1. Non Blood Specimens
Procedures and Tests

2. Non blood specimens Urine Saliva Semen Serous fluid Sputum Swabs
Breath
Faeces
Hair
Tissue
Nail, skin, hair and scabie collection

3. Urine Most commonly tested next to blood Diagnose Decide treatment
Effects of treatment
Accuracy depends on method of collection, type of container, handling and transport

4. Urine
Must be able to explain collection procedure verbally and with written info

5. urine Urinalysis ( UA ) Physical – colour, clarity, odour, volume
Chemical – bacteria, blood, WBC, protein, glucose
Microscopic – cells, crystals, microorganisms

6. urinalysis Plastic strip called a dipstick is used
Pads of test reagents on strip that react to substances in urine

7. Urinalysis Clean, dry container Chemical free Tight fitting lids
If C&S is also ordered, container must be sterile
Samples can only sit for 2 hours at room temp
Longer than 2 hours, refrigerate

8. Culture and sensitivity
Ordered where patient may have UTI
Grown on a special medium to encourage microorganism growth
Sterile container
MSSU

9. Urine Cytology
Performed on urine to detect cancer, CMV, some viral diseases
Clean, fresh catch specimen
Test asap after collection

10. Urine Drug Screening
Detects illicit drug use, steroids, prescription drugs
Random sample
Clean container

11. Types Random Collect at any time U/A Screening tests Timed First am
Tolerance test
24 hour
Double void

12. types First am Immediately on waking after 8 hours of sleep
SG is higher
Tolerance
GTT
Timed with blood collection and glucose intake

13. Types 24 hour Collection and pooling of all urine in 24 hours
Begin between 0600 and 0800
Large, clean, wide mouthed container
Some have preservatives
Some need refrigeration
Labelled correctly

14. 24 hour urine

15. urine Double voided Empty bladder Wait 30 minutes Collect urine
Tests for glucose and ketones

16. Saliva Monitors hormone levels Detects alcohol
Indicates recent drug use
Semen
Assess fertility
Effectiveness of vasectomy
Sterile container
Must be kept warm
Urgent delivery

17. Serous Fluid Found between pleura, pericardium and peritoneum
Large amounts present with inflammation or infection
aspiration

18. Sputum Mucous ejected from trachea, bronchi, lungs by deep coughing
Prefer first am specimens
Remove dentures, rinse mouth, gargle with water
Deep coughing
Room temperature urgent processing

19. Swabs DNA analysis Less invasive than blood test Painless
Inside of mouth

20. Breath
Hydrogen content
Helicobacter pylori
C-urea breath test

21. Faeces Gastrointestinal disorders Ova and parasites Fat Bacteria Blood
Clean, dry container
Often a special diet

22. hair Trace elements Heavy metals Drugs Tissue Biopsies
Arrive in formalin
Transport only

23. Skin Scrapings
Tinea, dermatitis, psoriasis and eczema can look the same
Always scrape the skin first
Then moisten a swab with normal saline and swab the freshly scraped skin
Especially scrape the edges of the lesions

24. Ringworm Scrape the outside ring, not the centre
Do not be too rough as the fungus is light and can become airborne easily

25. Pityriasis Versicolour
Yeast that grows on the skin overgrows
May or may not be coloured or scaly
If nothing comes off when scraped apply some clear sticky tape, peel off and apply to a slide

26. Nappy Rash
Caused by candida
Can be difficult to scrape

27. Vesicles Cut the blister top off and put between two slides
Swab any of the vesicle fluid with swab

28. Feet Scrape the outer edges of the lesion
White yeast infection between the toes is harder to get
Swab between the toes

29. Nail Scrapings
Look for nails that only have a small bit of whitening starting
Trim nail back as much as possible
Scrape the top of the nail onto a black card
Scrape under and side of nail gently
Moisten with swab in normal saline and press underneath nail