What is an acceptable sputum specimen?
The quality of sputum samples is determined by the minimum number of squamous epithelial cells and polymorphonuclear leukocytes per low power field. An acceptable specimen has more than 25 leukocytes and fewer than 10 epithelial cells per low power field.
What is the criteria for rejecting a sputum specimen as not acceptable?
One criterion states that the sputum specimen should be rejected if 25 or more squamous epithelial cells/low power field (SQE/LPF) are observed. The second criterion recommends a cutoff of more than 10 SQE/LPF. In either case, a minimum of 20 LPFs should be observed.
How do you measure quality of sputum?
Involving the method for assessment of the sputum quality allows us to estimate the amount of oropharyngeal contamination. This method is performed by microscopic examination of the cellular components in a stained smear of the specimen, seen under the low power field magnification (LPF).
What factors are important in obtaining a good sputum specimen?
The mouth should be free of foreign matter and may be rinsed with filtered or sterile water prior to collection. 3. Take deep breaths through your mouth and cough up the mucous from deep in your lungs. Breathing deeply over a pan of boiling water may help raise sputum.
How long is sputum sample good for?
It is concluded that sputum should not be stored at room temperature for longer than 3 days for culture but it can be stored for 4 weeks without any loss of smear-positivity.
How will you validate a respiratory specimen such as sputum?
The are two main ways that sputum samples are collected: Coughing and spitting into a cup: The most common method of obtaining a sputum sample is by coughing deeply and then spitting the phlegm that comes up into a sample cup. This is generally the least invasive method of sputum culture testing.
What are the criteria for specimen rejection?
Specimen rejection criteria
- Basic incorrect blood tube/other sample.
- Samples without the appropriate preservative (e.g. acidified urine samples).
- Samples that are received ambient, when a frozen sample is required.
What is the major cause of specimen rejection?
The most common reasons for specimen rejection were contamination (n=764, 35.1%), inappropriate collection container/tube (n=330, 15.2%), quantity not sufficient (QNS) (n=329, 15.1%), labeling errors (n=321, 14.7%), hemolyzed specimen (n=205, 9.4%), and clotted specimen (n=203, 9.3%).
What is a sputum Q Score?
What is a Sputum Q-Score? A standardized Gram stain screening method to check the quality and acceptability of the specimen submitted for culture when assessing sputum vs saliva. The grading is performed based on the type of cells seen.
What is a normal sputum culture?
Normal: Sputum that has passed through the mouth normally contains several types of harmless bacteria. These include some types of strep (Streptococcus) and staph (Staphylococcus). The culture should not show any harmful bacteria or fungi. Normal culture results are negative.
What should the nurse assess and document when collecting a sputum specimen?
Sputum is always considered abnormal, because healthy people swallow bronchial secretions. Sputum analysis is important, because it enables diagnosis of conditions such as pneumonia, tuberculosis, lung abscess and lung cancer. The nurse should record the colour, amount and consistency of the sputum collected.
How long can sputum be stored before testing?
Why sputum specimens should not be refrigerated?
3.3 Sputum specimen shipment
With CPC transport medium: should not be refrigerated because at low temperatures the CPC will crystallize and ruin the sample. Specimens should be kept at room temperature, protected from heat and light.
What are unacceptable specimens?
Examples of unsuitable specimens are: Incorrect specimen collection container. insufficient specimen quantity. Transported incorrectly. Inadequate fixative.
What is the most common cause of specimen rejection?
In summary, the major causes of specimen rejection identified in our clinical chemistry laboratory were contamination by IV fluid or TPN solution, inappropriate collection container/tube, QNS, labeling errors, hemolyzed specimen, and clotted specimen; the frequencies of these causes are at variance with those …
What reasons would a specimen not be accepted for testing?
Insufficient sample received. No sample received. Labelling or form issues (mislabelled/unlabelled/no forms/no clinical information). Clotted/haemolysed/lipaemic/icteric samples.
What are some common mistakes for specimen rejection?
Two of the most common errors that occur during specimen collection and handling are clotting and inaccurate volume. Exposure to temperature extremes may also cause specimens to be rejected for testing. Clotting compromises the integrity of a specimen, making it unsatisfactory for testing.
What is 2+ grading of sputum smear for AFB?
Accordingly, sputum smear is graded as scanty, 1+, 2+, and 3+. Scanty is when the sputum contains 1–9 AFB in 100 fields, grade 1+ for 10–99 AFB in 100 fields, grade 2+ if 1–10 AFB per field (check 50 fields), and grade 3+ for more than 10 AFB per field (check 20 fields), respectively [7].
How much sputum is normal?
The normal lung produces approximately 20 – 30 millilitres of mucus per day to assist with the functioning of the muco-ciliary escalator. Mucus is called sputum when an excess amount is produced within the airways and needs to be expectorated.
How do you read a sputum report?
Sputum Culture
- Clear. This usually means no disease is present, but large amounts of clear sputum may be a sign of lung disease.
- White or gray. This may also be normal, but increased amounts may mean lung disease.
- Dark yellow or green. This often means a bacterial infection, such as pneumonia.
- Brown.
- Pink.
- Red.
What are the principles of collecting sputum?
They should be instructed to sit up and take several deep breaths to loosen secretions before giving a deep cough to release the sputum. Ideally, the specimen should be no less than the size of a small fingernail.
How many hours can a sputum sample last?
The sample can be refrigerated for up to 24 hours if needed. Don’t freeze it or store it at room temperature. If you can’t cough up sputum, try breathing the steam from boiling water or take a hot, steamy shower. The sputum must come from deep inside your lungs for the test to be accurate.
How long is a sputum sample viable?
What are the criteria for rejection of specimens?
Why are specimens rejected?