Specimen collection is a critical step in medical diagnostics and patient care. Proper collection, handling, and transport of specimens ensure accurate laboratory results, which guide diagnosis, treatment, and disease management. Errors in specimen collection can lead to misdiagnosis, treatment delays, and compromised patient safety.
Healthcare professionals must follow strict protocols to maintain specimen integrity, prevent contamination, and ensure patient safety.
1. General Principles of Specimen Collection
Ensure patient identification – Use at least two identifiers (name, hospital ID, or date of birth).
Select the correct specimen type – Different tests require blood, urine, stool, sputum, tissue, or other body fluids.
Follow aseptic techniques – Prevent contamination using sterile gloves, disinfectants, and clean collection tools.
Use appropriate containers – Specimens must be collected in labeled, sterile, and leak-proof containers.
Follow collection timing guidelines – Some tests require fasting, morning samples, or collection at specific intervals.
Ensure proper storage and transport – Maintain the required temperature (room temperature, refrigerated, or frozen).
Minimize patient discomfort – Use proper techniques and reassure the patient.
Document collection details – Include date, time, collector’s name, and special conditions.
2. Types of Specimen Collection
Specimens are collected from various body fluids, tissues, and secretions for diagnostic testing. The most common types include:
A. Blood Specimen Collection
Purpose:
Diagnose infections, anemia, clotting disorders, and chronic diseases.
Monitor blood glucose, cholesterol, and organ function.
Assess immune response and therapeutic drug levels.
Types of Blood Collection:
Venipuncture (Venous Blood Collection)
Collected from a vein (e.g., antecubital vein).
Uses a vacutainer system, syringe, or butterfly needle.
Commonly used for CBC, blood culture, glucose tests.
Capillary Blood Collection
Collected from fingertips (adults), heel (infants).
Used for blood glucose monitoring, newborn screening.
Requires a lancet and capillary tubes.
Arterial Blood Collection
Collected from an artery (radial, brachial, femoral).
Used for arterial blood gas (ABG) analysis.
Requires heparinized syringes and immediate transport.
Precautions for Blood Collection:
Use proper antiseptic techniques (70% alcohol or iodine).
Avoid hemolysis by gentle handling.
Use the correct order of draw to prevent contamination.
Label tubes immediately after collection.
B. Urine Specimen Collection
Purpose:
Diagnose urinary tract infections (UTI), kidney disease, diabetes, drug use.
Assess hormone levels and metabolic disorders.
Types of Urine Collection:
Random Urine Sample
Collected at any time of the day.
Used for routine urinalysis, pregnancy tests.
Midstream Clean-Catch Urine Sample
Collected midstream after perineal cleaning.
Used for urine culture to detect bacterial infections.
24-Hour Urine Collection
All urine over 24 hours is collected in a single container.
Used to measure protein, creatinine clearance, electrolytes.
Catheterized Urine Collection
Collected using a sterile catheter.
Used for patients unable to void normally.
Precautions for Urine Collection:
Use sterile containers for urine culture.
Refrigerate 24-hour urine samples to prevent bacterial growth.
Label containers properly with date, time, and patient information.
Needle Biopsy – Fine needle aspiration for tumors or cysts.
Surgical Biopsy – Open biopsy for larger tissue samples.
Endoscopic Biopsy – Collected via gastroscopy, colonoscopy.
Precautions:
Preserve samples in formalin (histopathology) or sterile saline (microbiology).
Avoid crushing delicate tissues.
3. Specimen Handling and Transport Guidelines
Ensure proper labeling – Include patient name, date, time, and test requested.
Use the correct transport medium for microbial cultures.
Maintain proper temperature:
Refrigerate urine, stool, and blood samples if transport is delayed.
Keep CSF, blood cultures, and respiratory samples at room temperature.
Follow biohazard protocols – Use leak-proof containers and transport bags.
Minimize delays in delivery – Transport specimens within the recommended time frame.
4. Common Errors in Specimen Collection and How to Avoid Them
Error
Cause
Prevention
Improper labeling
Missing patient details
Verify identity before collection
Contaminated sample
Poor aseptic technique
Use sterile equipment
Hemolyzed blood sample
Rough handling, incorrect needle size
Use gentle handling, correct technique
Inadequate sample volume
Insufficient collection
Follow recommended guidelines
Delayed transport
Specimen left at room temperature too long
Transport immediately
Principles of Specimen Collection
Introduction
Specimen collection is a critical process in medical diagnostics that ensures accurate laboratory results for disease diagnosis, monitoring, and treatment planning. The effectiveness of laboratory tests depends on proper specimen collection, handling, storage, and transportation. Adhering to strict principles minimizes contamination, errors, and misdiagnosis.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) provide guidelines to ensure safe and effective specimen collection.
1. General Principles of Specimen Collection
To obtain reliable test results, the following principles must be followed:
A. Proper Patient Identification
Use at least two patient identifiers (e.g., full name, hospital ID, date of birth).
Verify patient identity before specimen collection.
Ensure accurate labeling of specimen containers.
B. Correct Specimen Type and Collection Method
Use the appropriate specimen for the test (e.g., blood, urine, sputum, stool, swab, biopsy).
Follow standard operating procedures (SOPs) for each type of specimen.
Ensure adequate volume for testing.
C. Aseptic Technique
Use sterile equipment and proper hand hygiene.
Prevent cross-contamination by maintaining a clean environment.
Avoid touching the inner part of the container or swab tips.
D. Proper Timing of Collection
Some tests require morning samples (e.g., fasting blood glucose, sputum for tuberculosis).
Timed collections are needed for certain tests (e.g., 24-hour urine collection).
Blood cultures should be collected before starting antibiotic therapy.
E. Use of Appropriate Collection Containers
Choose the correct container based on the test:
Blood culture bottles for bacterial infections.
Urine culture containers for UTI diagnosis.
Vacutainer tubes for hematology and biochemistry tests.
Ensure containers are sterile and properly sealed.
F. Maintaining Specimen Integrity
Prevent hemolysis in blood samples by handling tubes gently.
Use preservatives when necessary (e.g., boric acid for urine, formalin for tissue biopsy).
Ensure proper storage temperature (e.g., refrigerated, room temperature, frozen).
G. Safety and Infection Control
Follow standard precautions (gloves, masks, gowns).
Dispose of sharps and biohazard waste properly.
Ensure spill management in case of accidental leakage.
H. Proper Labeling and Documentation
Label specimen containers with:
Patient’s name, hospital ID, date and time of collection.
Type of specimen and test requested.
Collector’s initials for accountability.
Complete laboratory request forms with patient history.
I. Rapid and Safe Transport to the Laboratory
Minimize delays to prevent degradation.
Follow temperature and transport guidelines:
Blood cultures – Room temperature.
Urine/stool – Refrigerated if delayed.
Tissue biopsy – In formalin or sterile saline.
Use leak-proof containers and biohazard bags.
2. Specific Principles for Different Types of Specimen Collection
A. Blood Specimen Collection
Principles:
Use the correct technique (venipuncture, capillary, or arterial collection).
Follow the correct order of draw to prevent contamination.
Catheterized specimens should be collected aseptically.
C. Stool Specimen Collection
Principles:
Avoid contamination with urine or toilet water.
Preserve stool samples in transport media if delayed.
Use clean, dry containers.
D. Sputum Specimen Collection
Principles:
Collect early morning samples for better bacterial yield.
Ensure deep cough expectoration, not just saliva.
Store in sterile, leak-proof containers.
E. Swab Specimen Collection (Throat, Nasal, Wound)
Principles:
Use sterile swabs and transport media.
Collect samples before starting antibiotics.
Avoid touching non-infected areas.
F. Cerebrospinal Fluid (CSF) Collection
Principles:
Perform lumbar puncture under sterile conditions.
Transport immediately at room temperature.
Ensure proper volume and labeling.
3. Errors in Specimen Collection and How to Prevent Them
Common Errors
Causes
Prevention
Wrong patient identification
Mislabeling or mix-up
Double-check patient ID
Contaminated specimen
Poor aseptic technique
Use sterile equipment
Insufficient volume
Incomplete collection
Follow standard volume guidelines
Incorrect storage
Not following temperature guidelines
Maintain correct storage and transport conditions
Hemolyzed blood sample
Rough handling or improper needle size
Use gentle handling and correct technique
Delayed transport
Specimen left at room temperature for too long
Transport immediately
4. Safety Precautions in Specimen Collection
Wear appropriate PPE (gloves, masks, gowns).
Use sharps containers for needle disposal.
Avoid spills and leaks by using proper sealing techniques.
Disinfect collection areas before and after use.
Follow biosafety protocols for highly infectious samples (e.g., COVID-19, tuberculosis).
5. Role of Healthcare Workers in Specimen Collection
Educate patients on proper collection techniques.
Follow infection control protocols.
Ensure accurate documentation.
Communicate with laboratory personnel for special handling instructions.
Report any collection issues to prevent diagnostic errors.
Types of Specimens in Medical Diagnostics
Introduction
Specimens are biological samples collected from the human body for laboratory analysis. These samples help diagnose diseases, monitor treatment, assess organ function, and detect infections. The accuracy of laboratory tests depends on proper collection, handling, and transport of specimens.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) classify specimens based on their source and purpose of testing.
1. Classification of Specimens
Specimens are broadly classified into:
Blood Specimens
Urine Specimens
Stool Specimens
Respiratory Specimens
Swab Specimens
Cerebrospinal Fluid (CSF)
Body Fluids
Tissue and Biopsy Specimens
Bone Marrow Aspirate
Hair, Nail, and Skin Specimens
Each type requires specific collection methods, storage conditions, and transport protocols to maintain its integrity.
2. Types of Specimens and Their Uses
A. Blood Specimens
Purpose:
Diagnose anemia, infections, diabetes, liver/kidney function, and clotting disorders.
Monitor medication levels and disease progression.
Types of Blood Specimens:
Venous Blood
Collected via venipuncture (e.g., from the antecubital vein).
Used for complete blood count (CBC), blood culture, glucose testing.
Capillary Blood
Collected from fingerstick (adults), heel prick (infants).
Used for glucose monitoring, neonatal screening.
Arterial Blood
Collected from radial, brachial, or femoral artery.
Used for arterial blood gas (ABG) analysis.
Storage & Transport:
Blood cultures: Transport at room temperature.
Coagulation tests: Store at 2-8°C if delayed.
Glucose testing: Use sodium fluoride tubes to prevent glycolysis.
B. Urine Specimens
Purpose:
Diagnose urinary tract infections (UTIs), kidney disease, diabetes, and drug use.
Assess hormone levels and metabolic disorders.
Types of Urine Specimens:
Random Urine Sample
Collected any time of the day.
Used for routine urinalysis, pregnancy tests.
Midstream Clean-Catch Urine Sample
Collected midstream after perineal cleaning.
Used for urine culture to detect bacterial infections.
24-Hour Urine Collection
All urine over 24 hours is collected.
Used to measure protein, creatinine clearance, electrolytes.
Catheterized Urine Collection
Collected using a sterile catheter.
Used for patients unable to void normally.
Storage & Transport:
Refrigerate if delayed beyond 2 hours.
Use preservatives (boric acid) for bacterial culture.
Needle Biopsy – Fine needle aspiration for tumors or cysts.
Surgical Biopsy – Open biopsy for larger tissue samples.
Endoscopic Biopsy – Collected via gastroscopy, colonoscopy.
Storage & Transport:
Preserve samples in formalin (histopathology) or sterile saline (microbiology).
Avoid crushing delicate tissues.
I. Bone Marrow Aspirate
Purpose:
Diagnose leukemia, anemia, blood disorders.
Assess bone marrow function.
Collection Method:
Collected via bone marrow aspiration from iliac crest or sternum.
Storage & Transport:
Transport immediately to hematology lab.
J. Hair, Nail, and Skin Specimens
Purpose:
Diagnose fungal infections, metabolic disorders.
Collection Method:
Hair plucking, nail scrapings, or skin scrapings.
Storage & Transport:
Store dry in sterile containers.
Specimen Collection Techniques and Special Considerations
Introduction
Specimen collection is a critical step in laboratory diagnostics that ensures accurate test results. Proper techniques help prevent contamination, ensure specimen integrity, and minimize patient discomfort. Different types of specimens require specific collection methods and adherence to special guidelines to maintain accuracy and reliability.
The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) provide protocols for proper specimen collection, handling, and transport.
1. General Guidelines for Specimen Collection
Patient Identification: Use two identifiers (e.g., full name, hospital ID, date of birth).
Aseptic Technique: Use sterile gloves, disinfectants, and aseptic methods.
Proper Labeling: Include patient name, date, time, test type, and collector’s initials.
Correct Collection Method: Use appropriate techniques and devices for each specimen type.
Proper Storage and Transport: Follow temperature and handling requirements.
Minimal Patient Discomfort: Use gentle techniques and reassure the patient.
2. Collection Techniques and Special Considerations for Different Specimens
A. Blood Specimen Collection
Collection Techniques:
Venipuncture (Venous Blood Collection)
Site Selection: Preferred site is the antecubital vein.
Procedure:
Clean the site with 70% alcohol and let it dry.
Use a vacutainer, syringe, or butterfly needle.
Follow the correct order of draw to prevent contamination.
Apply gentle pressure after collection to prevent hematoma.
Capillary Blood Collection
Used for infants (heel prick) or adults (fingerstick).
Ideal for glucose testing, newborn screening.
Avoid excessive squeezing to prevent hemolysis.
Arterial Blood Collection
Collected from the radial or femoral artery.
Used for arterial blood gas (ABG) analysis.
Requires heparinized syringes and immediate transport.
Invert anticoagulant tubes gently to prevent clotting.
B. Urine Specimen Collection
Collection Techniques:
Random Urine Sample
Collected anytime in a sterile container.
Used for routine urinalysis, pregnancy tests.
Midstream Clean-Catch Urine
Used for urine culture (detects infections).
Procedure:
Clean genital area with antiseptic wipes.
Start urinating, discard the first stream, and collect the midstream portion.
Seal container immediately.
24-Hour Urine Collection
Used for kidney function tests (creatinine clearance, protein excretion).
Procedure:
Discard the first morning urine.
Collect all urine for the next 24 hours.
Keep the container refrigerated.
Catheterized Urine Collection
Used for bedridden patients or those unable to void naturally.
Requires sterile technique.
Special Considerations:
Use sterile containers for urine cultures.
Refrigerate urine if delayed beyond 2 hours.
Avoid contamination with stool or vaginal discharge.
C. Stool Specimen Collection
Collection Techniques:
Routine Stool Sample
Used for parasite examination, bacterial culture, and occult blood tests.
Collect in a dry, clean container.
Fecal Occult Blood Test (FOBT)
Used to detect hidden blood (colon cancer screening).
Patients should avoid red meat, NSAIDs, and vitamin C before testing.
Fecal Fat Analysis
Used for malabsorption disorders.
Requires a 72-hour stool collection.
Special Considerations:
Avoid mixing stool with urine or toilet water.
Transport within 1-2 hours for microbiological analysis.
Refrigerate if storage is required.
D. Respiratory Specimen Collection
Collection Techniques:
Sputum Collection
Used for tuberculosis (TB), pneumonia, fungal infections.
Best collected early morning before eating/drinking.
Encourage deep coughing to obtain lower respiratory secretions.
Nasopharyngeal Swab
Used for COVID-19, influenza, and respiratory viruses.
Insert a flexible swab into the nostril, reaching the nasopharynx.
Oropharyngeal Swab
Used for strep throat, diphtheria.
Rub swab firmly over the tonsillar area.
Bronchoalveolar Lavage (BAL)
Performed using bronchoscopy for lung infections.
Special Considerations:
Use sterile swabs and viral transport media (VTM) for viral testing.
Avoid contamination with saliva in sputum collection.
Deliver specimens immediately to the lab.
E. Swab Specimen Collection
Collection Techniques:
Throat Swab
Detects streptococcal infections.
Swab tonsils and back of the throat without touching the tongue.
Nasal Swab
Used for COVID-19, MRSA screening.
Insert swab deep into the nasal cavity.
Wound Swab
Used to detect wound infections.
Collect pus or fluid from the deepest part of the wound.
Genital Swab
Detects STIs (chlamydia, gonorrhea, HPV).
Use sterile swabs with transport medium.
Special Considerations:
Avoid contamination with normal flora.
Label correctly and transport quickly.
F. Cerebrospinal Fluid (CSF) Collection
Collection Technique:
Collected via lumbar puncture (spinal tap).
Requires strict aseptic technique.
Used for meningitis, encephalitis diagnosis.
Special Considerations:
CSF should never be refrigerated.
Transport immediately to the lab.
G. Body Fluid Collection (Sterile Fluids)
Collection Techniques:
Pleural Fluid (Thoracentesis) – From lungs.
Peritoneal Fluid (Paracentesis) – From abdominal cavity.
Synovial Fluid (Joint Aspiration) – From joints.
Pericardial Fluid (Pericardiocentesis) – From heart sac.
Special Considerations:
Handle under sterile conditions.
Transport immediately for culture.
H. Tissue and Biopsy Collection
Collection Techniques:
Needle Biopsy – Fine needle aspiration for tumors.
Surgical Biopsy – Larger tissue samples for histopathology.
Endoscopic Biopsy – Collected during gastroscopy, colonoscopy.
Special Considerations:
Preserve samples in formalin (histopathology) or sterile saline (microbiology).
3. Safety Considerations in Specimen Collection
Wear PPE (gloves, masks, gowns).
Dispose of biohazard waste properly.
Use leak-proof containers for transport.
Follow infection control protocols for high-risk specimens.
Appropriate Containers for Specimen Collection.
Introduction
The use of appropriate containers for specimen collection is critical for accurate laboratory testing, infection prevention, and maintaining specimen integrity. Containers must be sterile, leak-proof, properly labeled, and suitable for the specific type of specimen.
World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) guidelines outline the best practices for choosing and using specimen containers to ensure reliable test results.
1. Characteristics of an Ideal Specimen Container
Sterile and Leak-Proof – Prevents contamination and spills.
Properly Labeled – Includes patient information, date, time, and test type.
Material Compatibility – Some specimens require glass, plastic, or specialized preservatives.
Correct Size and Volume – Ensures sufficient sample quantity for testing.
Temperature Resistant – Some containers need to withstand refrigeration or freezing.
Secure Closure – Prevents evaporation, leakage, or spillage.
2. Appropriate Containers for Different Types of Specimens
Specimen Type
Appropriate Container
Special Considerations
Blood
Vacuum tubes (Vacutainers), Heparinized Syringes
Use correct anticoagulant tubes (e.g., EDTA, Citrate, Heparin).
Use transport media (Cary-Blair, buffered glycerol) for culture.
Sputum
Wide-mouthed, sterile leak-proof container
Collect early morning deep cough sample.
Throat/Nasal Swab
Sterile swab with viral transport medium (VTM)
Essential for COVID-19, flu, bacterial throat infections.
Cerebrospinal Fluid (CSF)
Sterile screw-capped tube
Never refrigerate CSF, transport immediately.
Body Fluids (Pleural, Peritoneal, Synovial, Pericardial)
Sterile screw-cap container or syringes
Transport immediately to avoid clotting.
Tissue/Biopsy
10% Formalin (histology) or Sterile Saline (microbiology)
Avoid crushing delicate tissues.
Bone Marrow Aspirate
Heparinized syringe or sterile vial
Ensure immediate transport to hematology lab.
Hair, Nail, Skin Scrapings
Dry, sterile container or fungal transport media
Prevent moisture contamination.
3. Detailed Guidelines for Specimen Containers
A. Blood Specimen Containers
Blood samples are collected in vacuum tubes (Vacutainers) or syringes, with different additives depending on the test.
Tube Type
Cap Color
Additive
Common Uses
Plain (Serum) Tube
Red/Gold (SST)
No anticoagulant
Biochemistry, hormone tests, serology
EDTA Tube
Purple/Lavender
EDTA (Ethylenediaminetetraacetic acid)
Complete Blood Count (CBC), Hemoglobin (HbA1c)
Citrate Tube
Blue
Sodium Citrate
Coagulation studies (PT, APTT, INR)
Heparin Tube
Green
Lithium or Sodium Heparin
Arterial Blood Gas (ABG), Electrolytes
Fluoride Tube
Gray
Sodium Fluoride & Potassium Oxalate
Glucose testing
Blood Culture Bottles
Aerobic & Anaerobic Bottles
Culture medium
Bacteremia, Septicemia detection
Special Considerations:
Follow the correct order of draw to prevent contamination.
Invert tubes gently to mix additives without clotting.
Store at recommended temperatures (e.g., blood cultures at room temperature).
B. Urine Specimen Containers
Urine samples require sterile, leak-proof containers depending on the test type.
Test Type
Container
Preservative/Storage
Routine Urinalysis
Sterile urine container
Refrigerate if delayed >2 hours
Urine Culture
Sterile urine container
No preservative
24-Hour Urine Collection
Large 2-3L plastic bottle
Store refrigerated
Drug Screening
Tamper-proof urine container
Chain of custody labeling
Special Considerations:
Ensure proper patient hygiene before collection (midstream clean-catch).
Use boric acid preservative for delayed transport.
C. Stool Specimen Containers
Stool samples require sterile, wide-mouthed containers for different analyses.
Test Type
Container
Preservative/Storage
Routine Stool Analysis
Clean, dry container
Room temperature
Ova & Parasite Test
10% Formalin or SAF (Sodium Acetate Formalin)
Refrigerate if delayed
Stool Culture
Cary-Blair transport medium
Refrigerate
Fecal Occult Blood Test (FOBT)
Special occult blood test card
Room temperature
Special Considerations:
Avoid contamination with urine or toilet water.
Transport within 1-2 hours for bacterial culture.
D. Sputum Specimen Containers
Use sterile, wide-mouthed containers with a screw cap.
Transport quickly for tuberculosis (TB) culture.
Avoid mixing with saliva.
E. Swab Specimen Containers
Swabs require sterile transport media to preserve sample viability.
Test Type
Container
Preservative/Storage
Throat Swab
Sterile swab in transport tube
Room temperature
Nasopharyngeal Swab
Viral Transport Medium (VTM)
Refrigerate
Wound Swab
Amies Transport Medium
Room temperature
F. Cerebrospinal Fluid (CSF) Collection Containers
Use sterile, screw-capped plastic tubes.
Never refrigerate CSF—transport immediately for bacterial culture.
G. Body Fluids (Pleural, Peritoneal, Synovial, Pericardial)
Use sterile, leak-proof screw-capped vials or syringes without anticoagulants.
Transport immediately to the lab.
H. Tissue & Biopsy Containers
Histopathology: Use 10% Formalin.
Microbiology: Use sterile saline (no formalin).
4. Safety Considerations for Specimen Containers
Use leak-proof containers with biohazard labeling.
Avoid overfilling to prevent spills.
Dispose of used containers properly according to hospital waste policies.
Use PPE (gloves, masks) when handling infectious specimens.
Transportation of the Sample: Guidelines and Best Practices
Introduction
The transportation of biological samples is a critical step in the diagnostic process, ensuring that specimens reach the laboratory intact, uncontaminated, and in a timely manner. Proper handling and transport prevent specimen degradation, contamination, and misdiagnosis.
World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Clinical & Laboratory Standards Institute (CLSI) guidelines emphasize the importance of secure packaging, appropriate temperature control, and timely delivery.
1. General Principles of Sample Transportation
Proper Labeling: Each sample must be clearly labeled with patient name, ID, date & time of collection, specimen type, and test required.
Use of Proper Containers: Ensure samples are in leak-proof, sterile, and transport-friendly containers.
Temperature Control: Maintain appropriate storage conditions (room temperature, refrigerated, or frozen).
Timely Delivery: Minimize transport time to prevent specimen deterioration.
Safety Measures: Follow biohazard protocols and infection control guidelines.
Documentation: Use a logbook or electronic tracking system for specimen movement.
2. Specimen Packaging and Transport System (Triple Packaging System)
To ensure safe and secure transport, WHO recommends the Triple Packaging System, consisting of three layers of protection.
A. Triple Packaging Components
Primary Container (Specimen Container)
Leak-proof, sterile container holding the specimen.
Properly labeled with patient details and test type.
Must be sealed tightly to prevent leakage.
Secondary Packaging
Waterproof and biohazard-proof bag (zip-lock or plastic container).
Contains absorbent material (cotton, paper) to soak up leaks.
May include multiple specimen containers.
Outer Packaging
Rigid transport box (plastic or metal) with a secure lid.
Labeling: Must include:
Biohazard sign
Transport category (e.g., Category A, B)
Sender and receiver information
Storage conditions (e.g., “Keep Refrigerated”)
Used for long-distance or inter-facility transportation.
3. Sample Transport Conditions by Specimen Type
Different specimens require specific transport conditions to maintain stability and integrity.
Specimen Type
Transport Conditions
Special Considerations
Blood
Room temperature (except coagulation tests)
Transport within 30-60 minutes
Urine
Refrigerate at 2-8°C if delayed >2 hours
Use boric acid preservative for culture
Stool
Room temperature for culture, refrigerate for parasites
Use Cary-Blair transport medium for bacterial culture
Sputum
Room temperature (TB) or refrigerated for other tests
Avoid saliva contamination
Swabs (Throat, Nasal, Wound, Genital)
Use Viral Transport Medium (VTM) for viruses, room temperature for bacterial cultures
Transport within 24 hours
CSF (Cerebrospinal Fluid)
Room temperature, transport immediately
Never refrigerate
Body Fluids (Pleural, Peritoneal, Synovial, Pericardial)
Transport immediately
Use sterile, screw-capped vials
Tissue & Biopsy
10% Formalin for histopathology, sterile saline for microbiology
Avoid crushing or drying
4. Temperature-Controlled Sample Transport
A. Room Temperature (15-25°C)
Blood samples (except coagulation tests)
Swabs (throat, wound, nasal)
CSF (cerebrospinal fluid)
Stool samples for culture
B. Refrigerated (2-8°C)
Urine (if delayed beyond 2 hours)
Stool for ova & parasites
Sputum (except TB tests)
Pleural, peritoneal, synovial, pericardial fluids
C. Frozen (-20°C or -70°C)
Plasma or serum for long-term storage
Viral samples for molecular testing (e.g., PCR)
Some microbiology specimens (e.g., certain bacterial toxins)
5. Specimen Transportation Methods
A. Intra-Hospital Transport
Hand-carry or pneumatic tube system within the hospital.
Use sealed biohazard transport bags.
Timely delivery is critical to avoid test delays.
B. Local or Short-Distance Transport
Use couriers trained in biosafety.
Specimens should be hand-delivered to ensure safe handling.
Maintain appropriate temperature control using portable refrigerators or cool boxes.
C. Long-Distance Transport (Inter-Laboratory)
Follow International Air Transport Association (IATA) guidelines.
Use insulated boxes with dry ice or gel packs for temperature-sensitive samples.
Ensure proper documentation and tracking.
6. Transportation of Infectious Specimens (WHO/IATA Classification)
Specimens are categorized based on their infectious risk.
Packaging: Requires triple packaging with biohazard labeling.
Transport via regular medical logistics services.
7. Documentation and Tracking of Specimens
Specimen Transport Log: Includes time of collection, transport details, and receiving lab signature.
Chain of Custody Forms: Required for forensic, drug testing, and legal specimens.
Electronic Tracking System: Ensures real-time location monitoring of samples.
8. Challenges in Specimen Transport and Solutions
Challenge
Potential Issues
Solutions
Delayed Transport
Degradation of specimen, inaccurate results
Use fast courier services, maintain proper storage
Improper Temperature Control
Bacterial overgrowth, enzyme breakdown
Use ice packs, refrigerators, dry ice
Leakage/Spillage
Biohazard risk
Triple packaging, leak-proof containers
Mislabeling
Sample rejection, wrong diagnosis
Double-check labels, electronic barcode system
Loss of Specimens
Delayed diagnosis
GPS tracking, transport logs
9. Safety and Biosafety Guidelines
Use PPE (gloves, masks, face shields) when handling specimens.
Follow spill management protocols for accidental leaks.
Disinfect transport boxes daily.
Train all transport personnel in biosafety and biohazard handling.
Staff Precautions in Handling Specimens
Introduction
Healthcare workers responsible for specimen collection, handling, and transport face risks of infection, contamination, and exposure to biohazards. Proper safety precautions, adherence to standard protocols, and use of personal protective equipment (PPE) are essential to protect staff, maintain specimen integrity, and prevent cross-contamination.
Guidelines from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Clinical & Laboratory Standards Institute (CLSI) outline best practices to ensure safe handling, transport, and disposal of clinical specimens.
1. General Precautions for Staff Handling Specimens
Hand Hygiene
Perform handwashing with soap and water or use alcohol-based hand rub before and after handling specimens.
Follow WHO’s “Five Moments of Hand Hygiene”.
Use of Personal Protective Equipment (PPE)
Wear gloves, lab coats/gowns, face masks, and eye protection.
Change gloves between patients to prevent cross-contamination.
Use N95 respirators for handling airborne pathogen samples (e.g., tuberculosis, COVID-19).
Aseptic Technique
Use sterile gloves, syringes, and containers to prevent specimen contamination.
Disinfect collection sites before drawing blood or collecting samples.
Proper Specimen Labeling
Ensure correct patient identification before collection.
Label specimens with name, date, time, and test type before transport.
Leak-Proof and Secure Packaging
Use triple packaging (primary, secondary, outer containers).
Ensure specimens are tightly sealed to prevent leakage.
Absorbent material should be placed in secondary packaging to contain spills.
Specimen Transport Precautions
Carry specimens in biohazard transport bags.
Maintain proper temperature control (room temp, refrigerated, or frozen).
Ensure timely transport to prevent degradation.
Spill Management
In case of a specimen spill, follow these steps:
Alert nearby personnel.
Wear PPE (gloves, mask, eye protection).
Cover the spill with absorbent material (paper towels).
Disinfect the area with 1:10 diluted bleach or hospital-grade disinfectant.
Dispose of contaminated materials in biohazard waste.
Report the incident according to hospital policy.
Avoiding Aerosol Generation
Do not forcefully eject fluids or vortex mix infectious specimens.
Use biosafety cabinets for high-risk pathogen processing.
Handle blood cultures and TB specimens inside enclosed containers.
Proper Storage Before Testing
Refrigerate (2-8°C) urine, stool, and some blood samples if testing is delayed.
Keep cerebrospinal fluid (CSF) at room temperature for immediate testing.
Freeze (-20°C or -70°C) viral and molecular testing samples.
Waste Disposal and Decontamination
Dispose of used gloves, swabs, and biohazard waste in designated containers.
Autoclave contaminated lab materials before disposal.
Regularly disinfect work surfaces, transport containers, and lab benches.
2. Specific Precautions for Different Types of Specimens
A. Blood Specimens
Avoid recapping needles to prevent needlestick injuries.
Use safety-engineered sharps containers for disposal.
Invert anticoagulant tubes gently to prevent clotting.
Store blood cultures at room temperature and deliver promptly.
B. Urine Specimens
Ensure midstream clean-catch urine collection to prevent contamination.
Refrigerate if transport is delayed beyond 2 hours.
Use boric acid preservative for culture tests.
C. Stool Specimens
Avoid urine contamination.
Use Cary-Blair transport medium for stool culture.
Refrigerate if testing is delayed.
D. Sputum and Respiratory Specimens
Instruct patients to cough deeply into a sterile container.
Wear N95 masks while handling tuberculosis (TB) samples.
Transport immediately for processing.
E. Swab Specimens
Use sterile swabs and transport medium (Viral Transport Medium – VTM) for viral infections.
Label samples correctly to avoid mix-ups.
F. Cerebrospinal Fluid (CSF)
Collected via lumbar puncture under sterile conditions.
Transport immediately without refrigeration.
Process in a biosafety cabinet for suspected meningitis pathogens.
G. Tissue and Biopsy Specimens
Use 10% formalin for histopathology.
Use sterile saline for microbiology tests.
Avoid crushing or damaging fragile tissues.
H. High-Risk Infectious Samples (e.g., COVID-19, Ebola, TB)
Process in biosafety level-3 (BSL-3) laboratories.
Use double-layer packaging and a triple containment system.
Follow IATA Category A transport protocols.
3. Occupational Hazards and Preventive Measures
Hazard
Potential Risk
Preventive Measures
Needlestick Injuries
Bloodborne infections (HIV, Hepatitis B, C)
Use safety needles, avoid recapping, dispose in sharps containers
Aerosol Exposure
Respiratory infections (TB, COVID-19)
Use biosafety cabinets, wear N95 masks
Spills & Leaks
Exposure to infectious fluids
Use triple packaging, disinfect immediately
Incorrect Labeling
Misdiagnosis, delayed treatment
Verify patient details before collection
Specimen Contamination
False test results
Follow aseptic techniques
4. Handling and Transport of Infectious Specimens
A. Biohazard Safety Levels
Biosafety Level
Specimen Types
Precautions
BSL-1
Non-harmful samples (routine blood, urine)
Standard PPE
BSL-2
Moderate-risk pathogens (HIV, Hepatitis B)
Gloves, lab coats, face shields
BSL-3
High-risk airborne infections (TB, COVID-19)
N95 masks, biosafety cabinets
BSL-4
Extreme-risk pathogens (Ebola, Marburg)
Full body suits, specialized containment
B. Transport Guidelines for Infectious Samples
Use Triple Packaging System:
Primary container: Leak-proof, sterile tube.
Secondary container: Biohazard-proof transport bag.
Outer packaging: Hard transport box with biohazard labeling.
Follow WHO & IATA Guidelines:
Category A: Highly infectious specimens (e.g., Ebola, anthrax) – Transport in UN 2814 containers.