Document OJyzGZQJOa3ondm5pyVNzJDoe

NURSE INSTRUCTIONS FOR SLOOP SLIDES, DIFFERENTIAL AND RETICULOCYTE DIFFERENTIAL SHOE The differential slide is of great importance to compliance with Federal Standard 29CRF1910.1028. It is a slide from which a morphological examination of the condition and number of specific blood cells is determined. Due to the fact that modern methodology is vastly improved in automatic dyeing pro cesses at the lab, strict and careful preparation of the slide is necessary. Detailed instructions have been furnished you or your office -- please follow these instructions carefully -- see manual "Preparation of Blood Films". 1. After preparing the differential slide, be certain to check appropriate type exam (interim or pre-employment) and be sure: a. That the patient's name is affixed to the slide b. That the form is filled out with patient name, screenee or medical number, and that the box on the left side of the form is checked next to "Differential Slide". c. That in packing the slide within the lab mailing kit, the original form copy is transmitted inside the lab kit mailing jacket. d. That you have signed the lab orders. e. That is only a differential slide is being shipped (see instructions for contacting AHP), you contact AHP at i to alert our records people and insure computer capture. Send one of the other two form copies by mail to AHP as an extra precaution. MC/P 0000140B6 NURSE INSTRUCTIONS FOR BLOOD SLIDE RETICULOCYTE The reticulocyte count is of great importance to some parts of compliance with the Federal Benzene Standard 29CFR1910.1028. It is a determination of the percentage of immature red cells which is used as an indicator of whether the bone marrow continues its ability to constantly provide new cells to the body's blood system. Therefore, quality slide preparation is of great im portance to accuracy. Follow carefully the instructions in the manual provided your company which are found under "Blood Film Prep for Reticulocyte'1. After preparing reticulocyte slide, be certain to check the appropriate box for type of exam (interim or pre-employment) and see that: a. Patient's name is affixed to slide. (Write name in frosted area of patient). Write with a lead pencil. b. The form is filled out and includes patient name, screenee or medical number (patients in re-examination only), and that box in the left column is checked t-aside the "reticulocyte slide". c. The original (top sheet) of the form is included within the lab mailing jacket which surrounds the foam kit. d. You have signed the order. e. If only a reticulocyte slide is being shipped (see in structions for contacting AHP at 615-356-67^0 notify AHP in order to alert our records people, thereby insuring computer capture of results. Send one of the two remaining copies of the lab order to AHP by mail as an extra precaution. NURSE INSTRUCTIONS BLOOD ANALYSIS CHEMISTRY The blood chemistry profile is of great importance in the health measure of your patient and in compliance with several federal standards, including 29CFR1910.1028. rj { 1 . Rued 2 ml of soru: . 2. Follow procedure for collection of so rue for s;-:a 12/60. H7tj:: oiCLi::i:STEFAsi: 1 . '.'cod 3 nl s scrum. 2. rollc*.; procedure for collection of serum for SMA 12/GO. ir.OCD l.LA'J Ltv:* 1 2 3 1. draw one 10 ml brown or grey top vacutair.er. 2. Place on aliquot mixer, minimum of 10 minutes to prevent clotting. PRERARI?Xt SLOOP SLIDES FOR; Differential Platelet Count 1. Two slides should he made to insure quality. ?. Prepare slides according to directions for Preparation of Flood films. 3. Label package and ship according to directions. Reticulocyte 1. Two slides should be made and sent. 2. One capillary tube for each slide should be used. This is to insure proper staining of cells. 3. Prepare slides according to Blood Film Preparation for Reticulocyte. MCP 000014O88 Differential With Platelet Count l-- The importance of well prepared films lor the examination of your patient's blood cannot be over emphasized. The actual distribution of the leukocytes on the film, as well as their morphology, can be altered by poor technique. The anticoagulant used by American Health Profiles has been specially selected to maintain accuracy for the enumeration of blood cells and will maintain adequate leukocyte morphology for a short tine. However, in order to provide the best possible service to you for your patients, we strongly urge you to develop good tcclinique in the prepara tion of bleed films. 1. A Jrop of blood (approx. ?. nr.i. in diameter) should bo. [>l:u:od on the slide near cite frosted end . 2. Draw spreader/slidc toward drop of blood 3. Allow blood to spread. 4. Push spreader/slide smoothly and fairly rapidly down the slide. 5. Allow sr.enr to air dry. Identify the film with the patient's name. THE IMPORTANCE of a AS* ANf.lC IN THE PREPARATION OF OLOOD SMEARS _<1 AiW|b (COMCCt po-ulion) // X.. 3 c: ______ Gu'llor th.VI ''*V Am (Mm Will \h' Ini) l man IV Am.)"* (film v.. 11 !<' tan I1' n) MOD 000014089 3LQCD FILM PREP FOR RETICULOCYTE Materials Needed: a. New Methylene Blue Stain b. Capillary tubes. c. Blood sample drawn in EDTA (Lavender Top Tube) Prep: 1. Fill two capillary tubes approximately 1/3 fall of New Methylene Blue Stain. 2. Place a large drop of blood from the needle of the vacutainer on a clean slide immediately after withdrawing the needle from the patient's arm. 3. Now fill the capillary tubes an additional 1/3 with blood from the large drop on the slide. Avoid getting an air bubble between stain and blood :'n the capillary tube. 4. Mix carefully by gentle inversion at least 60 seconds. 5. Place capillary tubes in a clean moist area at room temperature for 30 minutes. 6* After incubation for 30 minutes, prepare a blood film from the blood/scain mixture in capillary tubes and allow to dry thoroughly. Label and put in slide holder for shipment. BLOOD ANALYSIS 1. Caution: Read the manual steps carefully. They are written for two (2) separate conditions in order to insure a quality analysis. If you have access to a centrifuge, follow the instructions using the centifuge. If none is available, follow the clotting and serum collection procedures. 2. After centrifuged or clot separation method has been used, pour the serum into *tube labeled serum', affixing patient name upon the tube label. 3. Be certain the lab form is checked beside (SNA 23) blood chemistry. 4. Be certain that you have signed the authorization on the three-part lab form and that the original copy is included inside the lab kit mailing jacket. 5. Be certain to alert American Health Profiles at 615-356-6700 that the shipment is "in transit" in order to allow prompt processing and receipt of results. 6. Mail a second copy of the lab orders to AHP in order to insure computer capture of individual medical results. GLOOD SAMPLES SMAC (suggest minimum of 2 hours' fasting). CENTRIFUGE METHOD 1. Foliov: venipuncture technique. 2. Draw 1 15 ml. orange top tube (15 ml tube stored outside it itself). 3. Allow to stand at room temperature to clot approximately 30 minutes. A. Spin in centrifuge according to instructions. 5. Using a pipette, draw off serun as soon as possible, and place in serum tube -- label, snap top, wrap top with scotch tape. Replace tube in kit for mailing. WITHOUT CENTRIFUGE 1. Follow venipuncture technique. 2. Use 15 ml orange top tube to draw 15 ml blood. 3. Allow to stand at room temperature and to clot for at least one hour. 4. Locate (in kit) the plastic tube labeled (serum). 5. Carefully pour off the serun from *'* ^lotted sample, or use pipette to draw off serum into the serum tube, . label and replace top wrap with scotch tape. Replace full tube in kit for mailing. COULTER 7S HEMATOLOGY 1. Follow venipuncture technique. 2. Draw one 5 ml lavender top tube (if more than one specimen is going to be drawn, please draw this last). 3. Immediately place the 5 ml lavender top tube an the aliquot mixer and mix for 10 minutes. If no mixer, gently tilt tube from end to end for 2 minutes. Do not agitate; mix gently. 4. Do not refrigerate. MCD 000014092 URINE SAMPLING ( URINALYSIS: 1. One 10 ml specimen container, 1/4 preservative tablet. Make this a fresh sample. 2. Label container as instructed. 3. Refrigerate. UROBILINOGEN (qualitative): 1. One 10 ml specimen container, 1/4 preservative tablet. Fresh sampling. 2. May use urinalysis sample if both requested. UROBILINOGEN (quantitative): 1. Have the screenee empty his bladder at 2:00 p.m. and discard this sample. At 4:00 p.a., again have the screenee empty his bladder completely. Save the entire specimen and send to the lab as soon as possible. 2. Place specimen in brown container or protect from direct light. 3. If screenee is receiving antibiotics, please note this on lab slip. URINE PHENOL LEVELS "Spot: urine specimens of about 10 mL are collected as close to the end of the working day as possible. After thoroughly washing their hands with soap and water, workers shall collect urine samples from a single voiding in a clean, dry specimen container having tight closures. Following the collection samples are to be stored under refrigeration.* *N0TE: It is important that the urine specific gravity remain constant above 1.010. It has been recommended, to obtain better results, restricting oral fluids (to a minimum) for at least 8 hours prior to collection of specimens. See Emergency Benzene urine instructions this manual. MCD 000014093 fiwm .a ...... ........... ..... in f .lAf/LHiCAN HEAiJH ali_i LiLilPfiQl ILLS, INC. Employee Name: Company: Date Shipped: PRE-EMPLOYMENT KITS Employee I.D. V: Location: Shipped Via: Date of Specimen: Medical Procedures Ordered: ( | SMA 12/60 (calcium, alkaline phosphatase, inorganic phosphorous, glucose, cholesterol, total protein, albumin, total bilirubin, LCH, SGOT, uric acid, BUN) SMAC (calcium, phosphorus, glucose, BUN, uric acid, cholesterol, sodium, potassium, chloride, creatinine, protein, osmolality, albumin, total bilirubin, direct bilirubin, indirect bilirubin, alkaline phosphatase, LDH, SGOT, GGTP, SGPT, globulin, A/G ratio) | | Coulter 7S (white blood count, hemoglobin, packed cell volume, red blood count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration) | | Urinalysis (character, specific gravity, pH, microscopic examination, sugar, protein, ketones, occult blood, white blood cells, bacteria) I | Differential with platelet count Reticulocyte Slide I I Other Authorized by:_________ Prepared by:____________ whii*-ihi* copy to b* mai to; American Health Profiles P. O. Box 50237 Nashville, Tennessee 37205 Canary-thla copy to b* Included In lib hitPlnk-thla copy to tx rtinod for your modlcol roeordt- Call 615-356-6700 with shinning number Signature Signature Form No. F-G4 MCD 000014094 SHIPPING LAB SPECIMENS MOD 000014095 SHIPPING LABORATORY SPECIMENS 1. Be sure all slides, serum tubes, or urine bottles are correctly collected (according to the provided manual) and that each tube, bottle, or slide has the employee identification number firmly affixed to the container or slide before closing the kit. Please use indelible ink or typewritten labels to place the I.D. numbers on the labels and cover with scotch tape. 2. The mailing kit is insulated to keep the contents at a constant temperature. 3. Use only the serum tubes, slides, and urine bottles provided in each kit. This kit is designed to hold these containers firmly in shipment. 4. When the kit for each day's testing is full, or the testing for that day has been completed, prepare for shipment and take to the nearest airport for prompt ship ment to the laboratory -- either by Federal Express, Air Freight or Special Delivery Mail. 5. Wrap container with strong tape, going around container completely on all four corners securely. 6. Address carton with complete mailing address and return address. State to "Hold for Pickup11 if sent Air or Federal Express. Place "RUSH - HUMAN BLOOD" labels on side of container. 7. Specimens must be shipped by the fastest service available. 8. Please notify our office of need for shipping instructions and contact us after samples are in transit. 9. Blood is to be packaged as directed and shipped immediately to: to lab as indicated Each shipment should be clearly marked: NOTIFY ON ARRIVAL Lab as indicated (Again -- "RUSH - HUMAN BLOOD" stickers should be on each side of the package). 10. If several lab kits are to be mailed, they may be sent via Air Express, etc. in one single cardboard carton. (a) Carton must be packed securely so that kits will not be jarred or damaged. (b) Carton should be wrapped securely with packaging tape around all four corners and sides of box. (c) Carton is to have address & return address clearly printed on one side of box. (d) "RUSH - HUMAN BLOOD" stickers should be on all sides of box. (e) Notify our office of shipping details and arrival times. 7 OVERLAP-------------- - - - /< i ', .r >. / OOOOl^Qgg