Specialized Laboratory Collections
Blood Bank
All Blood Bank specimens must have accurate patient
identification. All specimens drawn are given a label with
patient’s full name, date of birth, and medical record number or
Social Security number. This label is usually computer
generated. The individual drawing the specimen will verify
patient demographics after patient is accurately identified
from patient identification band, initial the label, and
document the time specimen is drawn. This is our method of
indicating positive identification of the patient with 3 unique
identifiers.
Blood for crossmatching will not be drawn by phlebotomist if
patient does not have a wrist band with their name and medical
record number, or if there is any discrepancy between band and
request label.
Specific transfusion requirements for blood components:
• Date of surgery
• Type of surgery
• Indication for transfusion
Exceptions:
• In emergency situations, when a wrist band is not
available, the phlebotomist will put a red Blood Bank
identification wrist band on the patient. The band will be
on all Blood Bank records for the next 3 days. Do not
remove this identification band. If it is removed, blood
cannot be transfused to the patient, the specimen will
have to be redrawn, and laboratory work will have to be
repeated causing delays which may impede patient care.
Cytology
Body Fluids:
• Fresh body fluids are the specimen of choice. Some
specimens can be sent to the laboratory in original
container in which they were collected (pleural,
thoracentesis, etc.) Others, should be put in a clean, dry
container. DO NOT add any type of fixative to
container. DO NOT ADD FORMALIN.
• Label container with patient’s full name, date of birth or
medical record number, date and time of collection, type
of specimen, and physician. Place specimen in Ziploc®
portion of biobag.
• Complete a Laboratory Request Form and attach it to the
outside of Ziploc® portion of biobag. Deliver
immediately to laboratory.
• .
Conventional Method:
• Smears are made from material collected from various
regions (vaginal, endocervical, and endometrial smears).
Proper specimen collection, preparation, and careful
labeling are essential to enhance the accuracy of
evaluation of smear.
• Write patient’s full name and date of birth on frosted end
of a clean, glass slide with pencil.
• Smear material collected evenly over clean, glass slide.
Spray slide immediately with a spray fixative. DO NOT
let smear dry before spraying.
• When spray is dry, place slide(s) in a cardboard or
plastic holder.
• Label slide holder with patient’s full name, date of birth
or medical record number, date and time of collection,
type of specimen, and physician. Place specimen in
Ziploc® portion of biobag.
• Complete a Laboratory Request Form and attach it to
outside of Ziploc® portion of biobag. Deliver to
laboratory.
Gastric and Esophageal Brushings:
• Please call the Laboratory at 207 283 7187 for
specific instructions.
Gastric Specimens:
• Due to the digestive properties of the specimen, these
should be submitted only Monday through Friday (8
a.m. to 4:30 p.m.).
Gynecological Material:
• Southern Maine Medical Center’s primary test method is
the ThinPrep® which requires special collection
materials. Please refer to #TRAP “Cytology,
Endocervical” in the alphabetical test listing.
• Collect the sputum in a clean, dry container. DO NOT
add formalin to the container.
• Label container with patient’s full name, date of birth or
medical record number, date and time of collection, type
of specimen, and physician. Place specimen in Ziploc®
portion of biobag.
• Complete a Laboratory Request Form and attach it to the
outside of Ziploc® portion of biobag. Deliver
immediately to laboratory.
Fine Needle Aspiration of Cystic Lesions of the Pancreas:
• Fine needle aspirates of cystic lesions of the pancrease
require special handling, therefore, please contact 1 of
the pathologists prior to the procedure. In case you are
not able to reach the pathologist, do the following:
— Aspirate the specimen in a syringe or syringes,
remove the needle, cap the syringe and hand
deliver it to cytology with the request for CEA,
amylase, mucin, and cytology. Do not add any
fixative (formalin, CytoLyt, or alcohol), EDTA, or
heparin to the specimen. Tests for CEA will be
referred to Mayo Medical Laboratories and the
remainder of the testing will be performed inhouse.
If you have any questions please call 207-2837187..
Urine:
• Urine collected for cytology should be sent in the fresh
state. First morning specimens are acceptable for
cytologic examination. Twenty-four hour urine
specimens are not acceptable for cytology.
• Label container with patient’s full name, date of birth or
medical record number, date and time of collection, type
of specimen, and physician. Place specimen in Ziploc®
portion of biobag.
• Complete a Laboratory Request Form and attach it to the
outside of Ziploc® portion of biobag.
Products of Conception:
• Any specimen or material collected in the emergency
room, delivery room, or operating room for products of
conception, D & C, etc., are sent to pathology routinely
with formalin added.
• Label specimen with patient’s full name, date of birth or
medical record number, date and time of collection, type
of specimen, and physician.
.
• Results are usually available within 1 to 2 days.
Histology
Spinal Fluid:
• Spinal fluid for cytology studies must be sent to the
laboratory immediately. Spinal fluid should be in a
separate tube labeled for cytology. DO NOT add any
formalin to the tube.
• Label tube with patient’s full name, date of birth or
medical record number, date and time of collection, type
of specimen, and physician. Place specimen in Ziploc®
portion of biobag.
• Complete a Laboratory Request Form and attach it to the
outside of Ziploc® portion of biobag. Deliver
immediately to laboratory.
• Results are usually available within 1 day.
Sputum:
• Sputum should reach the laboratory within 1 hour of
expectoration. An early-morning specimen produced
by deep coughing is the best material.
Surgical Specimens:
• Deterioration produces loss of cellular detail which is
needed for accurate diagnosis. This takes place through
the following:
—Drying
— Chemical decomposition
— Thermal injury
— Decomposition is speeded up by heat and slowed
by cold
• Proper specimen labeling and identification are
imperative for processing.
• Pertinent clinical data must be provided by attending
physician to provide a complete and accurate diagnosis.
Specimen Collection:
• Ten percent formalin is provided by the Histology
Laboratory. Please do not use anything other than 10%
unless otherwise advised by physician or special
procedure.
— Surgical tissue and biopsy collection:
• Specimen is placed in container with 10%
formalin immediately unless the surgeon
requests otherwise.
• Formalin should be used by 5 times the
volume of the specimen.
• Use appropriate size container. There are 4
sizes to choose from. These may be obtained
through the laboratory.
• Multiple specimens from 1 procedure must be
put in separate containers and labeled
appropriately. Only 1 Histology Request
Form needs to accompany all specimens.
• Proper labeling is essential. Please label
container directly with patient’s full name,
date of birth or medical record number, date
and time of procedure, source, and physician.
Pertinent insurance information is also
required.
• Histology Request Form must be filled out
completely.
• All specimens must be biobagged. These are
provided by the laboratory. Please make sure
container is tightly sealed. Do not put request
form together with specimen. Either tape the
requisition to outside of bag and place
specimen inside or put it in outside
compartment of bag.
• If more than 1 specimen is obtained, complete
only 1 Histology Request Form listing each
specimen on the form. Identify each specimen
on specimen container. If possible, place all
specimens from 1 case into 1 Ziploc® portion
of biobag.
— Frozen Sections - All frozen sections should be
scheduled with Pathology at extension 6-7182. A
pathologist is on call at all times to cover in the
event of an unscheduled frozen section.
• Place tissue for frozen section on a moistened
saline towel and give to pathologist. Have all
necessary paperwork with the specimen. DO
NOT put specimen in fixative of any kind.
• Call the Pathology Laboratory and tell the
secretary the case, name of surgeon
requesting the frozen section, and OR room
number.
• The pathologist will write his/her findings on
the form and give to the surgeon. The signed
copy will be placed in the patient’s chart. The
tissue will be sent to the Histology Laboratory
for permanent sections.
— Urinary tract calculi (kidney, bladder, and ureteral
stones) - Chemical analysis of urinary tract stones
is helpful in determining future management of the
patient. Different stone types respond differently to
dietary and drug treatment so knowing the
chemical composition may be clinically relevant.
• Place the calculi in a dry container. Cover
tightly. DO NOT ADD FORMALIN.
• Label container with patient’s full name, date
of birth or medical record number, date and
time of collection, stone type if known, and
physician. Place specimen in Ziploc® portion
of biobag.
• Complete a Histology Request Form and
attach it to outside of Ziploc® portion of
biobag or put into outside pocket. Send to the
Histology Laboratory.
— Foreign bodies (fragment of glass, metal, splinters,
etc.) - The surgeon makes the decision to send
foreign bodies to the Pathology Laboratory.
• Place the foreign body in a dry container. It is
not necessary to add 10% formalin; however,
formalin is acceptable.
• Label container with patient’s full name, date
of birth or medical record number, date and
time of collection, type of foreign body, and
ordering physician. Place specimen in
Ziploc® portion of biobag.
• Complete a Histology Request Form and
attach it to the outside of Ziploc® portion of
biobag. Send to Histology Laboratory.
— Bone marrow - The specimen requirement is a
bone marrow aspirate in an EDTA tube, a biopsy in
10% formalin, a minimum of 4 smears, and 2
peripheral blood smears.
• All specimens delivered to the laboratory
must be labeled with patient’s full name, date
of birth or medical record number, date and
time of collection, and site of aspiration/
biopsy (left or right iliac). It must be received
in the laboratory within 1 hour of aspiration.
• A Histology Request Form must accompany
the bone marrow specimen. A Complete
Blood Count (CBC) must be (or have been)
run within 24 hours.
• Specimens may be submitted at any time, but
the test is set up Monday through Friday and
results are usually available within 3 days.
— Cytology specimen collection - The purpose in the
collection of cytology specimens is to facilitate the
processing, diagnosis, and accuracy of the
detection of tumor cells in fluids.
• For conventional Pap smears, only fixed
slides will be accepted. The patient’s name
must be written on all slides submitted.
• Fill out a Laboratory Request Form for each
cytology specimen that is sent to the
laboratory. The laboratory cannot accept any
specimen without a request form.
• Label cytology container with patient’s full
name, date of birth or medical record number,
date and time of collection, type of specimen,
and physician. Place specimen in Ziploc®
portion of biobag.
• If the cytology specimen is fluid (ie, urine or
sputum), refrigerate after collection. DO
NOT ADD ANY FIXATIVE.
• All cytology specimens delivered to the
laboratory between 4:30 p.m. and 7 a.m.,
Monday through Friday, weekends, and
holidays, are to be left in the Clinical
Laboratory refrigerator. A laboratory
technologist should be notified. The
Pathology Department will be closed during
this time.
Microbiology
Following are some general guidelines for collection, labeling,
and transport of routine microbiology specimens:
General Consideration for Collection and Transport:
• Sterile containers must be used for all cultures.
• Specimens should be transported to Southern Maine
Medical Center (SMMC) as soon as possible.
• Collection containers should be closed securely and
precautions taken to prevent leakage of specimen during
transport. These specimens are to be considered
biohazardous and must be biobagged with paperwork put
in the secondary pocket.
• Whenever possible, specimens should be obtained prior
to the administration of antibiotics.
• Specimen source is required on specimen container and
request form for processing.
• DO NOT USE EXPIRED TUBES OR MEDIUM
FOR SPECIMEN COLLECTION.
• Specimens should be properly labeled with patient’s full
name, date of birth or medical record number, location
of patient, date and time of collection, and source. Refer
to individual test listings in “Alphabetical Test Listing”
for proper transport media.
Laboratory Instructions for Sputum Collection:
• Instruct patient to obtain material from a deep cough,
which is expectorated into a sterile container. The
volume of specimen need not be large (3 mL). The
specimen should be brought to the laboratory as soon as
possible. A Gram stain is performed on all sputum
cultures. Induced specimens on transtracheal aspirates
are recommended for adult patients who can not produce
sputum. Antibiotic sensitivities will be performed on
pathogens isolated.
• Be sure that the cap is securely sealed on container once
specimen is collected. A leaky container is a biohazard.
Stool Culture:
• Collect specimen in Cary-Blair media
Stool Specimen Collection for Ova and Parasites:
• Random collection - A random stool specimen collected
every other day for a total of 3 specimens is
recommended for an accurate examination for intestinal
parasites. Specimens should be mixed thoroughly in a
preservative according to instructions on the outside of
the special container (EcoFix™ kit).
Stool Specimen Collection for Clostridium difficile:
• Collect specimen in a screw-capped, sterile container
without transport media.