20th posting~~

Hi again. This will be the last posting for my group about our SIP experience. This time, I will be talking about a particular new shift that I was assigned to a few weeks ago. It was called Corporate and Polyclinic section or CP for short. The shift starts at 10am and will finish at 7pm, with my lunch break at 2pm instead of the normal 1pm.

As I was new in doing that shift, I was asked to observe how the workflow is. For the poly samples, I was told that there are a total of 3 batches of samples that is sent every day. The first batch usually comes before 11am, the second batch after 1pm and the third one before 5pm. And for each batch, we would receive samples from 3 polyclinics. They are Bukit Batok, Chua Chu Kang and Jurong. Now let me explain the workflow.

The moment the samples arrive at the lab, the deliveryman will tell the poly clerk in-charge the maximum and minimum temperature of the samples. The poly clerk will take down the temperatures together with the time delivered. The poly clerk will then check that the samples sent matches with the ones that are in the form. After that, the clerk will have to ‘ech’ the specimens into our lab system. ‘ech’ is simple a method we use to manage the samples sent by the poly. It is necessary to ‘ech’ all the samples first before running them as if not, the machine would not recognize the sample and it would not run. After that, the samples are then passed on the med tech doing the CP shift.

The poly usually sent the samples either in plain, fluoride or edta tube. The plain tubes are usually used for the routine biochemistry tests. Thus, we just need to load the tubes into the MPA where all the pre-analytical processes like centrifuging will take place. It will then automatically run the samples into the adjacent machine called the swa or cobas. However, if the sample is insufficient, we will have to spin it down first using a centrifuge and then load it into mpa or swa. As for the fluoride tubes, we have to spin all of the tubes first before loading it into the machine. This is because if we load it into the mpa, the system is not able to transmit the result. For the edta tubes, we have to check if it is for type and screen or just for blood count. If it is for type and screen, we need to spin it down first before giving it to the blood bank section. If it is for blood count, we will straightaway pass it to the hematology section. The tubes are then archive into special racks. This is to make identification easier.

After each batch, the med tech needs to check the incomplete log for any incomplete test. If there is any not run tests, we need to locate the tube and run it again. That’s basically it for poly samples.

For corporate samples, it is only slightly different. Instead of ‘ech’, we need to order it as corporate screening samples. So, we are going to order the tests like how we order our in-house test. We just need to change the location to indicate where it came from. For example, those samples that came from the Institute of Mental Health, the location code is 1IMH. The corporate samples usually order the test in different packages. Therefore, instead of ordering each test one by one, we have a code that will include all the tests for that package. Thus, each package will have different code. We just need to make sure that we are ordering the correct packages as stated in the form. After ordering, the workflow from then on is similar to poly samples.

Then once again, the med tech needs to check the incomplete log for any miss out tests. After all the result is out, we need to print it out and sent it back to the companies together with the request form. And also, corporate samples will not be sent every day. It will only be sent on certain days as requested by the companies.

Hmm.. that’s basically the job of the CP person.

Toodles~

Done by: Nur Sofieyana
Class: TG02

Week 19 entry

Seems like just yesterday we've started the first of SIP and now we're left with one more week to go. YAY! =D

So now, i would like to share with all of you my experience of being posted into a Cytology Laboratory. The Cytology Laboratory in the Hospital that I am attached to makes use of Liquid-Based Cytology for the diagnosis of cervical cancer.

Collection of Specimen for Pap Smear Test

First, a broom-like device is inserted into teh endocervical canal of patient to allow the shorter bristles of the device to fully contact the ectocervix. teh device is gently pushes iand rotted in a clockwise direction5 times. then, the broom is rinsed into the PreserCyt® Solution by pushing the broom into the bottom of the vial for 10 times (Figure 1), at the same time forcing the bristles apart. Finally the broom is swirled vigorously to furthe release any material into the vial. The collection device is discarded and the vial is tightly capped, corrected, labeled with the sticky label and sent down together with the patient’s form, to the Cytology Laboratory.

Figure 1(Image taken from http://www.moondragon.org/obgyn/procedures/papsmear.html)


The Thin Prep Process

In the Cytology Laboratory, Pap Smears are prepared via Liquid-Based Cytology. Patients samples that comes in vials are processed using the ThinPrep 2000 Processor(Figure 2.).

Figure 2. (Image taken from websites.labx.com)


The process involves 3 steps:
1. Dispersion of cells in the vial.
2. Cell collection onto the filter.
3. Cell transfer from the filter onto a glass slide to produce thin layer of cells onto the glass slide. (shown in Figure 3)

Figure 3. (Image taken from http://www.moondragon.org/obgyn/procedures/papsmear.html)


After the Pap Smear is obtained on the glass slide, it is fixed in 70% alcohol for 20 minutes minimum and then stained using the Pap stain. Basically, the stains involved in the Pap stains are the Haematoxylin stain (used to stain nucleus of cells), Orange-G and EA-60 (cytoplasmic stains). after staining, teh slides are mounted with Depex, dried and then read by Cytologists.



Comparison of Conventional Method and Liquid Based Cytology

Originally, Pap Smears are prepared using the Conventional Method which had many disadvantages compared to Liquid Based Cytology. This is shown in the table below.









This is my last blog post for SIP and i hope all of you have benefitted from reading my blog posts =D.

byebye!

Raihana.