Test Code Non-Gynecologic Request Form Cytology, Respiratory Tract, Sputum Series
Methodology
Includes routine cytologic evaluation on microscopic slides and a cell block, whenever possible.
Performing Laboratory
Peninsula Regional Medical Center - Pathology
Specimen Requirements
Acceptable Specimens:
Deep cough or aerosol induced specimen. For routine collection, a series of 3 early morning specimens is recommended. Optimally, specimen is collected on 3 consecutive days.
Routine Collection
1. Attach a patient identification label to a 120 mL sterile, screw-capped sterile container.
2. Instruct patient to take 3 deep breaths and hold each momentarily.
3. Have patient cough deeply into container.
Post Bronchoscopy Sputum
1. Attach a patient identification label to a 120 mL sterile, screw-capped container.
2. Following bronchoscopy, instruct patient to cough into specimen container.
3. After 2 hours of sputum collection, deliver to Histology Department. If there is a delay in transport, send specimen refrigerated.
Specimen Collection
1. Specimen rejection criteria is based on improper specimen labeling, collection, handling, or submission.
A. Clotted or frozen specimen
B. Specimen that is contaminated on outside of collection container
C. Specimen that has leaked into plastic biohazard bag
D. No non-gynecologic cytology requisition form
E. Name on requisition does not match name on specimen container
F. Unlabeled specimen container. Two patient identifiers are required on specimen container.
G. No physician’s name
H. If rejection compromises patient care (one-time specimen such as Silver Stain for identification of Pneumocystis carinii or STAT request) laboratory personnel will contact a pathologist to determine if specimen will be tested.
2. Label specimen container with patient’s full first and last name, date of birth, date of collection, specimen source, and submitting physician’s name.
3. Complete a non-gynecologic cytology requisition form. Include the following information:
A. Patient’s full first and last name
B. Date of birth
C. Medical record or Social Security number
D. Date of collection
E. Submitting physician’s name. Include names of physicians to receive cytology report copies.
F. Specimen source
G. Pertinent clinical information
4. Place specimen in a plastic biohazard bag and insert a non-gynecologic cytology requisition form into separate paper pouch.