Portable Laboratory Kit [PLK 06]
Standard Operative Procedure Manual
WHO India- Armed Forces Medical Services
Portable Laboratory Kit
Chapter 1
INTRODUCTION
The standard operating procedures (SOP) are vital documents which are essential
components of quality system in any health care setting. These are used to ensure
consistency in performing an activity. Their use is recommended by all the staff members of a
laboratory every time they perform an activity.
The aim of this manual is to provide guidance on the minimum basic requirement and role of
a portable laboratory in clinical diagnostic services, disease surveillance including post-
disaster disease surveillance, outbreak investigation and public health survey.
Key to successful laboratory based surveillance lies in:
Right sample collection.
Right time to collect samples for disease surveillance.
Right methodology for transportation of sample.
Right laboratory to be chosen.
This manual will help laboratories to play an important role in post-disaster
disease surveillance in:
Proper sample collection, storage, handling and transportation
Laboratory testing using standard procedures
Presumptive/ confirmed diagnosis of a syndrome
o Acute diarrheal disease syndrome: cholera, bacillary dysentery, parasitic
diarrheas, rotavirus diarrhea
o Acute jaundice syndrome: viral hepatitis, leptospirosis
o Acute neurological syndrome: bacterial meningitis, dengue fever, Leptospirosis
o Acute/ chronic respiratory infection syndrome: diphtheria, tuberculosis, influenza
o Acute febrile illness: Malaria, typhoid, dengue
Water quality monitoring using rapid methods
Quality assurance, biosafety and waste management in a portable laboratory
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This manual is intended for use in a portable laboratory for field use in a post-disaster
situation. The language used has been kept as simple as possible. The manual describes
examination procedures that can be carried out using basic microscopy and other simple
apparatus and rapid diagnostic tools.
Each laboratory procedure has been comprehensively described along with the requirement
of material / equipments. Reagent requirements for each procedure, suitable tables, figures
and photographs have also been given along with each procedure wherever possible.
The manual describes procedures including sample collection, transport, referral and
testing, and underscores the need for biosafety, networking and data management. The
document is prepared in line with setting basic minimum lab requirements as part of the
post-disaster disease surveillance.
The laboratory turnaround time can be very critical & deciding in these emergency situations
which require a rapid response. Precious samples may get missed out and time lost in
mobilizing appropriate back-up laboratory support. The proposed portable laboratory should
be easily mobilized to the field, on the lines of WHO Emergency Medical & Surgical Kits
(EHA Kits), and be able to provide rapid diagnostic support for common outbreak prone
communicable diseases in a safe manner and maintaining reasonably good quality.
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Chapter 2
LABORATORY BIOSAFETY
International standards are rigid and it is not always possible though not impossible to
adhere to such guidelines in all situations. Good laboratory practices and technique,
however, are fundamental to laboratory safety. Important concepts to have lab safety in a
portable laboratory are listed below.
Entry / access to laboratory area
Entry to laboratory working area should be only for laboratory persons.
Doors to the laboratory should be kept closed.
No smoking, eating, or drinking is allowed in laboratory area.
Personal Protection
While working in the laboratory always wear lab coat and all other protective equipment
to conform to the guidelines of Universal Precautions.
Wear gloves for all procedures that may involve direct or accidental contact with blood /
infectious materials.
After use, gloves should be removed carefully without touching infected surface,
disposed off in container containing disinfectant solution. Hands should be washed with
soap & water.
Laboratory personnel must wash their hands after handling infectious materials/
performing test procedures and before they leave the laboratory working area. See
washing of hands procedure (Fig: 3.2)
Laboratory coat should not be worn outside the laboratory area
Eating, drinking, applying cosmetics and handling contact lens are strictly prohibited in
the laboratories.
Laboratory coat used/unused should not be placed in the same cupboard with street
clothes or food articles etc.
Lab personnel should receive suitable vaccination e.g. Hepatitis B.
General procedural precautions
Mouth pipetting must be strictly avoided.
Materials / articles must not be held in the mouth. Do not lick / wet labels for sticking.
All technical procedures should be such that they minimize the formation of aerosols
and droplets.
Do not use hypodermic needles and syringes for pipetting devices.
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All spills, accident or exposure to infectious materials, must be reported (only for
exposure to HIV infected) and a record should be maintained. Necessary immediate
action should be taken for disinfection, etc.
All needle-stick injuries should be recorded and reported.
Display written procedures for the clean up of all spills.
Laboratory working areas
Keep the laboratory area neat, clean and free of materials that are not required.
Decontaminate the working surface after any spill and at the end of the working day
using 1 % Sod. hypochlorite.
All contaminated materials, specimens, cultures, must be decontaminated in the
laboratory premises before final disposal or cleaning for reuse.
If there are windows in lab area, they should have arthropod/mosquito & fly proof mesh.
Procedure for clean up of all spills
Pour 1% freshly prepared sodium hypochlorite over spills in sufficient quantity
Cover the spills with paper towel or absorbent materials
Leave for 10 min
Clean it
Wipe up the whole spill with fresh absorbent material using gloved hands and
discard it in a contaminated waste container
Wipe the surface with soap and water.
Fig 3.1: Spill clean up procedure
Bio safety Management
Have one person responsible for bio safety activities: laboratory technician
Staff should be trained in laboratory biosafety
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Laboratory Equipment
Ensure that adequate equipment be provided and used properly.
Ensure regular maintenance and upkeep of the equipment (AMC, internal audit).
Essential biosafety equipments are
Pipetting aids to avoid mouth pipetting
Screw capped tubes and bottles.
Autoclaves to decontaminate infectious material wastes.
Plastic disposable Pasteur pipettes, when ever possible should be used.
Equipments should be validated before being taken for use and then revalidation should
be done at regular intervals.
Training
Human error and poor techniques are important in non protection of laboratory workers.
Thus training is important. Staff training should include safe methods adopted for commonly used
laboratory procedures like:
Inhalation risks: using loops, streaking agar plate, pipetting, smear preparation, opening
culture stocks, centrifugation, taking blood/serum samples etc.
Ingestion risks: handling specimens, smears, cultures.
Inoculation risks: accidental needle stick injuries.
Handling blood and other infectious agents.
Decontamination and disposal of infectious material.
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STEPS OF GOOD HAND
WASHING
PROTECTIVE BARRIER
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Chapter 3
LABORATORY WASTE MANAGEMENT
Laboratory waste:
Any thing which has to be discarded is called waste. The laboratory organisms require
appropriate handling. The most common documented transmission of infection from
waste to health care worker is through contaminated metallic waste. Laboratory waste is a
potential reservoir of pathogenic micro-organisms. Decontamination of waste and its ultimate
disposal are closely interrelated. Laboratory wastes are of different category & can be classified
as can be seen in Fig:-3.4
Fig:- 3.4 Classification of Laboratory Waste
Waste Management:
Material required
Waste disposal color coded bags with biohazard symbol. blue, red, black and
yellow.
Trolley baskets for holding the bags.
Autoclave for decontamination of waste on site.
Disinfectant solution (Sodium hypochlorite solution.).
Soap for hand washing and towel for drying hands.
Gloves.
Puncture proof containers plastic / metal with a biohazard symbol.
Chemical privy or some other method to disinfect sullage before disposal (instead
of direct disposal into a pit).
At every step starting from the site of generation of waste, follow the basic
principles of
Segregation.
Collection.
Transportation.
Storage.
Treatment to disinfect.
Final disposal.
Segregate waste into the prescribed categories at the point of generation.
Categories
All waste should be decontaminated (chemically/autoclaving) before final disposal/
reuse.
a) Non contaminated waste which can be reused or recycled, disposed off as
general house hold waste.
b) Contaminated sharps disposed off in puncture proof containers fitted with
cover, labeled as infectious.
c) Contaminated reusable materials for decontamination by autoclave, thereafter
washing and reuse/ recycle.
d) Contaminated disposable material for autoclaving & disposal.
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Table: TREATMENT AND DISPOSAL OF LABORATORY WASTE ACCORDING TO
CATEGORY
Color
Category of
Examples coding of Treatment & disposal
lab waste
bag
No pre cleaning to
be done.
Transfer material to
autoclave.
Contaminated
reusable
Autoclave at 121°C
infectious Reusable gloves, Petri-
Yellow / 15 lbs pressure
waste dishes, glass pipettes
for 45 minutes.
materials
If cleaning is
required, do
washing as
described & Re
use.
Needles, syringes,
Disinfection by
scalpels, blade, glass
chemical treatment
Waste Sharps etc. that may cause
Blue follwed by auto-
puncture and cuts. This
claving and deep
includes both used &
burial
unused sharps
Items contaminated
with blood and body
fluids including cotton,
Soiled Waste Incineration or
dressings, soiled Yellow
autoclaving
plaster, linen, other
material contaminated
with blood
Waste generated from Disinfection by
Soiled Waste disposable items other chemical treatment
(Disposables) than the sharps such Yellow follwed by auto-
as tubings, catheters, claving and deep
intravenous sets etc burial
Waste generated from
Disinfection by
laboratory and
Liquid Waste chemical treatment
washing, cleaning -
and discharge into
house keeping and
drains
disinfecting activities
Note:
Chemical treatment is done using at least 1% hypochlorite solution
or any other equivalent chemical reagent. It musts be ensured
that chemical treatment ensures disinfection.
There will be no chemical pretreatment before incineration.
Chlorinated plastics shall not be incinerated.
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Fig: Color coded bags
Methodology
Table: TYPES OF WASTE ITEM GENERATED IN A DIAGNOSTIC
LABORATORY
Section Waste item (s)
Sample collection vials, needles,
Sample collection
syringes, cotton swabs, lancets
Sample collection vials, test tubes,
glass bottles, saline bottles, plastic
bottles, testing containers, slides,
Bacteriology
infectious samples, bacteriological
medium with growth, culture plates,
blood, immersion oil and stains
Samples collection vials, blood, serum
Serology stored, tips, ELISA plates (TYPHIDOT
plates), reagents
Urine and stool containers, reagents,
Clinical pathology slides, filter papers, wooden sticks,
paper strips, chemical reagents
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Table: TREATMENT & DISPOSAL OF VARIOUS COMMON LABORATORY
WASTE ITEMS
Suggested method for treatment &
Waste item
disposal
Mutilate needle by using needle destroyer
Collect in a puncture proof container
Transfer to metal box
Sharps like needles, lancets Autoclave the metal box
Handover to a nearby central treatment
facility. If not available, then dispose in
burial pit/ landfill
Disinfect in hypo solution, discard in blue
Syringes
color bag
Discard in a yellow bag
Blood contaminated cotton
Autoclave
swabs
Discard as general non-infectious waste
collect in a stainless steel tray
autoclave directly in disposal autoclave
Culture in plates/ bottle in (holding time: 1 ½ hours at 15 lbs psi at
liquid or solid media with 121 degree C
bacterial growth empty the melted contents in a stainless
Specimens from patient steel bucket
wash & reuse reusable plastic/ glass
containers
autoclave
Glass slides
discard as sharps
decant carefully into a stainless steel
Infectious liquid waste
container
(post analysis blood/
autoclave in disposable autoclave
plasma/ serum; liquid
dispose in burial pit
waste following routine
liquid waste following routine washing can
washing procedure)
be discharged in the drain
sample vials with residual blood/ plasma
are discarded in buckets containing 10
liter of 1 % hypochlorite
Sample collection vials
immerse for 1 hour in hypochlorite
(blood/ serum/ plasma)
autoclave in disposal autoclave
wash & reuse reusable containers
drain residual hypochlorite into sink
Disinfect in 5 % Cresol / 10% formalin
Sample collection
discarded containers in hypochlorite
containers (urine & stool)
autoclave in disposal autoclave
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In the lab, the lab waste handling is an essential job which needs to be under
supervision of MO or laboratory technician. Broad guidelines to be followed are:
Segregate the different category of waste at the point of generation.
Discard infectious wastes (non sharp) if possible in disinfectant solution or
autoclave to render it non-infectious.
Discard sharp waste i.e. needles, blades etc in puncture proof containers. After the
container is 2/3 filled, it should be autoclaved/ shredded and land filled for disposal.
If nothing is available for disposal deep bury (as per standard guidelines) in a
secure area.(INCLUDE STANDARD GUIDELINES FOR DEEP/ SAFE BURIAL)
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CHAPTER - 4
COLLECTION, TRANSPORT & STORAGE OF CLINICAL SPECIMENS
GENERAL BIOSAFETY MEASURES
Use disposable gloves wherever required, while collection of clinical specimen
Wear laboratory coats while collection & handling of specimens, wherever required
Use protective eye or face shields if procedure is likely to generate aerosols l All
laboratory waste should be handled with care to avoid injuries from sharps
As far as possible, manual handling of waste should be avoided
The waste should be placed in appropriate leak-proof biohazard bags and
autoclaved before disposal.
The clinical samples should be processed only in designated laboratory having the
proper containment facility.
BLOOD SPECIMEN COLLECTION
Blood and separated serum are the most common specimens taken to investigate
outbreaks of communicable diseases. Whenever possible, blood specimens for culture
should be taken before antibiotics are administered to the patient
Venous blood sample
Materials required
Skin disinfectant: 70% alcohol
Sterile screw-cap tubes, blood
(isopropyl alcohol, ethanol) or 10%
culture bottles (50ml for adults,
povidone iodine, swabs, gauze
25ml for children) with appropriate
pads, band aid --- sterile packaged
media where ever required.
cotton swabs.
Disposable latex gloves Labels.
Tourniquet and sterile disposable
Disposable bags for waste
syringes and needles
Hypochlorite solution
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Fig: Venepuncture for collection of blood sample
Method of collection
Let patient be seated comfortably.
Place a tourniquet above the venepuncture site. Palpate and locate the vein.
Disinfect the venepuncture site meticulously with 10% povidone iodine or 70%
isopropyl alcohol by swabbing the skin concentrically from the centre of the
venepuncture site outwards. Let the disinfectant evaporate. Do not re-palpate the
vein. Perform venepuncture and collect required quantity of blood.
Remove the tourniquet. If collection is done for blood culture, withdraw the needle
and then apply swab on skin. Apply pressure to site until bleeding stops, and apply
band-aid (if desired).
Using aseptic technique, transfer the specimen to sterile sample collection bottle.
For blood culture bottles, swab the top with 70% alcohol, flame it and then
inoculate the blood in the bottle through the hole in the cap. Secure caps tightly.
Blood should not be squeezed through the needle.
Label the tube, including the unique patient identification number, using permanent
marker pen.
Do not recap used sharps. Discard directly into the sharps disposal container or
destroy using a needle destroyer as per the procedure.
Complete the case investigation and the laboratory request forms using the same
identification number.
Do not use wet tubes / bottles for collecting blood or push through the needle as it
leads to hemolysis.
Handling of blood samples
Keep blood culture bottles and blood sample tubes upright and secured in a screw
cap container or in a rack in a transport box at room temperature.
Cushion or suspend bottles during transport over rough terrain to prevent lysis of
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red cells. Place enough absorbent paper around them to soak up all the liquid in
case of a spill.
Blood sample bottle should be kept undisturbed at room temperature for 30 to 45
minutes to prevent lysis.
SEPARATION OF SERUM FROM BLOOD
Additional materials required
Sterile Pasteur pipettes and bulb, or
disposable Pasteur pipettes. The latter are
easier to handle and can easily be disposed
of in the field laboratory. Sterile screw-cap
tubes - 2 per sample (preferably 5ml vials).
Keep it at 4 to 8°C for the clot to retract for a
minimum of 1 to 2 hours. It can be stored at
this temperature for 48-72 hours till serum is
separated.
Remove the clot aseptically using sterile
Pasteur pipette and centrifuge the Fig: Sterile test tube for
supernatant at low speed (1500 rpm for 5-10 blood/ serum collection
minutes) to remove residual blood cells.
Clear portion/ serum may be aliquoted. Ensure that the centrifuge is in good
condition and the tubes are properly closed and balanced to avoid breakage and
spilling.
In case a centrifuge machine is not available, and there is likely to be a delay
before samples can be transported to a laboratory, allow 4-6 hours to elapse after
taking the blood sample to ensure adequate clot retraction. Using the Pasteur
pipette, remove the clear yellow serum whilst taking care to keep the tip as far as
possible from the clot, and avoid agitating the blood tube during the removal
process. Transfer to plastic screw cap tubes and secure caps tightly.
Label the tubes with the same patient details that appear on the blood sample
tube.
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Fig: Separation of serum from clotted blood sample
Sera may be stored at 4-8°C for up to 10 days. If the serum needs to be stored for
weeks or months before processing or sending to other lab, then keep in freezer
compartment of refrigerator.
Do not freeze un-separated blood samples to avoid hemolysis.
CAPILLARY BLOOD SAMPLE (FINGER-PRICK, EAR LOBE, AND HEEL PRICK)
Materials required.
Disposable sterile lancets , Glass slides, cover slips, slide
disinfectant (70 % alcohol), swabs box , Filter paper
Fixatives such as methanol.
Method of collection
Disinfect finger or thumb for adults, thumb for children, or side of heel for infants by
swabbing with 70% isopropyl alcohol, and prick with a sterile lancet. Wipe away
the first drop of blood.
Discard used lancets directly into the sharps disposal container.
Collect blood directly onto labeled glass microscope slides and/ or filter paper
(Whatman No. 3 with circle of 18mm diameter). When collecting on a filter paper,
ensure that the pre-marked area is completely soaked with blood on both the
sides.
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Fig: Making of thick and thin smears
Method of preparation of blood films
Blood films should be made by trained personnel. They can be prepared from
heparinized or EDTA blood specimens sent to the laboratory.
Thick films for microscopy
Disinfect and prick site with a lancet as described above.
Take one or more large drops of blood onto the centre of the slide making sure that
the slide does not touch the skin.
Spread the blood in a circle about 1 cm in diameter using the corner of another
glass slide.
Air-dry the film in a horizontal position. Do not dry the film by heating over a flame
or other heat source.(See FIG). Label the slide with patient identification number
and name.
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Thin films for microscopy
Take another drop of blood to the glass slide about 2 cm from one end making
sure that the slide does not touch the skin.
Place the slide horizontally on a flat surface.
Hold the side of a second clean glass slide (the spreader) on to the center of the
specimen slide and move it back until it touches the drop and the blood spreads
along its base.
At an angle of about 45°, move the spreader firmly and steadily across the
specimen slide and air-dry the film quickly. Do not dry over a flame or other heat
source.
Label the slide with patient identification number and name.
Fix the dried film by dipping the glass slide in methanol for a few seconds and air
dry.
Handling and transportation
Transport air-dried and/or fixed films at ambient temperature preferably within 24
hours of specimen collection. Do not refrigerate. Thick and thin films should be
kept in separate slide boxes.
CEREBROSPINAL FLUID (CSF) SPECIMEN
CSF is used in the diagnosis of viral, bacterial, parasitic, and fungal meningitis. The
specimen must be collected by trained and experienced personnel only. The MO
incharge or the laboratory technician should request the appropriate authorities for
such a procedure. All CSF samples should be transported at room temperature
except for viral isolation when the sample must be transported under cold chain.
Fig: Collection of CSF sample
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STOOL SAMPLE COLLECTION
Stool specimens are most useful for
microbiological diagnosis if collected soon after
onset of diarrhea (for most viruses 99 %
Principle
HEPACARD is a one step immunoassay based on the antigen capture, or "sandwich"
principle. The method uses monoclonal antibodies conjugated to colloidal gold and
polyclonal antibodies immobilized on a nitrocellulose strip in a thin line.
Procedure
Test is done on serum or plasma.
Take the HEPACARD device from the pouch. Reseal the pouch.
Label the test card with patient’s name.
Add 2 drops (70ul) of serum or plasma into the sample well using the dropper.
Separate dropper to be used for each sample.
Allow reaction to occur for 20 minutes.
Read the result. Appearance of two pink lines one in test ‘T’ area and one in
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control ‘C’ area is reported as REACTIVE. Difference in intensity of colour between
test and control may be present depending on the concentration of the HBSAg in
the test sample. When only one pink line develops in control ‘C’ area it is reported
as NON-REACTIVE. When no line develops the test is INVALID.
Discard all the materials and sample into the discarding jar.
Interpretation of result
Reactive:
Appearance of pink colored line, one each in test region ’T’ and control region ‘C’
indicates that the sample is REACTIVE. A difference in intensity of color may occur
between the Test line and Control line depending on the concentration of the
HBsAg in the serum but this does not affect the interpretation of the result.
If the concentration of HBsAg in the sample is very high, only test line may be
observed. This is due to Hook’s effect. Such samples should be diluted 1:10 or
1:20 in normal saline and again re-run the test. Diluted sample should show both
control and test line.
Non-reactive:
Appearance of one distinct pink line in the control region C only, indicates that the
sample is NON-REACTIVE for HBsAg
Invalid:
When neither control line nor the test line appears on the membrane, the test
should be treated as INVALID
Precautions
Handle all specimens as infectious agents
Do not open the foil pouch to remove the product until it attains room temperature
and you are ready to perform the test.
Reseal the pouch with clamp and rod: fold the pouch with the help of rod and insert
the clamp from one edge of the pouch and move it along the complete rod length
to reseal the pouch
The HEPACARD should not be frozen and must be protected from exposure to
humidity.
Interpret the result at the end of 20 minutes only
HEPACARD should be stored at 2-80 C in the coolest and driest area available. It
has a shelf-life of 15 months from the date of manufacturing.
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Plasmodium falciparum ANTIGEN DETECTION TEST (Parachek-F):
Parachek-F is a qualitative rapid test for diagnosis of P.falciparum malaria. The test
detects the presence of Pf HRP-2 (P. falciparum histidine rich protein 2) and is
based on immunochromatographic principle.
Components
25 hermetically sealed pouches containing
1 test
1 silica gel sachet
1 sample loop, 5ul
Reagent- one dropper bottle of clearing buffer
25 alcohol soaked pads
25 single use lancets
Specifications
Rapid test (15 min) in 2 steps (application of 5ul blood and 300ul reagent i.e.6
drops)
Sensitivity 95.5%
Specificity 96%
Procedure
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Instructions for use
Can be carried out on capillary/venous blood
The gold standard must remain the thick drop and the smear Geimsa stained
The test does not give parasitemia. It only detects P. falciparum.
The test stays positive 7-12 days after smear negativation.
Attention while reading.70% mistakes are due to misreading
Storage
Store at room temperature (2-30º C)
Shelf life: 12 months
Not to be used beyond expiry date
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BACTERIOLOGICAL WATER TESTING BY H2S STRIP TEST
Waterborne pathogens can enter the drinking water systems through faecal
contamination. These include bacteria, viruses, protozoa and parasites. Testing a
sample of drinking water for all the pathogens is neither practicable, nor necessary. It
is sufficient to determine whether the water sample has been recently contaminated
with faeces and therefore with other pathogens. Such water is not fit for human
consumption. Bacteriological water quality monitoring thus helps establish the
potablility of water.
IN THE LABORATORY THERE ARE TWO SIMPLE PROCEDURES OF TESTING WATER
SAMPLES FOR FAECAL CONTAMINATION
Most Probable Number (MPN) method for coliform bacteria
H2S-Strip method: This is a simple, reliable and easy-to-perform,
‘Presence/Absence’ test for bacteriological quality, which works on the principle
that there is a close correlation between faecal contamination and the presence of
hydrogen sulphide (H2S) producing bacteria and, that faecal pollution of water can
be deduced by demonstration of H2S production..
Collection of specimens
Please refer to chapter 4
TEST PROCEDURE: (see Figure)
Pour the water sample to be tested for faecal pollution into the bottle, up to the pre-
calibrated level (20 ml).
Incubate at 37°C or allow standing at ambient temperature (30-37°C); for 24-36
hours. No incubator is necessary under field conditions, as the bottles can be held
in the pockets and body temperature can be made use of.
Fecal pollution is indicated if the contents of the bottle turn black.
Quality control:
Use sterile bottles for collection of water samples for bacteriological examination
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Ensure proper collection of sample as per the water source
Add sodium thiosulfate for chlorinated water supply
Advantages of H2S-Strip Test
No need to measure the volume of water to be tested;
No need to de-chlorinate the water sample, since it instantaneously de-chlorinates
the sample;
The end point (reading) is very clear, due to development of black colour; No
incubator is necessary;
The test starts immediately on collection into the bottle, unlike other methods which
start after the sample is transported and tested in the laboratory.
Disadvantages of H2S-Strip Test
In principle, does not conform to the conventional standards of bacteriological
testing of water samples.
At best, it is a screening test.
Purely qualitative, "PRESENCE- ABSENCE" test.
May not work in cold ambient temperatures.
WATER TESTING FOR RESIDUAL FREE CHLORINE (Ortho Tolidine test)
It is widely used for field measurements, using simple colour-match comparators, so that
testing can be done on site. Yellow colour (in different intensities, depending upon the
level of residual chlorine) is generated following the addition of ortho-toluidine to the
water sample and is matched against standard colored discs or tubes/ampoules
containing known standards of ortho-toluidine solution.
Several chloroscopes are available in the markets which are based on the same
principle as outlined above. The procedure should be followed as per the manufacturers
instructions. The procedure for one such chloroscope is described below:
New Water Chloroscope
Contents:
A plastic box with
In the front: Left side row of 5 standard filter discs of varied colour density to
compare the colour developed in the treated water after adding reagent, looking
through the right side row of inspection windows.
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In the rear: provided with a translucent sheet to allow uniform diffused light for the
comfort of the viewer
Inside: Built-in test tube holder with removable top lid, two glass test tubes - one for
the untreated water (blank) and the right one for the treated water. One 35 ml
HDPE dropper bottle of chloroscope reagent. (O-tolouidine)
Procedure
Remove the top lid
Fill the left side test tube with untreated water and insert it on the color disc side
Fill the right test-tube with water treated with chlorine solution or tablet
Add 3-4 drops of the reagent (OT) fro m the dropper bottle, shake well and replace
on the right side
Close the top cover and view against light.
Compare the color of the water being tested with standard color disc
Note the reading of matching disc. This value indicates residual chlorine in ppm
(parts per million) in the treated water.
If the yellow color in the treated water is darker than the highest standard colour
disc, then the residual chlorine in water being tested is higher that 2 .0 ppm. In
such cases treated water can be suitably diluted with plain water and residual
chlorine estimated as described above.
Under normal conditions the recommended value is between 0.2 to 1.0 ppm
Quality control
Clean the test tubes and other contents of the Chloroscope after each use and at
the end of the day
Keep the OT solution in dark-coloured bottle to avoid exposure to sunlight
Use known chlorinated and un-chlorinated water for positive and negative controls
for the kit ad its reagents.
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Fig: New water Chloroscope
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ESTIMATION OF HEMOGLOBIN (SAHLI’S ACID HAEMATIN METHOD)
Procedure
Fill Sahli’s haemoglobinometer tube with N/10 HCL, up to the graduation mark10.
Draw 20 microlitres blood using a micropipette (alternatively 0.02ml of blood with a
haemoglobin pipette).
Without delay, this blood is expelled and mixed thoroughly with the acid in the
haemoglobinometer tube. This acid solution is now repeatedly drawn and re-
expelled into the same haemoglobinometer tube till the last traces of blood are
removed from the Hb pipette used.
Wait for 10 minutes. This allows the conversion of haemoglobin into a brownish
coloured acid haematin. Now add distilled water carefully drop by drop, with
continued thorough mixing (by repeated inversion of the tube). This is continued
until the final colour developed perfectly matches with that of the colour of the
standard (a non-fading tinted glass).
Now hold the haemoglobinometer tube at eye level and read the graduation mark
figures (on either side of the tubes) corresponding to the lowest level of the
meniscus. These correspond of the haemoglobin marks on one side of the tube
show the haemoglobin level directly in gm/dl, whereas on the other side the
graduations are as a percentage (in Sahli’s method, a figure of 14.8 gm/dl is
considered equivalent to 100% haemohlobin).
Note
Acid haematin is not in a true solution and may precipitate. Maximum colour
develops in 10 min in adults and may take longer in infants. Colour developed is
affected by protein, lipid, bilirubin and carboxy haemoglobin.
Internal quality control:
Pipetting should be accurate.
Use micropipette for taking the sample. Wipe out the excess blood out side the
filter tip/pipette.
Avoid frothing and air bubbles.
Once a week put up test with cynmethhaemoglobin method using standard.
Once a week send two samples to district laboratory after the tests are done for
counter checking.
75 Draft SOPM Portable Laboratory PLK 06
ESTIMATION OF HAEMOGLOBIN (CYANMETHAMOGLOBIN (HICN) METHOD)
Normal range
Male: 13.5-18 gm/dl
Female: 11.5-16.4 gm/dl
Kit contents
Reagent 1: Drabkin’s solution
Reagent 2: Cyanmethhemoglobin standard (65 mg/dl)
Storage and stability
Drabkin’s solution to be stored at Room temperature
CMG standard in the refrigerator
Specimen
Whole blood/blood with anticoagulants like EDTA, heparin or oxalate
Procedure
Take 5 ml of Drabkin’s solution in a test tube and add 0.02ml of the test blood.
Stopper the tube with a rubber bung. Mix thoroughly by inverting the tube,
repeatedly.
Allow the tube to stand for 10 min (at room temperature).
The absorbance is measured, against the reagent blank, in the photoelectric
colorimeter at 540 nm
A vial of HiCN standard is then opened and its absorbance measured, at room
temperature in the same instrument in a similar fashion against the reagent blank.
Standard HiCN reference solutions are commercially available in 10 ml sealed
ampoules/vials. They contains 550 to 850 mgm of Hb/litre. Take separate readings
with the same reference standard solution diluted 1:2, 1:3, 1:4 etc, with the reagent
blank. The Lambert-Beer’s law is valid for HiCN. The reference solution is intended
primarily for direct comparison with the blood sample where the Hb is also
converted to HiCN. The standard must be kept in the dark when not in used and
any unused solution should be discarded at the end of the day.
Calculation
Hb (gm/I) – Abs. of test sample X Conc. Of Std X Dilution factor
Abs of standard 1000
It is usually convenient to calibrate the colorimeter to be used for
haemoglobinometry by preparing a standard curve or tube which will relate
absorbance to Hb concentration in gm/dl.
76 Draft SOPM Portable Laboratory PLK 06
Notes
The method is accurate and the standard solutions last for years, as these do not
fade.
However, the use of cyanide is a positive disadvantage. For safety, only automatic
pipettes should be used. No mouth pipetting should be done.
Disposal of reagents and samples in running water in the sink is advised.
Abnormal plasma proteins and a high leucocyte count may result in turbidity when
blood is diluted in Drabkin’s solution. This can be avoided by centrifuging the
diluted sample.
Internal quality control
Pipetting should be accurate.
Use micropipette for taking the sample. Wipe out the excess blood out side the
filter tip/pipette.
Avoid frothing and air bubbles.
Once a week send two samples to district laboratory after the tests are done for
counter checking.
77 Draft SOPM Portable Laboratory PLK 06
TOTAL WBC/ LEUCOCYTE COUNT (TLC)
The hypotonic acetic acid lyses the red cells; Gentian violet permits easy
identification of the fluid and renders WBCs more readily visible by staining their
nuclei lightly.
Procedures
Place a thick coverslip over the center of the counting chamber. If correctly and
firmly applied ends of the cover slip show ‘rainbow’ colours.
Take 0.38ml of WBC diluting fluid in a 75X10mm glass/plastic test tube.
Take 0.02 ml (20 microlitre) of blood into Hb pipette. Wipe the outer surface of any
excess blood. Add the blood into the diluting fluid.
Mix well for 2 minutes
Charge the counting chamber with fine tipped pasture pipette.
Place the chamber on to the microscope stage and allow cells to settle down for 2
minutes.
Survey the ruled area with 10 X objective for uniform distribution of cells.
Count all the WBCs in the four large squares of the Neubauer’s counting chamber.
Include the cells touching the top and right margins and omit those touching the
bottom and left margins of the squares.
Calculation:
WBC count: N x 50/mm3
Internal quality control:
Pipetting should be accurate.
Avoid frothing and air bubbles.
Once a week send two samples to district laboratory after the tests are done for
counter checking.
PLATELET COUNT
Procedure
Place a thick coverslip over the center of the counting chamber. If correctly and
firmly applied ends of the cover slip show ‘rainbow’ colours.
Using a siliconised syringe, blood is collected with a clean venepuncture, and
transferred into a Red top vacutainer containing EDTA as the anticoagulant.
78 Draft SOPM Portable Laboratory PLK 06
Take 9.9ml of the diluting fluid in a screw capped paraffin lined bottle/stoppered
tube. To it add 0.1ml (100 microlitres) of blood with a pipette (dilution 1 in 100).
Mix on a mechanical shaker for 10-15 minutes or by inverting several times.
Taking the due precautions, charge both sides of the chamber with this
suspension. Placed it in a moist Petridish (improvised by putting well blotting paper
at the bottom) for at least 20 minutes. This allows the platelets to settle.
Examine with a 40 objective. Platelets appear as highly retractile small (but not
minute) plate blue particles.
Count all the plates in one or more of the large squares (1mm). The total number
of platelets counted should always exceed 200. Counting is facilitated by using a
phase contrast microscope or alternatively a light microscope with the condenser
racked well down, may be used.
Calculation
Platelet count = N X D
V
N= Total no, of platelets counted,
V= Volume of one large square = 1mm X 1mm X 0..1mm = 0.11 mm
D= Dilution (100)
Platelet count=N x100=Nx10x100
0.1
Note
Errors in count appear to be high even in the hands of most experienced workers.
These can be minimized by careful regard to detail, particularly with respect to
cleanliness of the preparation.
Internal quality control
Pipetting should be accurate. Glassware should be clean.
Use micropipette for taking the sample. Wipe out the excess blood out side the
filter tip/pipette.
Avoid frothing and air bubbles.
Once a week send two samples to district laboratory after the tests are done for
counter checking.
79 Draft SOPM Portable Laboratory PLK 06
LEISHMAN’S STAIN
Procedure
Place the air-dried smear, smear side upon a staining rack (two parallel glass rods
5cm a part).
Using a “marked” Pasteur pipette cover the entire smear by “pouring” one volume
of undiluted Leishman’s stain. Allow to stain for1/2-1 minute. The methyl alcohol in
the stain, fixes the smear.
Using another separate “marked” Pasteur pipette dilute the poured stain by adding
two volumes of buffered distilled water (best guide is the appearance of a metallic
scum). Mix by gently blowing over the slides. Allow to stain for 7-10 minutes.
Without disturbing the slide, wash with a gentle stream of buffered distilled water
until the thinner parts of the smear are pinkish-red (upto 2 min).
Wipe the reverse side of the slide. Set it upright in a rack, to air dry.
Notes
The final colour of the smear should be bluish pink.
Even a trace of water getting into the bottle of stain spoils it, hence it is essential to
keep an exclusive “marked’ Pasteur pipette for pouring the stain.
Sometimes the smear is over stained or is covered with excessive precipitate of
the stain. To rectify this, pour a small amount of the undiluted stain over it and
immediately was with buffered distilled water.
80 Draft SOPM Portable Laboratory PLK 06
ABO AND RH BLOOD GROUPING (MONOCLONAL ANTIBODY SLIDE TEST)
Principle
Human red blood cells possessing A and/or B antigen, D (rho) antigen will agglutinate
in the presence of antibody directed towards the antigen
Sample collection and storage
Anticoagulated blood
Reagents
Anti-A, anti-B and anti A, B, anti-D (Rho) – ready to use reagents prepared from
supernatants of mouse hybridoma cell cultures
Procedure
Bring reagents to room temperature before testing. Mark four circles with a glass
marking pencil on a glass slide.
Place one drop each of Anti A, Anti B, Anti AB and Anti D on a glass slide.
To each add a small drop of whole blood.
Mix well with mixing sticks.
Rock the slide gently taking care that the reagents do not mix up.
Observe agglutination at two minutes.
Report the blood group.
Internal quality control:
Use clean slides.
When there is doubt about the agglutination check in the microscope. If roulex
formation causes confusion add two drops of saline and rotate the slide.
Rh negative group should always be confirmed by Coombs test and the advice
should be remarked in the report.
81 Draft SOPM Portable Laboratory PLK 06
ESTIMATION OF SERUM BILIRUBIN (SPAN Diagnostics)
Principle
Direct (conjugated) bilirubin couples with diazotized Sulfanilic acid forming Azobilirubin,
a red purple colored product in acidic medium. Indirect: (unconjugated ) bilirubin is
diazotized only in the presence of its dissolving solvent(methanol).thus the red-purple
colored azobilirubin produced in presence of methanol originates from both direct and
indirect fractions. The difference of total and direct bilirubin gives Indirect
(unconjugated) bilirubin.
Sample
Serum samples must be kept away from both artificial and sunlight during processing
and storage. (Dark paper wrapped around the tube to avoid deterioration)
Reagents (supplied in the kit)
Reagent 1: Diazo A
Reagent 2: Diazo B
Reagent 3: Diazo Blank
Reagent 4: Methanol
Reagent 5: Artificial Standard (= 10 mg% Bilirubin)
Preparation of working solution
Diazo Reagent: Just before use, mix 1.0ml of Reagent 1 with 0.030 ml of reagent2
Reagent storage
All reagents stable at room temperature. Reagent 2 to be kept at 2-8 º C after opening.
Diazo reagent should be prepared fresh with each sample assay.
Procedure
Mark the tubes D 1 (Direct), D 2 (Direct blank), T 1 (Total), T 2 (Total blank). T 1 & T 2
should be kept under dark during the assay.
T1 T2 D1 D2
Serum/plasma, ml 0.1 0.1 0.1 0.1
Dist water, ml 0.9 0.9 0.9 0.9
Reagent3: --- 0.25 --- 0.25
Diazo Blank, ml
Diazo reagent, ml 0.25 --- 0.25 ---
Dist water, ml --- --- 1.25 1.25
Reagent 4 : 1.25 1.25 --- ---
Methanol, ml
Read OD of Reagent 5 [Artificial standard (=10 mg% Bilirubin)] against dist water.
82 Draft SOPM Portable Laboratory PLK 06
Discard Standard after use.
Calculation
Total Bilirubin in mg/100 ml (A): OD of T 1 – OD of T 2/ OD of Standard X 10
Direct Bilirubin in mg/100 ml (B): OD of D 1- OD of D 2/ OD of Standard X 10
Indirect Bilirubin in mg/100 ml: (A) – (B)
Normal values
Adults: Total bilirubin: 0.2-1.0 mg/100 ml of serum/plasma
Direct bilirubin: 0.0-0.2 mg/100 ml of serum /plasma
Internal quality control
Patient’s identification marking and test tube marking should be clearly marked.
Pipetting should be accurate. Glassware should be clean.
Always put up standards with each batch of tests. Testing of abnormal control
serum should be put up every week and record be maintained.
Send two samples a week to District laboratory for checking.
83 Draft SOPM Portable Laboratory PLK 06
ESTIMATION OF SERUM CREATININE (SPAN Diagnostics)
Principle
Creatinine in a protein free solution reacts with Alkaline Picrate and produces a red
colored complex, which is measured colorimetrically
Sample
Serum/ Plasma
Reagents
Reagent 1: Picric acid
Reagent 2: Sodium Hydroxide, 0.75N
Reagent 3: Stock Creatinine Standard, 150 mg%
Preparation of Working solution
Working Standard: dilute 0.1 ml of Reagent 3(stock creatinine standard) to 10 ml with
purified water and mix well. All other reagents are ready to use
Reagents storage
Stable at room temperature. Reagent 3 stored at 4-8 ºC after opening.
Procedure
Mark tubes Blank (B), Standard (S) and test (T) properly because markings tend to
come off when tubes are boiled
Deproteinize test sample by mixing 0.5 ml serum/plasma, 0.5 ml distilled water and
3 ml Reagent 1 (Picric acid). Keep in boiling water bath for 1 min only and
immediately cool under running tap water and centrifuge. Use the sample filtrate/
supernatant.
Blank (B) Standard (S) Test (T)
Supernatant --- --- 2ml
Working standard --- 0.5 ml ---
Dist water 0.5 ml --- ---
Reagent 1: Picric
1.5 ml 1.5 ml ---
acid
Reagent 2 (0.75 N
0.5 ml 0.5 ml 0.5 ml
Sod Hydroxide)
Mix well & Mix well & keep
keep at room Mix well & keep at at room temp
temp for 20 room temp for 20 for 20 min
min exactly & min exactly & exactly &
measure OD measure OD measure OD
against dist against dist water against dist
water with with green filter water with
green filter green filter
84 Draft SOPM Portable Laboratory PLK 06
Calculation
Serum creatinine in mg/ 100 ml: OD of T – OD of B/ OD of S – OD of B X 3
Normal values
Serum creatinine: Men: 0.9-1.4 mg/100ml
Women: 0.8-1.2mg/100ml
Internal quality control
Patient’s identification marking and test tube marking should be clearly marked.
Pipetting should be accurate. Glassware should be clean.
Always put up standards with each batch of tests. Testing of abnormal control
serum should be put up every week and record be maintained.
Send two samples a week to District laboratory for checking.
85 Draft SOPM Portable Laboratory PLK 06
ESTIMATION OF SERUM / PLASMA UREA (SPAN D)
Method
DAM method
Principle
Urea reacts with hot acidic Diacetylmonoxamine in presence of Thiosemicarbazide
and produces a rose-purple colored complex, which is measured colorimetrically
Sample
Serum or plasma (0.01 ml is required): (do not use anticoagulants containing
ammonium salts)
Reagents (supplied in the kit)
Reagent 1; Urea reagent
Reagent2: Diacetylmonoxime (DAM)
Reagent 3: working urea standard, 30 mg%
Preparation of working solution
Solution1: Dilute 1ml of Reagent 1 to 5ml of Reagent 2 with purified water
Reagent 2 and Reagent 3(standard) are ready for use
Storage
Stable in refrigerator. Freshly prepare solution 1 (1 ml of Reagent 1 with 5 ml of dist
water)
Procedure:
Mark tubes as Blank (B), standard (S) and test (T).
Blank (B) Test (T) Standard (S)
Solution 1 2.5 ml 2.5 ml 2.5 ml
Sample --- 0.01 ml ---
Reagent 3 --- --- 0.01 ml
(working Mix well Mix well Mix well
standard)
Reagent 2 0.25 ml 0.25 ml 0.25 ml
(DAM) Mix well & keep in Mix well & keep in Mix well & keep in
boiling water for 10 boiling water for boiling water for
min exactly, cool for 10 min exactly, 10 min exactly,
5 min in running tap cool for 5 min in cool for 5 min in
water, mix by running tap water, running tap water,
inversion mix by inversion mix by inversion
Measure OD with Measure OD with Measure OD with
green filter green filter green filter
Calculation
86 Draft SOPM Portable Laboratory PLK 06
Serum/Plasma Urea in mg/100 ml: OD of T/OD of S X 30.
BUN in mg/100 ml: Urea X 0.467
Internal quality control
Patient’s identification marking and test tube marking should be clearly marked.
Pipetting should be accurate. Glassware should be clean.
Always put up standards with each batch of tests. Testing of abnormal control
serum should be put up every week and record be maintained.
Send two samples a week to District laboratory for checking.
Normal values
Serum: 20-40 mg Urea (10-20mg Urea Nitrogen) /100ml
87 Draft SOPM Portable Laboratory PLK 06
ESTIMATION OF SERUM GLUCOSE (SPAN Diagnostics)
For in vitro quantitative determination of Glucose in human serum/plasma
Reagents
Glucose reagent
Glucose diluent
Glucose standard
Glucose standard
Working reagent preparation
Prepare working glucose reagent by dissolving Reagent 1 in Reagent 2 and keep in
amber colored bottle in refrigerator.
Storage
Reagents 1, 3, 4 in refrigerator
Reagent 2 at room temperature.
Procedure
Mark tubes as Blank (B), Standard (S) and Test (T).
Blank (B) Standard (S) Test (T)
Serum/ Plasma --- --- 20 micro ltr
Reagent 3 --- 20 micro ltr ---
Working glucose 1500 micro ltr. 1500 micro ltr. 1500 micro ltr.
reagent Mix well Mix well incubate Mix well incubate
incubate at 370 at 370 C for 10 at 370 C for 10
C for 10 min or min or room temp min or room temp
room temp for for 30 min for 30 min
30 min
Dist water 1500 micro ltr 1500 micro ltr 1500 micro ltr
Adjust Adjust colorimeter Adjust colorimeter
colorimeter with with reagent with reagent
reagent blank blank blank
Read OD at 490- Read OD at 490-
550 nm 550 nm
Calculation
Serum/ Plasma glucose in mg/dl: OD of T/ OD of S X 100
Reference range
Fasting 65-110 mg/ dL
Post Prandial 5 days of illness)
Typhi Dot (>7 days of illness)
Leptospira Dri Dot (>7 days of illness)
Paracheck/ HRP II kit (Plasmodium
falciparum)
Serum to be stored for measles
serology, if typical rash present
clinically
Tests on whole blood
Inoculation of blood culture bottle and
incubation at 37 deg C
98 Draft SOPM Portable Laboratory PLK 06
Algorithm for acute diarrheal diseases
Acute Diarrheal Diseases
Without blood in stool Bloody diarrhoea
If food Direct microscopy Differentiate between
poisoning o Hanging drop amoebiasis and bacillary
suspected, preparation dysentery
collect and o Parasitic ova and Gross examination
store food cysts Direct microscopy
samples, Direct test: latex o Pus cells/
faeces and agglutination for rotavirus RBCs
vomitus (in children 8 times above
normal) and mild elevation of alkaline phosphatase (usually only 3 times
above normal).
2. Exclusion of non-viral causes of acute hepatitis(e.g. Leptospirosis, drugs,
anti-tubercular drugs, toxins, non-specific injury)
Laboratory analysis of specimens from the first few suspected cases during
the outbreak is important to confirm diagnosis. Once the hepatitis is confirmed, it
is not necessary to examine specimens from all cases or contacts.
Sample collection and transport
Refer chapter 4 for details on collection and transport of a serum sample.
Epidemiologically important information
Source of drinking water
Storage of drinking water
Method of drawing drinking water
Type of latrine
Hand washing after defecation/ before meals
Symptoms present
Any treatment taken
Any family members with jaundice
Any history of jaundice before this episode
Hospital admission due to any cause
Any history of multiple injections/extramarital sexual contact/contact with a case in the
community/tattooing/blood donation/any chronic illness
Diagnostic capacity of portable lab in case of hepatitis
1. Serum Bilirubin
2. Serum sample collection and transport for Hepatitis A/Hepatitis E
3. Rapid diagnostic test for hepatitis B (HBsAg)
4. Rapid diagnostic test for Leptospira
109 Draft SOPM Portable Laboratory PLK 06
110 Draft SOPM Portable Laboratory PLK 06
INSTRUCTION MANUAL FOR KIT A
1. Portable lab Kit A comprises of Physical structure which can be assembled, used
and dismantled if required to be carried to another place (Fig 1). The inner dimensions
of the structure are 15’ long, 11’ wide and 8-9’ height.
Figure1
2. The structure has three main components: Base, Wall panels and Roof panels.
3. Base: Base comprises of four pieces of iron grids with support beams (Fig 2&3).
Figure 2
Figure 3
4. Each corner of the base piece has 2’ iron support pillar at the corner on which the
four corner pillars are slid (Fig 4) to support the wall panels.
Figure 4
111 Draft SOPM Portable Laboratory PLK 06
5. On the base pieces along the four sides are U-channels (Fig.5) into which wall panels
are slid (Fig. 6&7).
Figure 5 Figure 6
Figure 7
6. Wall panels: There are 14 wall panels numbered serially, top and bottom marked.
Panels are made of steel sheet on both sides with 10 cm compressed insulating material.
All the panels interlock into each other and into corner pillars. Ten panels are of one size
(11.7 M wide, 2.7 M height & 10 cm thick) and four are shorter (11.7 M wide, 2.55 M height
& 10 cm thick) for the roof slope. The numbering starts as 1 from left of the door facing the
base and ends as 14 at the right side of the door (Fig 8).
Figure 8
112 Draft SOPM Portable Laboratory PLK 06
7. Two of the panels have aluminum windows (Fig 9&10) fixed with acrylic sheet
inside. One of the windows is for Air-conditioner (Fig 9).
Figure 9
Figure 10
8. After all the wall panels are erected; U-channels are put on the top of the wall panels
and fixed with screws to the panels and into corner pillars.
9. Roof panels: There are 4 roof panels (Fig 11) each measuring 0.95 M wide, 5.2 M
height and 50 cm thick). Outer surface of the roof panels is corrugated for faster
drainage of rainwater. Roof panels are slid over the roof and fixed with screws to the
wall panels.
Figure 11
10. Angles: The angles are for covering the exposed panel ends and corners. These
are fixed to both ends of roof panels, corners at support pillars out side and inside.
These flashings give sealing at corners.
11. Door panel has a top piece, which should be slid into both sidewall panels. Door is
to be screwed to the right wall panel provided with doorframe.
113 Draft SOPM Portable Laboratory PLK 06
Portable Laboratory
The portable laboratory has been designed to cater for the needs of medical teams,
surgical teams and epidemiologists working in post disaster disease surveillance in
disasters. To start with the designing process started with the only requirement of
laboratory for disease surveillance. It was felt during the expert committee meetings
and subsequent field trials that there was a need of a more comprehensive laboratory.
Though very essential, a laboratory catering to surveillance or screening for diseases
alone may be unacceptable by the public in general and hence may be combined with
other components like distribution of medicines forming a part of medical teams. This
is more so in disaster situations where the need of a laboratory is essential for the
medical/ surgical teams operating in the field. Hence by adding few equipments and
consumables the laboratory becomes a comprehensive one in this regard.
Laboratory components
Kit A: Portable physical structure
Kit B: Equipments
Kit C: Consumables
All three components may not always be required. If a suitable permanent building is
available, Kit A may not be required to be carried in which case only Kit B and Kit C
are required. If a permanent building and essential equipment and power supply
already exist, only the Kit C is required to be carried. This versatility makes this lab
feasible in varied settings.
Capabilities
The laboratory can provide support for one month and for any length of time with
replenishment of consumables. The lab has the flexibility of being a basic
comprehensive lab or a post disaster disease surveillance lab or only as a clinical
lab.
The usefulness of the lab may be to:
Provide infrastructure for epidemiological investigating teams to collect, store
and dispatch clinical samples.
Strengthening the existing peripheral laboratory.
Provide screening tests for syndromic approach of investigation.
Basic hematological tests.
Basic clinical chemistry tests.
Blood grouping and cross matching and screening tests for blood transfusion.
Bacteriological cultures.
Serological tests.
Requirements of Manpower
Microbiologist for investigation of outbreaks
Epidemiologist
Two laboratory technicians for handling of samples and performing tests
Four casual labors at the time of unloading from the truck and setting up and
at the time of unpacking and loading into the truck.
One technical help and an electrician to be hired from the firm manufacturing
114 Draft SOPM Portable Laboratory PLK 06
the physical structure to set up the laboratory Kit A.
Administrative support: The laboratory administratively has to be married with
the medical teams operating in the disaster.
Additional Requirements
Complete identification and characterization of infectious agent may be
beyond the scope of the portable lab and hence the lab needs support from a
referral laboratory for diagnosing diseases of outbreak potential in addition
performing external quality control of the portable lab.
Storage space for the two-month requirement of consumables carried.
Power supply, if available.
Arrangement for stay etc of personnel working in the laboratory.
Costing of the Portable Lab
Total cost of the lab is US$ 25,000 (10, 00,000 INR)
1. Kit A (Physical structure): US $ 9375 (Transportation to any other place is
extra)
2. Kit B (Equipments & Instruments): US $ 7500 (3,00,000 INR)
3. Kit C (Consumables): US $ 6250 (2,50,000 INR)
4. Cost of assembly of Kit A, labor and packing materials): US $ 1875 (75,000
INR)
For placing an order, the following may be contacted
To place an order for all components of the Lab
Lucktron Hi-Tech
5/27, West Patel Nagar
New Delhi-110008
Tele: 91-11-25881360.
Contact Person: Mr Naresh Arora,
Mobile: 91-9810063648, 91-9910107949
To place an order for Equipments & Instruments (Kit B) and consumables (Kit C)
Instrukem India,
B-3B/41B Janakpuri
New Delhi-110058
Tele: 91-11-25598533, 25536790
Contact person: Mr Harbans Singh, Mobile: 91-9810091944
115 Draft SOPM Portable Laboratory PLK 06
Designing of Portable Laboratory
The lab has been designed keeping in mind the following aspects:
1. Types of disasters
2. Possible diseases in disasters.
3. Requirements for operating medical/ surgical teams in disasters.
4. Portability of physical structure in knocked down condition by road, rail, sea
and air.
5. Assembly in disaster situations with the help of local help/ hired help.
6. Separating components of physical structure, equipments/ instruments and
consumables to have flexibility.
7. Operating space for 3 people working in the lab.
8. Provisioning of basic clinical chemistry, basic hematological tests, serological
tests, collection/storage & transportation of specimen and bacterial cultures.
9. Designing of equipment, instruments and packaging material.
10. Versatility by way of designing components into three parts namely, physical
structure, equipment & instruments and consumables.
Designing of Physical structure
1. The laboratory is required to be moved by road or rail in containers or
transported by air in knocked down and packed condition.
2. The laboratory should be working on AC power and should have suitable
generator for alternate power supply.
3. The shelter will be made of lightweight, fire resistant and termite proof. Roof
to be covered with water resistant material. Minimum internal dimension
should be 14 feet long, 8 feet wide and 8-6 feet height (slopping roof). The
shelter should have wiring, electrical points and provision for one window
type AC. Provision for switchover to mains/ generator should be available.
4. Inside the cabin, three foldable workbenches are to be provided. One loft
water tank should be provided with facility to fill the tank from outside.
5. Two small refrigerators, small incubator, one small electric autoclave, small
water bath, centrifuge, binocular microscope with self-illumination and one
dual mode colorimeter should be catered for. Three lightweight storage
cabinets should be available.
Designing of Equipment & Instruments
Equipments and instruments to be provided should be locally available and procured
at short notice.
1. Air conditioner should be sufficient to maintain comfortable working
temperature. Air conditioners with heating element are not easily available.
Hence, for winters, provision of electric blower or heat convector will suffice
with effective insulation of the structure design. While choosing the tonnage
of the air conditioner, ability to work on the generators is kept in mind.
2. Generator: After calculating the power requirements and cost & weight
constraints the generators chosen. Two generators with capacity of 2.5 KV
each were provided. They require a small quantity of petrol to start the engine
and kerosene for running. These types of generators are available in rural
116 Draft SOPM Portable Laboratory PLK 06
setting also and can be maintained or repaired by local help. Gas based silent
generators are not easily available; are costly and maintenance and fuel
availability at all places are some of the limitations.
3. Instruments for Clinical pathology: Haemometer for haemoglobin
estimation, haemocytometer for cell counts, centrifuge and binocular
microscope with light source.
4. Instruments for biochemistry: Colorimeter, which can be operated both by
AC and by battery.
5. Instruments for microbiology: Bench top incubator.
6. Instruments for sample collection teams: Three small 4-litre vaccine carriers
(commercially available) are provided for collection and transportation of
samples from field.
7. Instruments for biosafety: Three manual needle destroyers and one electric
needle destroyer are provided. Pressure cooker type and electric sterilizers are
provided for sterilization of infectious wastes before disposal.
8. Packaging: Packaging materials like steel, wooden, plastic, tin and aluminum
were studied. Boxes made of wood and metal are costlier, heavier and not
readily available. Boxes made of tough plastic are lightweight and impervious
to water, but are not easily available in the local markets. Three types of
cardboard packages are designed. Largest is of the size 36X24X24 “and has
outer water repellant coating. The other two are of the sizes 24X12X12 and
12X12X12 “. The sizes are worked out after measuring the equipments and
instruments of the lab. Smaller items are packed in smaller sized boxes and
kept in larger box. If some empty space is in the outer box the space is filled
with empty smaller sized box so that contents do not move during transit. This
concept of box-in-box is named “Kangaroo Box”. For packaging of the panels
etc of the structure, waste cardboard is used. Original packing of air
conditioner, generators etc is retained.
9. Furniture: Workbenches: Simple lightweight and folding type are ideal for
field conditions. Top of the benches is of stainless steel. Lab stools: Simple
adjustable round steel lab stools are provided. Chairs: Lightweight plastic
chairs which can be packed inside the cardboard packaging.
10. Miscellaneous instruments for setting up and dismantling: Digging tools, 6’
high light weight ladder, tools kit, wrench are provided for setting up of the
physical structure.
117 Draft SOPM Portable Laboratory PLK 06
Packing & Loading of Portable Lab
1. Procure equipment/ instruments, consumables and packaging materials.
2. Packing is to be done as per the box wise load tables given.
3. Loading instructions are given as per the diagram and the legend.
4. All the test kits requiring cold chain will be kept in the refrigerators and
should be packed last, just before dispatch of the truck. They will be packed in
vaccine containers along with ice packs in Box No. 9, loaded last and
unloaded first. After reaching the destination, Box No 9, 4, 7, 17 & 18 are
unloaded first. Boxes 17 & 18 are generators, which will be unpacked and
started for connecting the refrigerators in Boxes 4 & 7. Kits kept in vaccine
containers will be transferred to the refrigerators. This exercise has been
practiced in the field trial and the cold chain could be maintained for 18 hours
during transit.
Loading Diagram of Portable Lab (Not to scale)
40 41
42 43
Top 33,34,35,36,37,38,39
4
17 19
Bottom Top Top Top
10 12 14
Top 21
46
9
11 13 15
6 20
Bottom Bottom Bottom
Bottom
Top Top
Top 16 1
7 Middle Middle 28,29,30,31,32
18 8 2
3 5 22,23,24,25,26,27
Bottom
Bottom Bottom
118 Draft SOPM Portable Laboratory PLK 06
SOP of Kit B – Equipment
Portable Generators
Two generators are provided. One is to be used for the air conditioner, 4-6 cfl lights of
20 Watts and exhaust fan. The other generator is to be used for other equipments.
Two 65 ltr refrigerators, portable incubator, binocular microscope and colorimeter can
be run on one generator. When the centrifuge is to be used for safety sake the
refrigerators can be switched off for a short duration. The electrical sterilizer provided
should not be used on the generator. When mains are available then only the electric
sterilizer is to be used.
Specifications
Make: HONDA
Model: EXK 2800
Rated out put: 2100 VA (Maximum out put: 2400 VA)
Rated frequency: 50 HZ
Rated voltage: 220 V
Rated current: 9.5 A
Dimensions in cms (LengthXWidthXHeight): 985 X470X720
Dry weight: 94 Kg
Fuels and oils
Engine oil (capacity – 1.2 ltr): SAE 10W-40 or SAE 20W-40
Starting fuel in cold starting (petrol tank capacity 2 ltr): Petrol
Running fuel (kerosene tank capacity – 16 ltr): Kerosene
Procedure of starting the engine
Check the fuel and engine oil levels before starting. Ensure the AC circuit breaker is
‘OFF’ before starting.
a. Pull the choke knob.
b. Turn the fuel cock (kerosene) to ‘ON’ position.
c. Pull the fuel cock (petrol) for about 4 seconds only.
d. Keep the engine switch on ‘ON’ position.
e. Pull the starter grip lightly till resistance is felt and then pull briskly.
f. Return the starter grip back slowly.
g. Push the choke knob back to original position.
h. FOR HOT STRATING STEP ‘c’ IS NOT REQUIRED.
119 Draft SOPM Portable Laboratory PLK 06
Procedure of stopping the engine
a. Bring AC circuit breaker to ‘OFF’ position.
b. Turn the fuel cock to ‘OFF’ position.
c. To stop in case of emergency, bring the engine switch to ‘OFF’ position.
Maintenance
Three free service coupons of 30 days, 90 days and 180 days are provided by the
authorized dealers at their service centers. List of their area offices in India are given
along with telephone numbers and e-mail addresses in the user’s manual. Local help
from engine mechanic can be availed in far-flung places. Such generators are used by
locals and farmers. Maintain record of daily check, usage time and repairs if any done
as per the sample of maintenance chart provided as annexure.
Daily checks
Check fuel levels and refill the tanks. Fill up to shoulder of the fuel filter.
Check the air cleaner and clean the air cleaner element with kerosene.
Check the spark plug and clean the carbon if required.
Periodic maintenance
Change of engine oil, change of spark plug and cleaning of filters are given in the
owners manual and are required to be done at the authorized service center.
Safety instructions
Always switch on the appliance drawing maximum power first.
NEVER use generator in an enclosed area or place with out adequate ventilation.
Exhaust gas contains carbon monoxide.
ALWAYS ensure proper earthing of the generator and the electrical appliances.
NEVER use dust cover over the generator while in operation.
To prevent fire hazard keep generator at least 3 feet away from building walls,
equipments and combustible or inflammable material.
NEVER handle the generator with wet hands.
While refilling, stop the generator engine and do not smoke. Wipe the spilled fuel.
Fill the correct fuel in correct tank.
If the engine oil level is low the oil alert system will automatically turn the engine
off.
Trouble shooting
Engine does not start - Check for fuel levels, engine oil level, spark plug for carbon
and air cleaner. Then follow the instructions of step a to g of procedure for starting. If
problem persists contact authorized dealer or local mechanic for help.
120 Draft SOPM Portable Laboratory PLK 06
PORTABLE VERTICAL SEAMLESS STERILISER (Pressure-cooker type autoclave)
Manufacturer: York Scientific Industries Pvt Ltd
The autoclave is made of thick high quality stainless steel sheet, drawn to cylindrical
shape with out any joints and welding to prevent residue or dust accumulation.
Pressure cooker with stove
Operating instructions
a. Open the container by firmly holding the lid handle towards the right side till both
arrow marks on the lid and the container coincide. Lift the lid.
b. Pour clean water in the container, up to the level of steel tripod kept inside.
c. Keep the items to be sterilized in an autoclavable container or steel drum over the
tripod.
d. Close the lid by keeping it on the container so that the two arrow marks on the lid
and the container coincide. Gently press the lid downwards and rotate the lid
towards the left.
e. Put the autoclave on gas stove and remove the safety valve weight.
f. When steam starts coming out through the safety valve, open the air exhaust out
let for two minutes.
g. Close the air exhaust out let cock and replace the safety valve weight over the
coupling. Steam builds up and note down the time when safety valve starts
working.
h. Keep the flame of the gas for 30 minutes and switch off the gas.
i. Open the steam/ water out let to let out the steam and water for 10 minutes. This
allows the items to dry up also.
j. Remove the lid as given in (a).
Safety precautions
Use the sterilizer in well-ventilated room and NOT in the laboratory structure.
Keep combustible and inflammable materials away from the area of sterilizer.
NEVER try to open the lid when the pressure in the sterilizer is still present.
Maintenance
Clean the container and the lid well with soap and water.
Remove the gasket when the sterilizer is not in use and keep in a dry place.
121 Draft SOPM Portable Laboratory PLK 06
NEVER operate the sterilizer with out water in the container.
Keep extra gasket for emergency at hand.
Maintain record of daily check, usage time and repairs if any done as per the
sample of maintenance chart provided as annexure.
122 Draft SOPM Portable Laboratory PLK 06
PORTABLE VERTICAL ELECTRICAL STERILISER (Autoclave)
Manufacturer: York Scientific Industries Pvt Ltd
The autoclave is made of thick high quality stainless steel sheet, drawn to cylindrical
shape with out any joints and welding to prevent residue or dust accumulation.
Operating instructions
a. Open the container by firmly holding the lid handle towards the right side till both
arrow marks on the lid and the container coincide. Lift the lid.
b. Pour clean water in the container, up to the level of steel tripod kept inside.
c. Keep the items to be sterilized in an autoclavable container or steel drum over the
tripod.
d. Close the lid by keeping it on the container so that the two arrow marks on the lid
and the container coincide. Gently press the lid downwards and rotate the lid
towards the left.
e. Put the autoclave on gas stove and remove the safety valve weight.
f. When steam starts coming out through the safety valve, open the air exhaust out
let for two minutes.
g. Close the air exhaust out let cock and replace the safety valve weight over the
coupling. Steam builds up and note down the time when safety valve starts
working.
h. Keep the flame of the gas for 30 minutes and switch off the gas.
i. Open the steam/ water out let to let out the steam and water for 10 minutes. This
allows the items to dry up also.
j. Remove the lid as given in a.
Safety precautions
Use the sterilizer in well-ventilated room and NOT in the laboratory structure.
Keep combustible and inflammable materials away from the area of sterilizer.
NEVER try to open the lid when the pressure in the sterilizer is still present.
Maintenance
Clean the container and the lid well with soap and water.
Remove the gasket when the sterilizer is not in use and keep in a dry place.
NEVER operate the sterilizer with out water in the container.
Keep extra gasket for emergency at hand.
Maintain record of daily check, usage time and repairs if any done as per the
sample of maintenance chart provided as annexure.
123 Draft SOPM Portable Laboratory PLK 06
ELECTRICAL PORTABLE BACTERIOLOGICAL INCUBATOR
Manufacturer: York Scientific Industries Pvt Ltd
Specifications
Make: York
Model: YSI 438
Outer wall: Powder coated
Chamber (Aluminum) size: 300 X 300 X 300 mm
Insulation: Mineral wool
Door: Double walled, insulated with double glass window.
Temperature control: Thermostatic. Control knob to set the temperature.
Heating elements: Nichrome wire inside porcelain beads.
Temperature range: Ambient to 800 C.
No of trays: two
Thermometer: L- Shaped glass thermometer.
Electric supply: 230 V, single phase.
Dry weight:
Operating instructions
a. Incubator to be placed on a firm surface.
b. Adjust the ventilation ports on the side.
c. Connect to mains or to power supply of generator.
d. Switch ON and rotate the thermostat knob to 37º C.
e. Observe the thermometer and if variance of set temperature is noted readjust the
knob.
f. After half an hour the incubator is ready for use.
Safety precautions
Always check the power line is earthed properly.
Protect incubator from direct sunlight and draughts.
Keep the door closed and open only when necessary.
Be careful while loading and unloading the trays not to damage the thermometer.
Maintenance
Avoid spillage of cultures, contaminated materials inside the incubator.
NEVER clean the incubator while in use.
Switch off the incubator and remove the plug and clean inside with wet mop of mild
124 Draft SOPM Portable Laboratory PLK 06
soap solution, wet mop of 5% Antiseptic lotion and then dry mop. Keep the
incubator to dry for 1 hour before use.
Outer surface can be cleaned with dry mop only.
Maintain record of daily check, usage time and repairs if any done as per the
sample of maintenance chart provided as annexure.
125 Draft SOPM Portable Laboratory PLK 06
CENTRIFUGE SIX TUBE
Manufacturer: Remi Motors Ltd
Specifications
No of tubes: Six
Maximum rotor speed: 3200 RPM
Width: 310 mm
Weight: 7 kg
Electrical load: 0.14 KVA
Electrical supply: 230 V, single phase, 50 HZ
Operating Instructions
a. Ensure proper earthing of the supply.
b. Keep the centrifuge on a firm, rigid place free from vibrations.
c. Check the speed control and set to ‘0’ position.
d. Connect the power. The pilot indicator lamp will be ‘on’.
e. Balance the volume of liquids being centrifuged to avoid vibration and damage to
the tubes causing spillage.
f. Keep all the buckets in the rotor even not necessary to balance the centrifuge.
g. Close the lid.
h. Move the speed control knob from ‘0’ position to desired speed moving clock wise.
i. To stop centrifuge turn the speed control knob anti-clock wise to ‘0’ position.
j. Open the lid only when the rotor comes to stand still.
k. Remove the buckets and tubes.
Safety precautions
Always check the power line is earthed properly.
Balancing the tubes should be ensured.
Use only centrifugable tubes.
Wear protective gloves while handling potentially infective material.
Do not open the lid before the centrifuge comes to stand still.
Take out the tubes with non-toothed forceps only.
Before taking out the tubes examine carefully for any breakage and spillage. In
case of breakage and spillage, remove broken glass pieces with long non-toothed
forceps. Remove the buckets and drop them in 5% antiseptic solution for 1 hr.
Remove the rotor and clean with 5% antiseptic solution and liberally mop the
insides with 5% antiseptic solution and dry the centrifuge in sun.
If centrifuge runs noisily, check for asymmetry of loaded buckets, tubes have
similar load, rubber profiles are correctly placed and if still noisy the rubber mount
of motor or bearing needs change.
Maintenance
Once a week clean all the buckets.
Remove the profiled rubber inserts and remove any splintered glass carefully,
sprinkle talcum powder over the rubber profile and replace rubber profiles.
126 Draft SOPM Portable Laboratory PLK 06
Wipe the drive shaft with greased mop once aweek.
Clean the body with wax polish.
After 100 hrs the carbon brushes of the motor need replacement.
Maintain the record of daily usage, maintenance and repairs if any carried out as per
the sample maintenance chart given as annexure.
127 Draft SOPM Portable Laboratory PLK 06
PHOTOELECTRIC COLORIMETER
Specifications
Wave length range: 400 to 700 nm
Wavelength peaks at: 400, 490, 520, 540, 590, 650 nm
Minimum volume: 1 ml
Light source: 6V, 10W tungsten filament lamp.
Test tube size: Inner diameter of 12 mm.
Detector: Photocell
Dimension: 290X315X210 mm
Weight: 5 kg.
Operating instructions
a. Switch on the instrument
b. Warm up time of 5 minutes are giving before taking readings.
c. Set the desired filter.
d. Put minimum of 1 ml ‘bank’ into test tube and keep in the test tube holder.
e. Adjust the coarse and fine knobs to 00 OD.
f. Take out the tube and place the standard solution and read OD.
g. Take out test solution and take OD.
Safety precautions
Ensure proper earthing before using the instrument. Always use 3 pin plug only.
Place the instrument on vibration free surface.
Use proper sized test tube only for taking the readings.
Do not use the instrument in the presence of inflammable gases.
Maintenance
Clean the outer surface with clean tissue.
In case of spillage immediately clean with wet mop of 5% antiseptic solution.
Maintain daily record of usage and repairs if any as given in the sample
maintenance card.
128 Draft SOPM Portable Laboratory PLK 06
BINOCULAR MICROSCOPE
Model: CH 20 I; Manufacturer: Olympus India Ltd
Specifications
Binocular observation tube, with inter-papillary distance range of 53 to 75 mm. 10X
eye pieces.
Revolving quadruple nose piece with scanner, 10X, 40X and 100X oil immersion
lenses.
Illumination: 6V 20W halogen bulb.
Focusing: Coaxial coarse/fine knobs.
Dimensions
198 (W) X 380 (H) X 234 (D) mm, weight: 4 kg.
Operating instructions
a. Place the microscope on a flat firm surface.
b. Connect light source to 220 V electrical point using proper earthing.
c. Place the slide to be examined on the stage holding the slide with clamps.
d. Switch on the power and increase illumination to desired level.
e. Adjust the condenser if required.
Safety precautions
Avoid exposure of microscope to direct sunlight and high humidity.
Do not use alcohol for cleaning the microscope lenses as the lens alignment will
get damaged.
Carry the microscope with both hands.
Maintenance
Clean all glass components with a clean tissue paper.
Keep the microscope covered with the microscope dust cover when not in use.
For detailed instructions of replacing the bulbs and trouble shooting refer to the
instructions manual.
129 Draft SOPM Portable Laboratory PLK 06
Room Air conditioner (Window Type)
Manufacturer: LG Electronics
Specifications
Type: Window Type
Tonnage: 0.75 Ton
Power requirement: 220 V, AC
Operating Instructions
a. Fit the AC in the window provided. Make sure it fits firmly and securely. Set the AC
slightly inclined towards out side to drain the condensed water to out side.
b. Connect the 3-pin plug to the power.
c. Set the thermostat to medium cool.
d. Close the vent control to allow the air inside to get circulated and cooled.
e. Adjust the air-direction by louver.
f. Switch on the AC using the remote control.
Safety precautions
Always use properly earthed power supply.
Do not operate with wet hands.
Always switch off the unit, remove the power cord from plug before cleaning the air
filter.
Do not clean the unit with water
Maintenance
Clean the air filter once in two weeks.
Contact the authorized dealer in case of problems.
130 Draft SOPM Portable Laboratory PLK 06
Refrigerator: 55 Liters
Manufacturer: Voltas Ltd
Specifications
Volume: 55 Liters
Dimensions: 455 (W)X470 (D)X565 (H) mm
Weight: 17 Kg
Frozen storage volume: 4 Liters
Shelf: 1
Power requirement: 220 V, AC
Operating Instructions
a. Keep the refrigerator at least 6 inches away from the wall.
b. Connect the 3-pin plug to power.
c. Set the thermostat to medium.
d. Store the reagents requiring 2-8ºC in the shelves of the refrigerator.
e. Always keep the freezing compartment and chill tray loaded with ice-packs. Frozen
ice packs should be used while transporting the samples. Keep the cryo -vials with
samples kept in cryo-box in the freezing compartment before transporting. Two
cryo-boxes can be fitted in the freezing compartment.
Safety precautions
Always use properly earthed power line.
Do not use sharp instruments inside the refrigerator to separate the frozen items.
Defrost when excess ice formation is seen.
Maintenance
Clean the exterior with wet mop using mild soap.
Clean inside with soda-bicarbonate solution and dry with dry mop.
131 Draft SOPM Portable Laboratory PLK 06
Other Equipment Provided
Working stool
Working bench
Pedestal fan
Fire Extinguisher
Vaccine carrier
132 Draft SOPM Portable Laboratory PLK 06
Aspirator Bottle for dispensing water/reagents
Water dispenser
133 Draft SOPM Portable Laboratory PLK 06
Annexure I
LABORATORY FORMATS
Case investigation form
(To be filled in by the clinician/ epidemiologist)
Date:
Patient’s name: Patient’s ID no.:
Father’s/ husband’s name: Age/ sex:
Address:
Date of onset of illness:
Date of reporting to health functionary/ post:
Clinical signs & symptoms (with duration):
Treatment history:
Results of previous investigations:
Specimen details:
Nature of specimen Date of collection Investigation required
Details of sender:
Signature:
Name of sender:
(NOTE: Please complete all the columns. Always send the sample under cold chain
unless specified otherwise)
134 Draft SOPM Portable Laboratory PLK 06
Laboratory reporting form
(To be filled in by the clinician/ epidemiologist)
Date:
Patient’s name: Patient’s ID no.:
Age/ sex: Lab Reference no:
Specimen details:
Nature of Date of Date of Type of test Remarks Results
specimen collection receipt in (if any)
lab
Interpretation:
Details of investigator
Name:
Signature:
Telephone number:
135 Draft SOPM Portable Laboratory PLK 06
Annexure II
LOAD TABLES
Clinical Pathology & Biochemistry Box No 1
Clinical Pathology
S No Item E / NE A/U Life/storage Quantity Box
No
1 Needle destroyer Manual NE No LL 1 1A
2 Binocular microscope NE No LL 1 1A
Olympus
3 Wintrobe tube pk of 25 E No SL B 1 1A
4 Wintrobe tube stand E No SL B 2 1A
5 Test tube stand plastic E No LL 1 1A
6 Slide rack aluminum E No SLB 2 1A
7 Uristix pk of 100 strips E Pkt SL B 2 1A
8 Ketostix pk of 100 E Pkt SLB 2 1A
9 Litmus paper blue E Pkt SL B 5 1A
10 Litmus paper red E Pkt SL B 5 1A
11 Isopropyl alcohol 250 ml E Bottle SLB 1 1A
12 Alcohol swabs pk of 500 E Pkt SL B 1 1A
13 Syringe disp 10 ml pack of E Pkt SL B 2 1B
50
14 Tourniquet velcro E No SL B 2 1B
15 Discarding jars E No SL B 1 1B
16 Blood grouping serum 12 E Pkt SLA 2 1B
ml
17 Stool urine containers E Doz SLB 10 1B
18 Malaria detection kit ICT - E kit SLA 10 1B
10 test kit
19 Haemometer set E No LL 1 1C
20 Haemocytometer set E No LL 1 1C
21 Haemoglobin pipette E No SL B 2 1C
22 WBC Pipette E No SL B 2 1C
23 Forceps non toothed 15 cm E No LL 1 1C
24 Wash bottles E No LL 1 1C
25 Test tube 10 ml pk of 100 E Pkt SL B 1 1C
26 Diamond pencil E No LL 1 1C
27 Spirit lamp brass NE No LL 1 1C
28 Safety Matches home lights E No SL B 1 1C
29 Disposable needle 24 G E Pkt SL B 1 1C
30 Vaccutainers EDTA pk of E Pkt SL B 1 1C
100
31 Adhesive plaster roll 4" E Roll SL B 1 1C
32 Lancets sterile pk of 200 E Pkt SL B 1 1C
33 Drabkins sol with Hb std 1 E No SL B 2 1C
ltr
34 Giemsa stain 125 ml E Bottle SL B 5 1C
35 Fouchets reagent 125 ml E Bottle SL B 2 1C
36 Glass slides pk of 50 E No LL 4 1D
37 Coverslips 22X22 mm box E Box LL 1 1D
38 Wire basket aluminum E No LL 1 1D
136 Draft SOPM Portable Laboratory PLK 06
39 Cotton 500 gr roll E Roll SL B 1 1D
40 WBC diluting fluid E Bottle SL B 2 1D
41 Platelet dil fluid E Bottle SL B 2 1D
42 Leishman stain 250 ml E Bottle SL B 10 1D
43 H Cl N/10 500 ml E Bottle SL B 4 1D
Items marked in BOLD are to be kept in vaccine containers with ice packs
Biochemistry
S No Item E / NE A/U Life/storage Quantity Box
No
Colorimeter dual power NE No LL 1 1E
mode
Digital timer NE No LL 1 1F
Test tube 10 ml pk of 100 E Pkt SL B 2 1E
Micropipette 20-200 E No LL 1 1E
Micropipette 100-1000 E No LL 1 1E
Double dist water 5 ltr jar E Jar SLB 2 1E
Discarding jars E No SL B 1 1E
Tourniquet velcro E No SL B 2 1F
Test tube stand plastic E No LL 1 1F
Wash bottles E No LL 1 1F
Isopropyl alcohol 250 ml E Bott SLB 1 1F
Tips yellow small pk 1000 E Pkt SL B 1 1F
Tips blue large pk of 500 E Pkt SL B 1 1F
Box for yellow tips E No SL B 1 1F
Box for blue tips E No SL B 1 1F
Safety Matches home lights E No SL B 1 1F
Syringe disp 10 ml pack of E Pkt SL B 2 1F
50
Disposable needle 24 G E Pkt SL B 1 1F
Vaccutainers plain pk of 100 E Pkt SLB 1 1F
Vaccutainers Na F, pk of E Pkt SL B 1 1F
100
Lancets sterile pk of 200 E Pkt SL B 1 1F
Cotton 500 gr roll E Roll SL B 1 1F
Alcohol swabs pk of 500 E Pkt SL B 1 1F
Wire basket aluminum E No LL 1 1G
Glucose GOD-POD kit E kit SLB 4 1G
S Bilirubin kit 50 test E kit SLB 4 1G
Creatinine kit 40 test E kit SLB 4 1G
Urea kit 40 test E kit SLB 4 1G
137 Draft SOPM Portable Laboratory PLK 06
Microbiology, Box No 2 to 4 (Box No 9 has items of cold chain in Vaccine
Containers)
S Item E/ AU Life/storage Qty Box
No NE No
BP Handle NE No LL 1 2A
BP Blades pkt of 100 E Pkt SL B 1 2A
Needle destroyer Manual NE No LL 1 2A
Tourniquet Velcro, pkt E No SL B 2 2A
Diamond pencil E No LL 1 2A
Glass slides pk of 50 E No LL 4 2A
Forceps non toothed 15 cm E No LL 1 2A
Test tube stand plastic E No LL 2 2A
Spirit lamp brass NE No LL 1 2A
Wire basket aluminum E No LL 2 2A
Wash bottles E No LL 2 2A
Inoculation loops pk of 10X10 E Pkt SL B 1 2A
Inoculation loop holder E No LL 2 2A
Spatula E No LL 1 2A
Measuring cylinder 25 ml E No SLB 5 2A
Measuring cylinder 100 ml E No SLB 5 2A
Pasture pipette with teat E Doz SL B 2 2A
Dropper with teat E Doz SL B 5 2A
Glass rods E No SL B 5 2A
Test tube 10 ml pk of 100 E Pkt SL B 1 2A
Disposable needle 24 G E Pkt SL B 1 2A
Vaccutainers plain pk of 100 E Pkt SLB 1 2A
Lancets sterile pk of 200 E Pkt SL B 1 2A
Cotton 500 gr roll E Roll SL B 1 2A
Alcohol swabs pk of 500 E Pkt SL B 1 2A
Isopropyl alcohol 250 ml E Bottle SLB 1 2A
Chlorine test kit set E No SLB 1 2A
Gas lighter E No SL B 1 2A
Safety Matches home lights E No SL B 1 2A
Syringe disp 10 ml pack of 50 E Pkt SL B 2 2B
Slide rack aluminum E No LL 2 2B
Soap paper strips E Pkt SL B 50 2B
pH paper 2-10 E Pkt SLB 2 2B
Gram's stain kit E kit SLB 2 2B
Albert's stain kit E kit SLB 1 2B
Petri seal colorless/white E Pkt SLB 1 2B
Sterilization indicator tape pk of 50 E Pkt SLB 4 2B
Filter paper whatman No 1 round 12.5 cm E Pkt SLB 1 2B
Filter paper sheets pk of 100 E Pkt SLB 1 2B
Micropipette 2-20 E No LL 1 2C
Micropipette 20-200 E No LL 1 2C
Tips yellow small pk 1000 E Pkt SL B 1 2C
Tips blue large pk of 500 E Pkt SL B 1 2C
138 Draft SOPM Portable Laboratory PLK 06
Box for yellow tips E No SL B 1 2C
Box for blue tips E No SL B 1 2C
Ependorf tubes (sterile) 1.5 ml pk of 500 E Pkt SL B 1 2C
Cotton swabs sterile in tube E Box SLB 2 2C
Sterile disp petriplates, pk of 100 E Pkt SLB 1 2D
Conical flask 100 ml Himedia E No SL B 5 2E
Conical flask 250 ml Himedia E No SLB 5 2E
Discarding jars E No SL B 2 2E
Labels pk of 1000 E Pkt SLB 1 2E
Cryotags pk of 1000 E Pkt SLB 1 2E
Plasticine 500 gr E Pkt SLB 1 2E
Mackonkey agar 100 gr dehydrated E No SLB 1 2E
XLD agar 100 gr E No SLB 1 2E
TCBS agar 100 gr E Pkt SLB 1 2E
Incubator bench top NE No LL 1 3A
Disposable gown set E No SL B 70 3B&3C
Disposable gloves pk of 100 E Pkt SL B 4 3B&3C
Refrigerator 65 ltr NE No LL 1 4
Sterilizer Pressure cooker type NE No LL 1 4
Rapid H2 S strip test pk of 5 tubes E Pkt SLB 40 9
BHI broth (50 ml) in blood culture bottle pk E Pkt SLA 3 9
of 10
BHI broth (20 ml) in blood culture bottle pk E Pkt SLA 2 9
of 10
Alkaline peptone water pk of 25 E Pkt SLA 4 9
Cary Blair medium pk of 10 E Pkt SLA 4 9
Loeflers slants pk of 25 E Pkt SLA 1 9
Selinite F Broth pk of 25 E Pkt SLA 1 9
Sterile transport swabs with Aimes pk of 50 E Pkt SLA 1 9
Sterile viral transport medium pk of 50 E Pkt SLA 1 9
HBSAg card test 50 test E kit SLA 1 9
HCV card test 10 tests E kit SLA 1 9
HIV Spot test kit of 10 tests E kit SLA 5 9
Leptospira Dridot 30 tests E kit SLA 1 9
Widal slide test kit of 56 tests E kit SLA 2 9
Typhidot kit E Kit SLA 2 9
N. Meningitis Ag Latex test kit of 30 tests E kit SLA 1 9
Dengue card test ICT, 25 test E kit SLA 1 9
Parafilm E Pkt SLA 1 9
Items marked in BOLD are to be kept in vaccine containers with ice packs
139 Draft SOPM Portable Laboratory PLK 06
General Items per Lab: Box/ Pkgs Nos 5 to 47 (Pkg 20 to 47 are of Kit A - Lab
Physical Structure)
S No Item E / NE A/U Life/storage QuantityBox No
1 Steriliser Electric NE No LL 1 5
2 Bucket with lid 65 ltr NE No LL 2 5
3 Water poison detection kit E No SL B 1 5
4 Disinfectant 5 ltr E Jar SL B 2 5
5 Water filter, steel NE No LL 1 6A
6 Electronic balance NE No LL 1 6A
7 Isopropyl alcohol 250 ml E Bottle SLB 2 6A
8 Needle destroyer Electric NE No LL 1 6B
9 Fire extinguisher- cease fire NE No LL 1 6B
10 Tips yellow small pk 1000 E Pkt SL B 2 6B
11 Tips blue large pk of 500 E Pkt SL B 2 6B
12 Ependorf tubes (sterile) 1.5 ml pk of 500 E Pkt SL B 1 6B
13 AC 0.8 Ton with stabilizer NE No LL 1 6C
14 Stationary items E Set SLB 1 7A
15 Carboy with tap 20 ltr NE No LL 1 7B
16 Scissors 15 cm NE No LL 2 7C
17 BP Handle NE No LL 1 7C
18 Tourniquet Velcro, packs E No SL B 4 7C
19 Glass slides pk of 50 E No LL 2 7C
20 BP Blades pkt of 100 E Pkt SL B 1 7C
21 Surgical gloves pk of 25 E No SL B 2 7C
22 Zip lock bags assorted E Kg SL B 1 7C
23 Medicated adhesive plaster (Band aid E No SL B 100 7C
strips)
24 Medicated adhesive plaster (Band aid E No SL B 100 7C
round)
25 Bio-safety bags E Kg SL B 2 7C
26 Liquid hand disinfectant 5X 500 ml E Pkt SL B 1 7C
27 Soap paper strips E Pkt SL B 50 7C
28 Tissue paper roll double ply E Roll SL B 4 7C
29 Refrigerator 65 ltr NE No LL 1 7D
30 Gas cylinder with stove NE No LL 1 8A
31 Pedestal Fan NE No LL 1 8A
32 Centrifuge 6 tube NE No LL 1 8A
33 Electric mosquito repellent with mats E No SL B 1 8B
34 Cryovials 1.8 ml pk of 1000 E Pkt SL B 1 8B
35 Cryobox 1.8 ml E No SL B 4 8B
36 Dry cell 1.5 v E No SL B 4 8B
37 Gas lighter E No SL B 1 8B
38 Safety Matches home lights E No SL B 2 8B
39 Syringe disp 10 ml pack of 50 E Pkt SL B 4 8B
40 Disposable needle 24 G E Pkt SL B 2 8B
140 Draft SOPM Portable Laboratory PLK 06
41 Vaccutainers plain pk of 100 E Pkt SLB 3 8B
42 Vaccutainers plain centrifusable pk of E Pkt SL B 1 8B
100
43 Adhesive plaster roll 4" E Roll SL B 2 8B
44 Lancets sterile pk of 200 E Pkt SL B 2 8B
45 Cotton 500 gr roll E Roll SL B 2 8B
46 Alcohol swabs pk of 500 E Pkt SL B 2 8B
47 Emergency light NE No LL 1 9
48 Taping machine NE No LL 1 9
49 Tape Roll E No LL 2 9
50 Taping Clips E Kg LL 1 9
51 Tape clip sealer NE No LL 1 9
52 Tool Kit NE No LL 1 9
53 Plastic rope E Kg LL 1/2 9
54 Pick Axe, for digging NE No LL 1 9
55 Shovel, for digging NE No LL 1 9
56 Hammer NE No LL 1 9
57 Wrench for tightening nuts & bolts NE No LL 1 9
58 Taurpolin for covering generators NE Sq LL 4 9
Mtrs
59 CFL Bulbs 20 W E No SL B 3 9
60 Electric cable for power from mains E Mtr SL B 45 9
61 Vaccine carriers, big NE No LL 2 9
62 Vaccine carriers, small 3 9
63 Torch light 4 cell with cells NE No LL 1 9
64 Extension boards NE No LL 4 9
65 Cryopacks E No SL B 100 9
66 Lab stools, steel round NE No LL 3 10
67 Chair plastic NE No LL 4 10, 15
68 Work benches, 4X2’ SS Top NE No LL 3 11
69 Cupboard steel 35”(H), 23” (W) X 23” NE No LL 3 12,13,14
(D)
70 Disposable gown sets E No SL B 30 15
71 Disposable gloves pk of 100 E Pkt SL B 1 15
72 Jars 10 ltr for kerosene E Jar SL B 2 15
73 Tray stainless steel 30X24 cm NE No LL 3 15
74 Dust bin plastic with lid E No SL B 1 15
75 Water storage tank 200 ltr with lid and NE No LL 1 16
10 Mtr pipe ¾ “ diameter
76 Generator 2.5 KV NE No LL 2 17 &
18
77 Ladder light weight 6’ NE No LL 2 19
141 Draft SOPM Portable Laboratory PLK 06
Packages 20 to 47 are Gunny Packing of the Kit A (Physical Structure of the
Lab)
142 Draft SOPM Portable Laboratory PLK 06