional membership
association that provides allied health professionals with
professional certification services and membership programs to
enhance their professional and personal growth. They offer
certifications to different categories including medical
technologists, medical laboratory technicians, medical
laboratory assistants and phlebotomy technicians.
2. AMERICAN SOCIETY FOR CLINICAL LABORATORY SCIENCE
3. CLINICAL LABORATORY MANAGEMENT ASSOCIATION
These associations share a common vision to be premier resources
for medical laboratory professionals and laboratory leadership, to
maintain and enhance their knowledge of medical laboratory science
and best practices. Their mission is to promote the practice of
excellence in medical laboratory medicine through education,
advocacy and networking.
Clinical Laboratory – facility subdivided into different sections where
common diagnostic procedures are done by specialized health
professionals.
R.A 4688 – Clinical Laboratory Law of 1966
34
 Approved on June 18, 1966
 Ensure the health of the general public by preventing the
operation of substandard laboratories.
 BRL – Bureau of Research and Laboratories
 BHFS – Bureau of Health Facilities and Services
Classification of Laboratories (According to Function)
Clinical Pathology
Anatomic Pathology
Hematology
Surgical Pathology
Clinical Chemistry
Immunohistopathology
Microbiology
Cytology
Parasitology
Autopsy
Mycology
Forensic Pathology
Clinical Microscopy
Immunohematology
Immunology / Serology
Laboratory Endocrinology
Toxicology and Therapeutic
Drugs Monitoring
Principles of Medical Laboratory Science Practice I
Additional Notes:
 National Reference Laboratory (NRL)






A laboratory in a government hospital which has been
designated by the DOH to provide special functions and
services such as the following:
o Confirmatory testing
o Surveillance
o Resolution of conflicts
o Training and research
o Evaluation of kits and reagents

35
Virology - scientific study of virus, an acellular entity that
contains either DNA or RNA but never both and uses the
cellular machinery of living organisms to survive.
Pioneers in the History of Microbiology
1. Girolamo Fracastoro
- suggested that disease was caused by “invisible living
creatures”; gave syphilis its name in the 16th century
2. Anton van Leeuwenhoek
- “Father of Bacteriology and Protozoology”
- discovered bacteria, free-living and parasitic microscopic
protists, sperm cells, blood cells, parasites, and fungi
3.
Francesco Redi
According to Ownership
According to Function
According to Institutional Character
- Disputed the Theory of
Spontaneous Generation
 Government
 Clinical Pathology
 Institutional-based laboratory
4.
John Needham
- Believed that organic
 Private
 Anatomic Pathology
 Free-standing laboratory
matter possesses a unique force
that brings forth life
5.
Lazzaro Spallanzani
- Observed
that
no
According to Service Capability
microbial growth is suggestive of
Primary Category
Secondary Category
Tertiary Category
air as a possible source of
contamination.
6.
Louis Pasteur
 Secondary category
 Routine hematology
 Primary category laboratory examinations
- Credited
for
his
laboratory
 Routine urinalysis
 Routine chemistry
development of the principles of
examinations
 Routine fecalysis
 Quantitative platelet determination
vaccination,
microbial
 Qualitative platelet
 Crossmatching – HB
 Special chemistry
fermentation, and pasteurization
determination
 Gram staining / KOH – HB
 Special hematology
7.
Joseph Lister
 Immunology /
 Blood typing – HB
- Introduced the use of
Serology
 Microbiology
carbolic acid (phenol) as a chemical
sterilizing agent for surgical
instruments
8.
Hans Christian Gram
- Credited for the Gramstaining technique which is used to
o External quality assessment program
distinguish two major groups of bacteria
RITM – Research Institute for Tropical Medicine (Microbiology,
9. Alexander Fleming
Parasitology, Blood Banking)
- Discovered the powerful antibiotic, benzylpenicillin
(Penicillin G) from a mold, Penicillin notatum
SACCL – STD/AIDS Cooperative Central Laboratory (Immuno/Sero)
NKTI – National Kidney and Transplant Institute (Hematology)
10. Robert Koch
LCP – Lung Center of the Philippines (Clinical Chemistry)
- Established the theory that etiologic agents cause
EAMC – East Avenue Medical Center (Water Microbiology &
diseases
Toxicology)
- Discovered the following agents: Bacillus anthracis,
Mycobacterium tuberculosis, and Vibrio cholera
MICROBIOLOGY refers to the study of organisms too small to be
seen by the unaided eye.
Different Parts of a typical bacterial cell
1. Cell membrane

Clinical microbiology - study of microbial pathogens that
- Lipoprotein layer that surrounds the cytoplasm
are considered health threats to people.
- Regulates the transport of solutes in and out of the cell

Diagnostic microbiology - involved in the examination and
2. Cell wall
identification of organisms through laboratory tests.
- Semi-rigid casing that provides structural shape and

Food microbiology - studies the practical application and
support to the cell
use of beneficial microorganisms in food processing.
- Protects bacterial cells from the effects of osmotic
changes
Branches of Microbiology
- Primary target of antimicrobial agents

Parasitology - focuses on the study of parasites
- Its reaction to stains determine whether it is Gram (-) or

Mycology - scientific study of fungi (yeast and molds)
Gram (+).

Bacteriology - studies bacteria, an example of a prokaryotic
3. Ribosomes
organism.
- Sites of protein synthesis, they give the cytoplasm a
granular structure
Principles of Medical Laboratory Science Practice I
4.
5.
6.
7.
8.
9.
Nucleoid
- Region where the DNA is concentrated
Capsule
- The protective layer of a bacterium that resists cellular
phagocytosis and dessication
- Encapsulated organisms, like Cryptococcus neoformans,
may be best visualized by negative staining technique
using India ink.
Pili
- Hair-like proteinaceous structures that extend from the
cell membrane into the external environment
Flagellum
- Structures that allow the bacteria to move; confer
motility or self-propulsion
- Motility is demonstrated through hanging-drop technique
(wet mount); through the growth of the organisms in a
semi-solid medium; and staining
- Orientation of flagella
o Atrichous - absence of flagellum
o Monotrichous - one polar flagellum
o Amphitrichous - single flagellum on both ends
o Lophotrichous - tuft of flagella on one end
o Bilophotrichous - tuft of flagella on both ends
o Peritrichous - flagella is all around the organism
Spores (endospores)
- Structures that allow bacteria to resist the sterilization
process, making them viable over time
- Composed of calcium dipicolinate
- Described according to its position: terminal (Clostridium
tetani), subterminal (Clostridium botulinum), and central
(Bacillus anthracis)
Inclusion bodies
- Food reserves of bacteria
- Some are specific to certain bacteria: Babes-Ernst bodies
(Corynebacterium diphtheriae), Much’s granules
(Mycobacterium tuberculosis), sulfur granules
(Nocardia/Actinomyces), and bipolar bodies (Yersinia
pestis)
Bacteria according to Shape
Bacterial species are differentiated based on their shapes. There
are three basic bacterial shapes: the cocci (spherical), the bacilli (rodshaped), and the spiral (twisted). However, pleomorphic bacteria
can assume several shapes.
A. Coccus – usually round but can be oval; plural: cocci
B. Bacillus – rod-shaped bacteria; plural: bacilli
C. Spiral – curved bacteria which can range from a gently
curved shape to a corkscrew-like spiral
Common Techniques in Microbiology Section
Staining bacterial smear helps in visualizing microorganisms
during a microscopic examination.
Types of Stains
A. Simple stain
- Only one stain is used and all structures present are
stained with same color
- Organisms should only be observed for size, shape,
and uniformity of staining (ex. Methylene blue stain)
36
B.
Differential stain
- Used to distinguish between groups of bacteria (ex.
Gram stain)
- Used to differentiate various types of bacteria that
have similar morphologic features
- Gram staining technique uses the following four
different reagents:
o Crystal violet – primary stain
o Gram’s iodine - Mordant
o Alcohol-acetone solution - decolorizer
o Safranin – counter stain
Gram stain Method
-
Divides bacteria into two broad groups which determine an
organism’s cell wall structure
- Gram-negative = pink/red stain
- Gram-positive = purple/blue stain
Gram stain Procedure
1.
Flood the fixed bacterial smear with crystal violet stain and
wait for 10 seconds.
2. Rinse with water.
3. Flood the smear with Gram’s iodine solution and wait for
10 seconds.
4. Rinse with water.
5. Decolorize quickly with alcohol-acetone solution. Continue
until no more color is extracted by the solvent. This usually
takes around 10-20 seconds. Care must be taken to avoid
over-decolorization.
6. Rinse with water.
7. Flood the smear with safranin and wait 10 seconds.
8. Rinse with water, air-dry, and examine using the oil
immersion lens. Take note of the difference in color.
PARASITOLOGY
Definition of Terms:
 Parasite - refers to any organism that depends on another
organism for shelter and nourishment
 Host - organism that harbors another organism.
o Definitive host - harbors the adult stage of the parasite
o Intermediate host - harbors the larval (asexual) form of
the parasite
 Mode of transmission - manner of how a parasite successfully
enters a susceptible host.
 Carrier - an asymptomatic host that harbors a parasite and is
capable of transmitting it to others.
 Pathogenic parasites - disease-causing parasites and may
require medical attention
 Non-pathogenic parasites - “commensals”; parasites that do not
cause harm to the host
 Ectoparasites - parasites that thrive externally on a host;
Ectoparasitism
 Endoparasites - parasites found inside the body of an infected
host; Endoparasitism
 Eosinophilia - increase in eosinophil count in blood and is usually
associated with parasitism
Major Groups of Medically Important Parasites
A. Protozoans
- Phylum comprised of the simplest organisms
Principles of Medical Laboratory Science Practice I

-
Most are free-living but some are mutualistic,
commensalistic, or parasitic
- Trophozoite – active reproductive stage
- Cyst – infective stage
- Encystation – refers to the transformation of trophozoites
into cyst
- Excystation – cyst to trophozoite
o Amoeba
 Has pseudopods (false feet) which appear as an
ectoplasmic extension of the parasite and help the
parasite move during its trophozoite stage.
 Usual mode of transmission is through ingestion of
contaminated food or water.
 Ex. Entamoeba histolytica – only pathogenic amoeba in
the gastrointestinal tract
o Flagellates
 Equipped with whip-like structures called flagella,
which aid the parasite in locomotion
 Most flagellates live in the small intestine
 Ex. Giardia lamblia
o Ciliates
 Protozoans that move through their hair-like structures
called cilia
 Ex. Balantidium coli is the only species pathogenic to
humans. This parasite also invades tissues.
B. Nematodes
- Nematodes (roundworms) are a class of helminths
- Adult nematodes are tapered, cylindrical bodies with an
esophagus and longitudinal muscles.
- Dioecious parasites = separate sexes
- Ex. Ascaris lumbricoides – largest nematode in the human
intestinal tract; one of the three common parasites focused
on by the DOH.
C. Cestodes
- Also known as tapeworms
- They are ribbon-like, multi-segmented, and dwell as adults
entirely in the human small intestine.
- The adult worm is composed of the scolex, neck, and several
proglottids.
- Ex. Taenia solium and Taenia saginata
D. Trematodes
-
-
also known as flukes or flukeworms
they are flat, leaf-like and hermaphroditic (except the
Schistosomes)
They have two suckers: an oral sucker that serves as its
mouth and the ventral sucker or “acetabulum” that acts as
an attachment
Requires two intermediate hosts: The first is always a snail,
and the second may vary (ex. Plants, crabs, snail)
Diagnosis— the diagnosis of parasitic infections often depends on
observing parasitic forms that include protozoan trophozoites or
cysts, helminthic ova, larva, or adult forms.
A.
Types of Specimen

Stool – most common

Tissue

Urine

Sputum
B.
37
Blood
Stool Examination: Fecalysis
Collection of Fecal Specimen
a thumb-sized stool specimen is appropriate for routine
fecalysis.
the specimen must be placed in a dry, clean, wide-mouth
container with a tight-fitting lid to avoid accidental spills. Stool
containers are readily available in drug stores and other health
firms.
Label the stool container properly. Write the patient’s
name, date, and time of collection on the body of the
container or on the lid legibly, not on any sheet that cover the
specimen bottle.
Make sure that the specimens are free from any
contaminations that may alter the result
Liquid stools – best to detect trophozoites;
Formed stools – best to detect cysts or ova.
should not be stored at room temperature longer than two hours.
specimen by using 10% formalin
to maintain protozoan morphology and prevent the further
development of certain helminths.
HEMATOLOGY is the scientific study of blood and its components.

Came from the Greek Word HAIMAS which means blood
and LOGOS which means study/science

Study of the quality and quantity of the cellular elements
of the peripheral blood and the bone marrow which
includes erythrocytes (RBC), leukocytes (WBC), and
t
Formed Elements
Size
h
2-4 µm
1. Thrombocytes (platelets)
r
6-8 µm
o2. Erythrocytes (RBCs)
6-9 µm
m3. Normal lymphocytes
10-22 µm
b4. Reactive lymphocytes
10-15 µm
o5. Basophils
10-15 µm
c6. Segmented neutrophils
y7. Band neutrophils
10-15 µm
t8. Eosinophils
12-16 µm
e9. Monocytes
12-20 µm
s
(Platelets)

Study of the disorders and abnormalities related or
associated with the quality and quantity of the cellular
elements of the blood

Study of the laboratory procedures and techniques being
used to examine the quality and quantity of the cellular
elements of the blood
I. FUNDAMENTAL HEMATOLOGY PRINCIPLES
A. Blood Composition
1. Whole blood includes erythrocytes, leukocytes, platelets,
and plasma. When a specimen is centrifuged, leukocytes
and platelets make up the buffy coat (small white layer of
Principles of Medical Laboratory Science Practice I
2.
cells lying between the packed red blood cells and the
plasma).
Plasma is the liquid portion of unclotted blood. Serum is
the fluid that remains after coagulation has occurred and
clot has formed.
a. Plasma is composed of approximately 90% water
and contains proteins, enzymes, hormones,
lipids, and salts.
b. Plasma normally appears hazy and pale yellow
(contains all coagulation proteins), and serum
normally appears clear and straw colored (lacks
fibrinogen group coagulation proteins).
38
LEUKOCYTES (White Blood Cells/Leukoplastids/ Leukocytes)
Function: defend the body against infection
a. Classified as phagocytes (granulocytes, monocytes) or
immunocytes (lymphocytes, plasma cells, and monocytes)
b. Granulocytes include neutrophil, eosinophil and basophil.
c. Neutrophils are the first to reach the tissues and
phagocytize (destroy) bacteria. In process, they die.
d. Monocytes differentiate into macrophages, and as such
they work in the tissues to phagocytize foreign bodies.
They arrive at the site of inflammation after neutrophils
and do not die in the process.
e. T lymphocytes provide cellular immunity. They represent
80% of lymphocytes in the blood.
f. B lymphocytes develop into plasma cell in the tissue and
produce antibodies needed for humoral immunity. B
lymphocytes represent 20% of lymphocytes in the blood.
g. NK (natural killer) lymphocytes destroy tumor cells and
cells infected with viruses. They are also known as large
granular lymphocytes (LGLs).
h. Eosinophil modulates the allergic response caused by
basophil degranulation.
i.
Basophils mediate immediate hypersensitivity reaction
(type I, anaphylactic).
PLATELETS (Thrombocytes)
a. Are cell fragments produced in the bone marrow by the
stem cells in which 2/3 of it are found in the circulation
while 1/3 is stored in the spleen.
Functions: (1) adhere to the walls of the blood vessels to plug
ruptures, thereby preventing the release of blood. (2) Release
chemicals that cause clots to form in the blood.
PHLEBOTOMY refers to the standard methods of blood collection
using lancets and needles of varying gauges.
B. FUNCTIONS OF THE BLOOD
1. Respiratory – most important
2. Nutritional
3. Excretory
4. Buffering Action
5. Maintenance of constant body temperature
6. Transportation of hormones and other
secretions that regulate cell function
7. Body defense mechanism
Types of Phlebotomy

Skin puncture – capillaries

Venipuncture- veins

Arterial puncture- arteries
endocrine
C. FORMED ELEMENTS AND RELATIVE SIZES
ERYTHROCYTE (Red Blood Cells/ Erythroplastids/ Erythrocytes)
a. Produced in the bone marrow by stem cells; Size range is
6-8 um
b. Round, biconcave discocyte consisting of hemoglobin, the
gas-transporting protein molecule that gives blood its red
color.
c. Average life span of 120 days (3 months). Its function is to
transport oxygen from the lungs to the different parts of
the body and carry CO2 back to the lungs.
d. Normal cells have a central pallor that is one-third
diameter of the cell.
e. Decreased RBC count is associated with anemia
f. Increased RBC count is associated with polycythemia
HEMATOLOGY AS A SECTION OF THE CLINICAL LABORATORY

Performs routinely with whole blood films to initially
evaluate and follow-up a patient.

CBC or Complete Blood count is the foundational
procedure performed in hematology.
It consists of the measurement of hemoglobin,
hematocrit, RBC count, white blood cell and
differential white blood cell count and platelet
estimate.
Standard parts of routine CBC using automated
analyzers include RBC indices (MCV, MCH, MCHC)
MCV: Mean Cell Volume
MCH: Mean Cell Hemoglobin
MCHC: Mean Cell Hemoglobin
Concentration
Functions of hematology Laboratory:
1. Count the number or concentration of cells
2. Determine the relative distribution of various types of cells
3. Measures biochemical abnormalities of the blood
4. Hemostasis and coagulation assays
Principles of Medical Laboratory Science Practice I

-
HEMOGLOBIN (Hgb) - is the iron-containing oxygen-transport
metalloprotein in the red blood cells. It is a conjugated protein made
up of heme and globin. The heme portion of hemoglobin gives RBC
their characteristic red color.
HEMOGLOBIN DETERMINATION
a. Symptoms such as fatigue, feeling of poor health, or
unexplained weight loss
b. Signs of bleeding
c. Pre-and Post-surgery treatment
d. Presence of chronic kidney disease or other chronic
medical problems
e. Pregnancy check-up
f. Monitoring of anemia and its cause
g. Analysis of the effects of a drug treatment
h. Examination of a patient who received blood transfusion
C.
39
Severe emotional or physical stress
Strenuous exercise
Decreased WBC count (leukopenia)
Viral infections
Congenital disorders
Cancer
Autoimmune diseases
Drugs that can destroy WBCs or can damage bone
marrow
Hypersplenism
Parasitic infections
Vitamin deficiencies
Platelet count

Increased Platelet count (thrombocytosis)
Cancer
HEMATOCRIT (Hct) - also known as packed cell volume (PCV) or
erythrocyte volume fraction (EVF) is the volume percentage of red
blood cells in a sample of whole blood.
HEMATOCRIT DETERMINATION
a. Useful in assisting physicians in the evaluation or
treatment of anemia.
b. Used to check for mineral or vitamin deficiencies.
c. Decreased level of hematocrit: anemia increased WBCs
due to long-term illness, infection, leukemia, lymphoma,
vitamin or mineral deficiencies and recent or long-term
blood loss.
d. Increased level of hematocrit: dehydration, severe burns,
diarrhea, polycythemia vera, lung or heart disease.
BLOOD CELL COUNT- is a basic procedure in the hematology section
from manual method to automated method of cell counting
CLINICAL SIGNIFICANCE OF CELL COUNTS
A. RBC count

Increased RBC count (erythrocytosis)
RBC production increases to compensate for low
oxygen levels due to poor heart or lung function.
RBC production increases to compensate for lower
oxygen levels at higher altitudes.
The kidney releases too much erythropoietin
The bone marrow is producing too many RBCs
The oxygen-carrying capacity of the blood is reduced
Blood plasma is being lost

Decreased RBC count(anemia)
Trauma
RBC destruction (e.g. hemolytic anemia)
Acute or chronic bleeding from the digestive tract or
other body sites such as the uterus or bladder
Nutritional deficiency (e.g. as iron or vitamin B12
deficiency)
Bone marrow disorder
Chronic inflammation
Kidney failure
B.
WBC count

Increased WBC count (leukocytosis)
Infection
Allergy
A reaction to drug
Bone marrow disease
Immune system disorder
-
Chronic kidney failure
Anemia (IDA or HA)
Inflammatory conditions
Infectious diseases (e.g. Tuberculosis)
Splenectomy
Use of birth control pills or medications (epinephrine,
tretinoin, vincristine)

Significant blood loss due to trauma or surgery
Strenuous exercise
Vitamin B12 or folate deficiency
Decreased Platelet count (thrombocytopenia)
Disorders in which the bone marrow cannot produce
enough platelets
Conditions in which platelets are consumed or used
up or destroyed faster than normal
Conditions such as: aplastic anemia, acute leukemia,
pernicious anemia and sometimes following
chemotherapy and radiation.
-
EXAMINATION OF THE PERIPHERAL BLOOD SMEAR

It is examined to determine the percentage of each type
of WBC (differential WBC count) and to assess the RBC,
WBC and platelet estimates and morphology. The
procedures include preparing the blood smear using two
glass slide methods, staining the blood film using a
Nonvital (dead cell) polychrome stain (Romanowsky),
most commonly used is the Wright’s stain, and examining
the blood film under a microscope

Use the low power objective to scan the stained blood
smear and check for cell distribution, clumping and
abnormal cells. A drop of cedar wood oil is then added
and a switch to OIO is made.

An optimal assessment site where the blood cells and
barely overlapping must be chosen and 100 WBCs must
be counted in a tracking pattern.
Principles of Medical Laboratory Science Practice I


Each WBC seen should be counted and identified as a
neutrophil (band or segmenter), eosinophil, basophil,
lymphocyte or monocyte.
The result must be expressed as a percentage of the 100
WBCs counted. Abnormalities of WBCs, RBCs and platelets
should be noted.
PERIPHERAL BLOOD SMEAR PREPARATION
1. Place a small drop of blood on the slide.
2. Using another slide (acts as a spreader slide), orient it to
300 – 450 angle.
3. Pull it backward until it touches the specimen.
4. Push the spreader slide forward.
5. A perfect smear must have a feathery edge, not too thick
and not too short.
CLINICAL CHEMISTRY – is the branch of medical science involved in
the analysis of biological materials, usually bodily fluids, to provide
diagnostic results on the state of the human body.
FBS – Fasting Blood Sugar
OGTT - Oral Glucose Tolerance Test
RBS – Random Blood Sugar
PPBS – Post-Prandial Blood Sugar

Glycosylated hemoglobin (HbA1c) – use to determine if
diabetes has been existing for several months already (longterm diabetes)

Diabetes mellitus – defect in the beta cells of the pancreas
which leads to decrease in the production of insulin, a hormone
necessary to maximize the utilization of glucose for energy
production.
Manifestation:
o Polyuria: excessive urination
o Polydipsia: excessive thirst
o Polyphagia: excessive eating
Terminologies:
o Hyperglycemia: high sugar level
o Hypoglycemia: Low sugar level
BASIC ANALYTICAL TECHNIQUES
1.
2.
3.
Spectrophotometry – Principle: Measures
light
transmitted at selected wavelength or spectrum; uses
prisms or gratings to isolate a narrow range of wavelength
of light.
Nephelometry - Principle: Light scattered by an unknown
substance is measured at right angles depending on the
wavelength and particle size.
Turbidimetry - Principle: Measures the amount of light
blocked (absorbance) by a suspension of particles
depending on particle size and concentration.
4.
Electrophoresis - Principle: Charged molecules move at
different rates when pulled through an electrical field.
CATIONS (positively charged ions) will move to the
CATHODE (negative electrode)
ANIONS (negatively charged ions) will move to the
ANODE (positive electrode)
5.
Flame Emission Spectrophotometry - Principle: Measures
light emitted by excited atoms. Certain elements give off a
characteristic light after excited atoms return to ground
state:
Sodium (Na): intense yellow
Calcium (Ca): brick red
flame
Potassium (K): violet flame
Internal standards: Lithium or Cesium
6.
Atomic Absorption Spectrophotometry- Principle:
Measures light absorbed by ground-state atoms. Routinely
used to measure the concentration of trace metals.
: Hollow Cathode Lamp is the usual light source employed.
B.
BLOOD LIPID PROFILE
LIPIDS – organic substances characterized by their general
insolubility in water and solubility in organic solvents.

sometimes regarded as “fat”

1 gram = 9 kcal of heat

Functions: primary energy source and an
important constituent of cellular membrane
Classification of Lipids:
1. Fatty acids
– Simplest form of lipids but not routinely
measured
Forms:
o Saturated: solid at room temperature
o Unsaturated: liquid at room temperature
2.
Triglycerides (triaglycerols)
– Considered neutral fats consisting of fatty acids
and glycerol
– Acts as a storage form of lipids in the human
body
– When serum samples turned turbid from blood
collected after a meal, it is due to the presence
of triglycerides.
3.
Cholesterol
– An example of a steroid alcohol
– Necessary for production of various hormones,
vitamin D, and even bile salt which is necessary
for fat digestion
– Measurement is usually requested in
conjunction with the diagnosis of cardiovascular
disease
4.
Phospholipids
– Most abundant form of lipids, nut not routinely
measured
– Includes lecithin (70%), sphingomyelin (20%),
and cephalin (10%)
ROUTINELY REQUESTED CLINICAL CHEMISTRY ASSAYS
A.
BLOOD GLUCOSE – It is requested in conjunction with the
diagnosis of diabetic conditions. Diabetes is a lifestyle
disease associated with an elevation of blood glucose in a
fasting state.
40
Principles of Medical Laboratory Science Practice I
– Lecithin-sphingomyelin (L/S) ratio is an
important parameter to determine fetal lung
maturity and is used to evaluate the safety of a
pre-term delivery

LIPOPROTEINS: lipid transporters which are classified
based on their density or through electrophoresis.
Generally, as the protein content increases, the lipid
content decreases, making its size smaller but denser.
TYPES OF LIPOPROTEIN
1. Chylomicrons
Transport exogenous triglycerides to adipose
tissue and cells
Accounts for the milky layer of postprandial
plasma (lipemic)
Largest and least dense
2.
VLDL (Very Low-Density Lipoprotein) or the pre-ßlipoprotein
Transports endogenous triglycerides to the
muscle and adipose cells
3.
LDL (Low-Density Lipoprotein) or the ß-lipoprotein
Tagged as the “bad cholesterol”
Transports cholesterol to peripheral tissues.
Increased levels suggest risk of developing
atherosclerosis
4.
HDL (High Density Lipoprotein) or the α-lipoprotein
Tagged as the “good cholesterol”
Transports cholesterol back to the liver for the
synthesis of bile salts and very low-density
lipoprotein (VLDL)
High levels suggest decreased risk of developing
atherosclerosis
Smallest but heaviest
C. KIDNEY (RENAL) FUNCTION TESTS
The kidneys are paired organs considered as the body’s
major “waste sweeper”. They are responsible for the removal of
waste products of metabolism. Thus, if these are badly damaged,
wastes accumulate in the body and become toxic.
The nephron is the kidneys’ functional units. It forms urine through
three major processes:
a) glomerular filtration
b) tubular reabsorption
c) tubular secretion
1. Creatinine
 Creatinine is a waste product of muscle metabolism derive
from creatine phosphate which is a substance stored in the
muscles and is used for energy.
 Increased level of creatinine is due to the impairment of
urine formation or excretion which occurs in renal disease,
shock, and water imbalance or ureter blockage.
 When renal function is impaired (about 50%), blood
creatinine levels increase.
 Doctors may request measurement of creatinine clearance to
evaluate renal functionality. This test requires the use of 24hour urine specimen.
41
2. Blood urea nitrogen (BUN)
 Waste product of protein catabolism
 90% of BUN is excreted in the urine
 Azotemia is an elevation of blood urea nitrogen. If such
elevation is accompanied by renal failure, it is termed
Uremia.
o Low BUN levels – during starvation, pregnancy, and a
low-protein diet
o High Bun Levels – a high protein diet; after
administration of steroid; and kidney disease
3. Glomerular filtration rate (GFR)
 Used to check how well the kidneys are working
 Estimates how much blood passes through the glomeruli
(tiny filters in the kidneys) each minute

Measure how well the kidneys are filtering the blood and
sees how far a kidney disease has progressed.
D. LIVER FUNCTION TESTS
Liver is the organ responsible for the synthesis of many
organic substances. It also detoxifies the body against noxious
substances.
1. Bilirubin
 A brownish yellow substance found in the bile. It is produced
when the liver breaks down old red blood cells through stool
(feces) and gives stool its normal color.
 Bilirubin circulates in the bloodstream in two forms:
a. B1 or indirect (or unconjugated) bilirubin
 water-insoluble bilirubin
 toxic bilirubin
 accumulation in the brain may lead to kernicterus
b. B2 or direct (or conjugated) bilirubin
 water-soluble bilirubin
 eliminated in the urine and makes it appear darkyellow
 Total bilirubin and direct bilirubin levels are
measured directly in the blood, whereas indirect
bilirubin levels are derived from the total and direct
bilirubin measurements. (Total serum bilirubin =
direct bilirubin + indirect bilirubin)
2. Liver enzyme tests
a. Aspartate aminotransferase (AST)
 Formerly called SGOT or serum glutamic oxaloacetic
transaminase
 Tissue sources: liver, heart, skeletal muscle, kidney,
pancreas, brain, spleen, and lungs
b. Alanine aminotransferase (ALT)
 Formerly called SGPT or serum glutamic pyruvic
transaminase
 Tissue sources: liver, heart, skeletal muscle, kidney, and
pancreas
 Considered as a liver-specific enzyme and is increased in
cases of hepatic disorders
* If ALT and AST are found together in elevated amounts in the
blood, liver damage is most likely present.
c. De Ritis Ration (ASL/ALT ratio)
Principles of Medical Laboratory Science Practice I
1.
Tumor Marker
AFP (Alpha-fetoprotein)
Condition
Hepatocellular carcinoma
2.
3.
4.
5.
6.
7.
8.
9.
10.
CEA (Carcinoembryonic antigen)
PSA (Prostate-specific antigen)
hCG (Human chorionic gonadotropin)
NSE (Neuron specific enolase)
CA 125
CA 19-9
CA 15-3
Calcitonin
Desmin
Gastrointestinal cancer
Prostate cancer
Gestational trophoblastic disease
Neuroendocrine tumor
Ovarian cancer
Pancreatic cancer
Breast cancer
Medullary thyroid carcinoma
Smooth muscle sarcoma



42
Oncology - the science of cancer emphasizes the
importance of early detection of tumors through
laboratory tests to address the associated condition
early and to provide proper intervention
appropriately.
Helps identify the cause of hepatic disorders
> 1: non-viral in origin
< 1: viral in origin
d. Alkaline phosphatase (ALP)
 Useful in the diagnosis of bone and liver diseases
e. Gamma-glutamyl transferase (GGT)
 Useful in the diagnosis of chronic alcoholism resulting in
liver damage
f. Cholinesterase
 Useful in the assessment of insecticide and pesticide
poisoning
3. Total serum protein test
o Measures the total amount of protein in the blood.
o Determines the total amount of two kinds of proteins in
the blood: albumin and globulin.
 Albumin is made mainly in the liver. It helps keep the
blood from leaking out of the blood vessels. It also
helps carry some medicines and other substances
through the blood and is important for tissue growth
and healing.
 Globulins are a group of proteins in the bloodstream
that help regulate the function of the circulatory
system.
o Hypoproteinemia refers to the low total protein level in
the blood
o Hyperproteinemia refers to the high total protein level in
blood
CARDIAC MARKER
E. CARDIAC FUNCTION TEST
Cardiac markers are usually requested to evaluate whether
one’s heart is healthy or not. Doctors consider this test if their
patients have experienced episodes of myocardial infarction as
manifested by chest pain (angina).
1st MYOGLOBIN
2nd TROPONIN T
3rd TROPONIN I
4th CK-MB (Creatine Kinase)
5th AST (Aspartate aminotransferase)
6th LDH (Lactate dehydrogenase)
Troponin Test - Considered the most sensitive and specific test for
myocardial damage
F. SPECIAL CHEMISTRY TESTS: TUMOR MARKERS
Tumor Marker - is a biomarker indicative of an inherent cancerous
condition.
MYOGLOBIN
TROPONIN T
TROPONIN I
CK-MB (Creatine Kinase)
AST (Aspartate
aminotransferase)
LDH (Lactate
dehydrogenase)
ONSET OF
ELEVATION
1-3 hours
3-4 hours
3-6 hours
4-6 hours
6-8 hours
PEAK
ACTIVITY
5-12 hours
10-24 hours
12-18 hours
12-24 hours
24 hours
DURATION OF
ELEVATION
18-30 hours
7 days
5-10 days
48-72 hours
5 days
12-24 hours
48-72 hours
10-14 days