How does blood sample collection happen?
- First of all the nurse will prepare the necessary articles for the procedure and will check, what are the tests to be done. She will check if the patient has arrived to do the testing on an empty stomach (for tests that require a fasting period or other preparation).
- A tourniquet will be applied to the arm and the patient will be asked to squeeze their hand slightly, so that the vein from which the sample will be collected, fills up with blood. This way punctating the vein is easier and more painless. The patient then holds the hand gripped.
- The nurse then desinfects the punture area and penetrates the skin with a sterile injection needle.
- When the vein has been reached, the nurse will loosen the tourniquet and the patient will be told to relax his hand. At this point, the needed number of blood collection tubes are filled. This depends on the testing requiered – usually one or two small tubes.
- When the needed tubes are filled with blood, the nurse will apply a piece of cotton wool with desinfectant and remove the needle.
- The cotton wool will be covered by a plaster and the patient will have to apply slight pressure with their finger to the punction place for about 5 to 10 minutes.
- If the pressure with the cotton wool isn’t applied hard or long enough, a slight hemmorhage is possible. The size of the bruise depends on the patient’s physical characteristics.
- Patients who take anticoagulants (blood thinners, for example, Warfarin), the cotton wool must be pressure applied longer, because their blood takes longer to coagulate than for patients who do not use such medication.
- With small children who are unable to keep their hands steady there is a risk of puncturing the vein and developing a bruise. The nurse will suggest the appropriate action in such a situation.
- If the bruise hurts, a spirit compress can be applied for an hour and a numbing ointment can be used.
Possible complications include:
Blood tests that require preparation on the patient’s part:
In most cases the general requirement is to give blood samples in the morning before any physical exercise and other diagnostic procedures. It is advised to refrain from smoking, eating and drinking coffee directly before sample collection. You must give blood on an empty stomach, in the morning after waking up and before breakfast if the blood tests you require include:
- Somatotropin, also known as the human growth hormone (you must also be in a state of rest 30 minutes before sample collection)
- Lipoprotein fractions, cholesterol, triglyderides (at least 12 hours since the last meal)
- Folic acid
- Vitamin B12
- Glucose, if your doctor hasn’t directed you to give the sample right after eating
- Glucose tolerance test (more information on that further on)
Other tests with special requirements:
PSA (prostate-specific antigen) – Blood must never been given recently after palpation, biopsy, cystoscopy or change of catheter connected to the prostate. After diagnostic manipulation of the prostate, samples for the PSA test can be given no sooner than 10 days after.
Fertility hormones in women are tested in the menstrual cycle phase prescribed by her doctor.
Prolactin testing must be done no sooner than 3 hours after waking and the patient must be in a state of rest 15 minutes before sample collection.
Lactate dehydrogenase (LDH), Creatinekinase (CK) – blood collection for this test after physical exercise is forbidden.
Deoxypyridinoline (DPD) in urine – the 1st or 2nd morning urine, collected until 10 AM. 10 ml are needed for testing.
Erythropoietin – sample must be given in the morning.
It is recommended, but not obligatory to give blood before any physical exercise or diagnostic procedures if complete blood count or reticulocyte count is ordered.
Glucose tolerance test
How to prepare:
- At least 3 days before the test keep your usual eating routine (at least 150-200 g of carbohydrates per day)
- At least 3 days before the test stop taking drugs that can affect blood glucose levels. Always check with your doctor, whether it doesn’t do bad for your health!
- Continue your usual excercise routine – avoid both intense physical excertion and bedrest
How the testing happens:
- You must arrive at the laboratory on an empty stomach (12 hours since the last meal) prepared for the testing taking 2 hours
- The whole time of the testing you must refrain from eating, smoking and physical activity. We warn you that during the testing some patients can experience dizziness and nausea
- The nurse will collect the first venous blood sample after the fasting period
- Then in the duration of 5 minutes you will have to drink a glass of water containing 75 g of glucose powder. You can take with you a lemon to make consumption of this very sweet substance easier.
- An hour after drinking the glucose solution another blood sample will be collected.
- After another hour - the last sample.
- After that the patient can eat and continue with their daily rhythm.
How to correctly collect a urine sample?
Different types of urine tests have different requirements, but they all have in common the following requirements:
Urine must be collected in a special container, which can be obtained in the laboratory or bought in a drugstore. An unsuitable or previously used container can affect the result of the testing. The lab can refuse to accept it.
- Before collecting the urine sample, the patient must abstain from sex for 12 hours.
- Before collecting the sample the patient must maintain their usual diet.
- The sample must not be collected directly after physical activity.
- When urinating in the container, it must not touch the body.
- The urine sample may never be mixed with feces or any other material.
- The sample must be brought to the laboratory immediately after collection. If that is not possible, it is kept in the refrigerator (never in the freezer). If it has been refrigerated for longer than 8 hours, the sample is unusable and will be rejected. A sample that has been long kept in unsuitable conditions will yield incorrect analysis results.
- The sample must be kept away from sunlight
- Laboratory personnel must be notified of the sample collection time (when it was collected)
Clinical urinalysis (Urinalysis with a strip and microscopy)
When examining the urine, the color, transparency, weight and acidity is measured. It is also possible to measure protein, glucose, bilirubin, ketones, nitrites, erythrocytes, leucocytes etc. Urine microscopy allows us to see cell elements and salt crystals.
Reference intervals (norms) which are shown in the testing results, are for urine, which has been collected correctly, with precise conforming to the rules.
Instructions for correct urine sample collection for clinical urinalysis:
- The first morning urine is collected (first urination after waking). The middle portion of the urine is used. This portion is the most concentrated.
- Urine is collected in a special urine container, that can be obtained in the lab or a drugstore. The sample is collected after thoroughly washing the genitals.
- You must wash your hands before obtaining the sample.
- The genitals are washed with water or rinsed with moist towels and dried with a paper tissue.
- The middle portion of the urine is obtained as follows: the patient urinates for a small moment outside the container, then fills the container, covers it with the lid and finishes urinating.
- The container is marked with the patients first and last name.
- The sample must be transported to the laboratory immediately. After 1 hour the decomposition of the formelements begins. If delivery at once is not at all possible, the sample must be kept in the refrigerator (never in the freezer).
- One type of urine test requires 10-20 ml of urine – about a table spoon. If several tests are required, there must be more sample.
- View the instructional images: Instruction for women (opens in a new tab), Instruction for men (opens in a new tab), Instruction for children (opens in a new tab)
Spontaneous urine is a urine sample that has been collected without any preparation. This kind of sample is usually used in acute situations. It must be noted that in these cases false positives and false negatives are possible.
For some tests, there can be a variable sample collection time and length. Your doctor may prescribe you a urine sample collection which will take considerable time.
24 hour urine
Albumin, cortisol, calcium, phosphorus and other elements are tested for in 24 hour urine. 24 hour urine is collected in the span of 24 hours in the following way:
- Right after waking, the bladder is emptied, the urine is not collected and the time of urination is written down (for example, 9:00)
- In the following 24 hours all the urine excreted is collected in one container. You must use a clean 2.5 – 3 liter container. Every time after adding new urine, the big container is closed and rotated so as to mix the contents. The sample is kept in the refrigerator (never in the freezer). At the laboratory beforehand you will receive a preservative to add to your 24 hour urine( in some cases).
- The next day at 9:00 (or other – the same time you started the sample collection, but on the next day), you must empty your bladder, adding the last portion of urine to the large collection container. To correctly collect 24 hour urine, you must observe the rule: sample collection starts and ends with an empty bladder!
- At the end of the urine collection all the urine amount is mixed up, the whole twenty-four hour amount is measured, from it20 ml are pored into a small urine container, mark it with the patient’s name and surname, it is obligatory to indicate the whole twenty-four hour volume (ml) and transport to the lab.
The second morning portion
A separate urine portion collected 2-4 hours after the first morning urine. This investigation is influenced by the meal taken, the liquid and the morning physical activities. It is advisable that the previous evening after 22.00 till the time of urine collection the liquid intake should not exceed one glass (200 ml) of water. It is also preferable that the urine for investigation had been in the bladder for 4 hours.
Urine for microbiological investigations, including for the determination of sexually transmissible infections.
Urine collection should be done before beginning to use antibiotics. Collect the urine midstream portion into a sterile container (available at the lab or drug store), the same way as collecting urine for clinical investigation (strips and microscopy). Within two hours it has to be transported to the lab, in case it takes longer, keep it in the fridge (not in the freezer). The sample is to be brought to the lab on the same day.
Urine Collection Set for Infants
The set consists of:
Sterile urine bag,
Capillary and a test-tube with preservative
Take the urine bag out of the sterile packing, take the adhesive part from the opening and stick the bag to the urethral area with the pointed part in the direction of the back.
Wait till the bag fills with urine.
Open the other packing, take out the capillary and tube.
Take the urine bag off the genitalia, place the pointed part of capillary into the opening of the bag so that it will be in the urine. Take the vacuum test-tube with preservative and place it with the cork down into the widening of the capillary, where there is an integrated needle and boldly perforating press the test-tube cork on it. Do not put fingers into the opening of the capillary widening – there is an integrated needle there! The vacuum will pull the necessary amount of urine into the test-tube. The test-tube should be slowly mixed up 8-10 timed so that the addition – the preservative could evenly mix with urine.
Transport the test-tube to the lab to do the analysis, the other parts of the set throw out.
Before collecting a faecal sample for any kind of analysis the anal area must be clean. To do the analysis there must be fresh material – the faeces should be transported no later than 8 hours after collection. Before transportation to the lab the faeces in a tightly closed container (available at the lab) must be kept in the fridge (by no means in the freezer). The container should be placed in a bag to avoid accidental contact with the environment. Faeces are collected as follows:
One can defecate on clean paper, a paper napkin or on an unused plastic bag.
Using chamber pot it must first be washed with soap and sponge, a number of times rinsed with running water, then sluiced with boiling water and dried.
Collect with a special spoon placed into the container about 10-15 g from the whole amount from different places and depth. It is especially important to collect different material in slimy faeces!
The container should not be filled up to the top.
On the container must be written the patient’s name and surname.
The faeces should not be collected mixed with urine or any other material addition or after enema.
Before transporting to the lab it is preferable to keep the faeces in the fridge (by no means in the freezer), especially in hot weather.
In order to determine the microscopic investigation elements, concealed blood, parasite eggs, Giardia lamblia antigen etc., the faeces are collected into a special clean, dry vessel which you can get at the lab or drugstore.
3 days before handing in the material keep to the usual meal regime. To be able on the basis of the coprogramma results to determine the functional abilities of the alimentary tract the patient must use diverse food containing proteins, carbohydrates, fat. One must use food rich in cellulose as roots, salad, nuts, roughly ground bread.
One must restrict the C vitamin usage (to 2g a day), the use of vitamin rich juice
The test should not be done during diarrhoea and menstruation period!
Faeces cannot be handed in after using medicines that change the composition of the faeces (barium, iron, bismuth containing drugs, laxatives).
The material can be kept:
Up to 4 hours at room temperature, in the fridge +4 to 8C 8-12 hours, in hot weather it should necessarily be kept in the fridge (but never in the freezer).
If the material contains mucus or blood the investigation is to be performed during 2-4 hours.aa
If the aim of the investigation is to establish the presence of concealed blood then 3 days before that one must not use food that can give erroneous results:
• black pudding, raw or underdone meat
• turnips, broccoli, horseradish, parsnips, red radishes
• before determination of concealed blood it is advisable 2 days to refrain from using alcohol, foodstuffs that irritate and cause bleeding, including aspirin
• not to hand in faeces during the haemorrhoid, menstrual or other periods of visible bleeding
• hand in faeces not earlier than 3 days after the end of the menstruation period
The faeces sample is collected the same way as for coproprogramma butr without food restrictions.
Faeces sample collection for microbiological investigation
The faeces sample is taken before starting antibacterial therapy. The faeces sample is collected just like for coprogramma but without food restrictions. In most cases the faeces good enough for the analysis are those taken into a special faeces vessel from different, especially changed places of faeces. The sample is transported to the lab as soon as possible, before transporting keeping it in the fridge.
To determine pathogenic microorganisms for the professional examination one must use the dry Cary Blair or Amies culture medium (usually with a red-topped cork) which is taken at the lab. Before taking the smear the place of anal opening must be clean. Right before taking the sample tear the culture medium packing and take out the cotton wool tampon. It is carefully inserted into the anal opening at 2.5 cm depth and gently twisted for to seconds. The cotton wool tampon is taken out. The cork from the culture medium in the packing is taken off. The cotton wool tampon is placed into the culture medium and the cork is put on tightly. Transport to the lab during the day. It is not necessary to keep it in the fridge.
Sputum are collected into a dry, clean vessel with a tight cover (that is to be get at the lab or drugstore), transport to the lab immediately. Before collecting the material clean your teeth and rinse your mouth with clean water. You must collect only the material that secretes when coughing.
Skin, Nails, Eye-lashes and etc. to Test for Fungus
To improve the quality of investigation we advise the patients, right before going to the specialist, not to cut the damaged nails and not to wash the damaged area. The damaged skin area should not be treated with creams, salves or cosmetics. For 2 weeks you have to refrain from using anti fungus and other local medical means before the doctor takes the sample to determine the fungus.
Collecting Sperm for Microbiological Investigations
We inform you that HC4 does not perform the spermogramma. Before getting the sperm sample for sowing purposes one must wash just like before collecting the urine sample (the picture opens in a new window). The sperm must be taken before you start using antibiotics or locally used medication begins. The sample is collected masturbating into a special sterile vessel for sowing that can be got at the lab or drugstore.
How to get ready for taking analyses at the gynaecologist’s or urologist’s office (smears for gonorrhoeae, trichomonosis, bacterial vaginosis,etc)?
Before collecting the material for STD do not use antibiotics. 7-10 days before doing the analysis one must not use the means of treating antitrichomonosis also locally (in the form of ointment). 3-4 weeks before investigation into bacterial vaginose one must not use nitromidasol group medication.
Taking material for STD smear men must observe a 4-5 hours urination pause before the investigation.