1. Medical Laboratory Careers Mrs. V. Kirkley, RN, MEd

2. Medical Laboratory Careers Phlebotomist- Venipuncture Techs: Collect and prepare blood for testing. Work under the direction of the Pathologist, Med. Lab. Technologist or Technician. Training HSTE classes, 3 to 12 month at a technical college, or onsite training. Salary $14,000 to $28,300 depending on the training, rural or urban location, and worksite.

3. Medical Laboratory Careers Medical Laboratory Assistants - Work under the direction of the Pathologist, Medical Lab Technologist, and /or Technician. Perform basic laboratory test, and prepare specimens for testing. Training 1 to 2 years on the job training, or HSTE Program classes. Board of Certified Laboratory Assistants – can issue certification Salary $14,500 to $26,300 depending on the training, rural or urban location, and worksite.

4. Medical Laboratory Careers Medical Laboratory Technician Work under the supervision of the Pathologist and Medical Laboratory Technologist. Perform many routine test that does not require the advanced knowledge of the Technologist. Training 2 year HSTE certified program or 2yr associates degree. (License required in some states) Salary $26,300 to $48,900 depending on the training, rural or urban location, and worksite.

5. Medical Laboratory Careers Medical Laboratory Technologist Work under the supervision of the Pathologist. They study tissues, fluids, and cells, to determine the presence of disease. They perform complicated chemical, microscopic and automated computerized testing. Training 4 year Bachelor’s or 6 yr Master’s degree. Licensure or Certification required in some states Salary $35,800 to $66,900 depending on the training, rural or urban location, and worksite.

6. Medical Laboratory Careers Pathologist – Dr. who specializes in the study of the nature and cause of disease s. The Pathologist reports to the Hospital Administrator and supervises all Medical Laboratory Personnel. Performs autopsy’s, and many complicated diagnostic test to determine cause of disease and treatment. Training 4 year Bachelors, 4 Years med School, 2-4 years residency and specialization. Salary $120,000 to $425,500 depending on the training, rural or urban location, and worksite.

7. The Microscope Parts of the Microscope ---Eyepiece --ARM REVOLVING NOSE PIECE-- OBJECTIVES-- ---------- STAGE ------- ---BASE Base – Solid Stand for Microscope Arm – Use to carry the Microscope Eyepiece – Sometime two, part through which the eye views the slides. Objectives – Lower power obj. is the shortest Some magnify 4X, or 10X, The high power obj. magnifier's 40X-45X. The oil –immersion magnifies 95X -100X. Revolving Nosepiece – Section which objectives are attached & turns to change Stage – flat platform for the slide to rest See Textbook for other parts like coarse adjustment knob, fine adjustment knob, condenser, illuminating light, and body tube.

8. BLOOD BASICS Erythrocytes - (red blood cells) are the blood cells that carry oxygen from the lungs to the body cells. Normal Count is 4.5-5.5 million per cubic millimeter of blood. Hematocrit (Hct.) and Hemoglobin (Hgb.) are test used to determine the erythrocytes in the blood by spinning down the specimens and measuring the volume of packed red blood cells.

9. BLOOD BASICS Continued Leukocytes – or (white blood cells) are important in fighting infections within the body. Also known as WBC’s their normal count is 5,000 to 10,000 per cubic millimeter of blood. An elevated WBC count could indicate the presence of an infection.

10. BLOOD BASICS Continued Platelets also known as Thrombocytes Platelets also known as Thrombocytes - Are formed in the bone marrow, live for 5-9 days and are important for the clotting process. There are 250,000 to 400,000 Thrombocytes per cubic millimeter.

11. Blood Arterial blood – drawn from the arteries which carry oxygen and are the thickest blood vessel due to the great pressure from within. An arterial blood draw must be followed with pressure applied to the site for an extended period of time. Arterial bleeding will pulsates or spurt with each beat of the heart.

12. Blood Venous blood – drawn from the veins which carry de-oxygenated blood, are thinner walled vessels and closer to the surface of the skin than arteries. Venous blood draws do not require as much pressure be applied for as long as an arterial blood draw. Venous blood flows but without the great pressure of the arterial blood flow.

13. BLOOD Capillary blood - is easily obtained from a finger stick or heel stick since the capillaries are close to the skins surface. Capillaries connect arterioles with venules and are the sight where oxygen and nutrients, as well as, carbon dioxide and waste products are exchanged.

14. LAB TEST Culture & Sensitivity Obtaining a Capillary Blood Obtained when the Dr. wants to find the causative agent and which antibiotic would be the most effective in curing the disease. Common skin puncture sites: Infants heel/great toe, middle and ring finger, and ear lobe.

15. LAB TEST FROM SKIN PUNCTURE Hematocrit (Hct) Hemoglobin (Hgb) Blood Smear Differential Count- Blood Typing Measuring Blood Sugar NORMAL VALUES Women 35-45, Men 40-55 (%) Women 12-16, Men 13-18 (per 100 ml) Important test from blood smear is the WBC’s w/differential - 5 types of WBC’s also RBC’s –sickle cell for example Types A, B, AB, and O plus additional typing for RH positive or negative Fasting blood sugar levels should be from 70-110 mg/dl

16. LAB TEST Urine Test- Often done to determine condition or disease process in a patient. The test is called a Urinalysis. Characteristics of urine checked; – COLORTRANSPARENCY – ODORPH – SPECIFIC GRAVITYGLUCOSE – ALBUMINACETONES – BLOODPUS – BACTERIAERYTHROCYTES – LEUKOCYTESBILIRUBIN – UROBILINOGEN

17. LAB SKILLS Steps Check Drs. Orders Assemble Equipment; sterile lancet & gauze pads, 70 % alcohol pads, disposable gloves, mask, eyewear, gown, sharps container and bio- hazard trash bag (Observe Standard Precautions)(Knock on pts. door) Wash hands- put on gloves, and other PPE if indicated. Check the body area where the specimen is to be obtained. The doctors orders should be specific Remove the sterile applicator from its package. Be sure NOT to touch the cotton tip of the applicator to any surface or contaminate it. Place applicator tip in the site where specimen is to be obtained. Use gentle but firm rotation motion to cover the tip with the specimen. Obtaining Culture Specimen

18. Steps continued Remove the applicator, from the site being careful not to contaminate it. Take caution Do Not touch sides of the container because the specimen smears on the side and is not placed in the medium. Place Applicator into sterile tube – or culture medium. Make sure tip is in medium – break glass in tube if present in order to saturate end of applicator. Label the Specimen – with pts name, address, ID#, doctors name, date, type of test, and site from which obtained. Take Specimen or send to Lab – Clean and replace equipment. Dispose of all waste properly. Remove Gloves – place in biohazard bag Wash hands Record all required information on pts. chart Obtaining Culture Specimen LAB SKILLS

19. Steps Assemble Equipment; sterile lancet & gauze pads, 70 % alcohol pads, disposable gloves, mask, eyewear, gown, sharps container and bio-hazard trash bag Wash hands- put on gloves, and other PPE if indicated. (Observe Standard Precautions)(Knock on pts. door) Introduce yourself, Identify the patient & Explain the procedure. Get consent. Select a finger- avoid calluses, cyanosis, edema, scares and sores. If hand is cold, warm them to increase circulation. Cleanse the finger with the alcohol prep pad and allow to dry. Stick Finger - Grasp pts. finger firmly between your thumb & forefinger. Maintaining a sterile lancet us a quick stabbing motion to puncture the skin. ObtainingCapillary Blood Blood&SkinPuncture

20. LAB SKILLS Steps Continued Caution do not squeeze or milk the finger. If necessary use gentle pressure a distance from the puncture site. Place lancet immediately in the sharps container Use sterile gauze to remove the 1 st drop of blood, discarding the gauze in the biohazard bag Use second drop for blood test – work quickly to prevent clotting. Instruct patient to hold sterile gauze firmly for 1 to 2 minutes against the puncture site. If a pt. is taking anticoagulants it may take 3-5 mins. Remain with pt. until bleeding stops Clean and replace all equipment – make sure all contaminated are disposed of properly Remove gloves and wash hands – dispose of gloves ObtainingCapillary Blood Blood&SkinPuncture

21. LAB SKILLS Steps Assemble Equipment – Alcohol pads, sterile lancet & gauze pads, glucose strips, glucose meter, watch with second hand, gloves, mask, eyewear, gown, sharps container, biohazard trash bag, paper and pen Wash hands- put on gloves, and other PPE if indicated. (Observe Standard Precautions) (Knock on Pts. Door) Calibrate the glucose meter for accuracy Introduce yourself, Identify the patient & Explain the procedure. Get consent. Perform procedure for obtaining capillary blood & skin puncture Place lancet immediately in the sharps container MEASURING ABLOODSUGAR

22. LAB SKILLS Steps continued Use sterile gauze to remove the 1 st drop of blood, discarding the gauze in the biohazard bag Remove one strip from bottle being careful not to touch pad & close bottle. Press start on glucose meter a beep will indicate when to place the drop of blood (depends on models) Read and Document results- within a few seconds the results will be displayed. Document date, time, results of test and your name and credentials. Report abnormally low or high result immediately. Remain with pt. until bleeding stops Clean and replace all equipment – make sure all contaminated are disposed of properly Remove gloves and wash hands – dispose of gloves MEASURING ABLOODSUGAR

23. STANDARD PRECAUTIONS FOR INFECTION CONTROL Wash Hands - Wash after touching blood, body fluids, secretions, excretions, and contaminated items. Wash immediately after removing gloves and between patient contact and avoid transferring microorganism to other patients or environments. Wear Gloves – Wear when touching blood, body fluids, secretions, excretions, and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin

24. STANDARD PRECAUTIONS FOR INFECTION CONTROL continued Wear Gloves continued – Change glove between task when they become contaminated with a high concentration of microorganisms. Remove gloves and wash hand promptly after completions of task and avoid touching any non-contaminated items in the environment such as a phone, door knob, etc. until you have done so. ALWAYS make sure you have removed gloves & washed your hands between patients!!

25. STANDARD PRECAUTIONS FOR INFECTION CONTROL continued Wear Mask, and Eye Protection – Protect mucous membranes of the eyes, nose, and mouth during a procedure that is likely to splash or spray body fluids/ secretions/ excretions. Wear Gown - Protect Skin & prevent soiling of clothing with body fluids etc. Remove gown promptly when finished to prevent transference of microorganisms.

26. STANDARD PRECAUTIONS FOR INFECTION CONTROL continued Patient-Care Equipment – Handel used patient care equipment in a manner so as to prevent skin or mucous membrane exposure/ contamination of clothing/ transfer of microorganism. Make sure reusable equipment is not used again until it has been properly cleaned. Follow proper procedures for cleaning & disinfection of environmental surfaces, beds, bedrails, and bedside equipment

27. STANDARD PRECAUTIONS FOR INFECTION CONTROL continued Linen - Handel, transport and process used/ soiled linens to prevent exposure or contamination to clothing or the environment. Sharps – Prevent injuries for contaminated sharp objects such as needles, scissors, scalpels, razors, or other sharp objects by placing them immediately in a sharps container. NEVER RECAP USED NEEDLES!! NEVER RECAP USED NEEDLES!! USE RESUSCITATIVE DEVICES AS AN ALTERNATIVE TO MOUTH-TO-MOUTH RESUSCITATION ! USE RESUSCITATIVE DEVICES AS AN ALTERNATIVE TO MOUTH-TO-MOUTH RESUSCITATION !

28. STANDARD PRECAUTIONS FOR INFECTION CONTROL continued PATIENT PLACEMENT – Use private rooms for patients who’s expected to contaminate the environment or others with highly infectious/ contagious microorganisms.