Question

Chapter 12: Computers and Specimen Handling and Processing 245 Case Study 12-3: Specimen Processing Issues Janine, a phlebotomist has been newly trained to do specimen processing in the hospital laboratory. She is QUESTIONS normally expected to work alongside an experienced 1. Should Janine have rejected any of the specimens? processor except when that person is on break or at Why or why not? lunch. Today, while the other processor was on his 2. What could have caused the gel to form at a slant lunch break, multiple specimens arrived from a new in the SSTs, and why do you think Janine exam- off-site drawing station. All of the specimens had ined them so closely? proper identification and paperwork. One of them, an ACTH specimen was in a cooling rack. There were 3. What can cause clotted blood to stick to tube stop- several serum separator tubes (SSTs) that had already pers? How can this be prevented? been centrifuged. The gel had formed at a slant in 4. One specimen was handled incorrectly. Which one all of them. She examined each of them very closely. was it and how should it have been handled? In addition, there were several other SSTs that had 5. What do you think caused the centrifuge to vibrate not been centrifuged. The clot was stuck to the tube loudly and shut itself off. What should Janine do stopper in every one of these tubes. Janine eventually about that? accessioned all of the specimens, loaded the unspun SSTs and the ACTH into the centrifuge, started it up, and began preparing to aliquot the SSTs that had already been spun. Just then the centrifuge began vibrating loudly and turned itself off.

Answer 1

1. The sample that Janine must have rejected are the tubes in which the clots stuck at the stopper .

2 . Difference in density of the inert components of blood causes this gel formation and it acts as a physical barrier serum and blood cells during centrifugation.

3. Inadequate clotting time and inappropriate mixing of clotting agent and blood causes the clot to stuck at tube stoppers

4. ACTH sample was mishandled , ACTH sample should be centrifuged in refrigerated centrifuge . It's stored and shipped at frozen (-20 degrees C) temperatures. When a refrigerated centrifuge is not available, it is preferable to spin the sample immediately and cool the sample afterward.