We aim to deliver accurate and precise data to the medical community. However samples sometimes undergo changes between specimen collection and reporting that would result in inaccuracy of test results. Please refer to Table 1: Poor Specimen collection methods causing inaccurate test results to see the factors that cause inaccuracy.
One way of ensuring test results accuracy is to prevent anticoagulant contamination. To do this, the tubes should be filled in the order below:
Order of Draw:
i. Blood culture tubes (applying full aseptic technique)
ii. Red cap
iii. Blue cap
iv. Yellow cap
v. Green cap
vi. Purple cap
vii. Grey cap
viii. Royal Blue (Trace Element)
The caps of the tubes are colour coded to indicate the types of preservative or lack of preservative. Please refer to our BD Vacutainer Guide to view the type of preservative (or lack of it) in each tube.The tubes are provided free of charge by Gribbles Pathology.
Unless indicated, samples should be stored in room temperature (air-condition) and away from sunlight until pickup.
General Instructions on Specimen Fixation
Non- Gynaecological Specimens' Specific Instructions
Cervical smears (Conventional method)
Routine smear which combines ectocervical and endocervical canal scrappings are most satisfactory.
Spatula for ectocervical samples and a cytobrush for the endocervix are recommended.
SurePath Pap Test (Liquid – based)
The SurePath Pap Test is being used as a replacement for the Pap smear. The SurePath Pap Test overcomes the limitations of the conventional method. By improving the way sample slide is prepared, the SurePath Pap Test actually improves the quality of the test.
The BD SurePath™ liquid-based Pap test is an FDA approved thin-layer cell preparation process intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses.
SurePath Pap test has a unique, easy to use collection process that standardizes the collection process and ensures 100% of the collected sample is sent to the laboratory for processing. No diagnostic cells are discarded in the clinic, as is true with “rinse and swish” systems, which on average can result in the loss of on average, 37% of the collected sample during cell transfer.
Patient Preparation for Cervical smear
Proper patient preparation encompasses the following:
Ideal sampling date is two weeks after the first day of the LMP.
Discourage sampling during normal menses.
Avoid use of vaginal medication, vaginal contraceptives, or douches for 48 hours prior to examination.
Guidelines for Referral of Specimen
The specimen must be received in an appropriately labeled container.
The specimen must be accompanied with a General Request form, with appropriate and relevant clinical data.
Details of treatment (e.g. HRT, DXT) and procedures (e.g. LLETZ, Cone biopsy) must be included in the clinical data.
A test request form must accompany all specimens. When more than one specimen is sent from the same patient at the same operation, please use only one form. Specimens from different anatomical sites should be sent in separate containers and must be itemised in the same request form. The containers of such samples must similarly be itemised and labeled with patient’s identification so that they can be cross–referenced to the patient and the anatomic site of origin of the sample.
The request form must include all that is required as in the General Guidelines to filling the General Request Form. In addition to that, please ensure the details below are also provided:
Special Instructions on Specimen Collection & Handling
Routine specimens should be sent in containers with 10% buffered formalin unless otherwise stated.
Appropriate containers are available from the laboratory on request. To prevent leakage it is advised to double wrap the specimen container.
Multiple small specimens, such as gastrointestinal biopsies, should be mounted on a piece of filter paper and properly labeled.
Large specimens such as colon, should be opened, the contents cleaned out and specimen should be completely immersed in formalin. Containers must be tightly secured.
Do not crush specimens with forceps, hemostats or other instruments. Avoid using cautery.
Do not force a large specimen into a small container. Large specimens must be completely surrounded by formalin for proper fixation.
Please tick the “URGENT” box on the General Request form; otherwise, the specimen will be processed as per normal.
For specimens where orientation is important, mark or tag the specimen e.g. Axillary tail of mastectomy specimens, orientation of surgical margin.
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