Oxford Radcliffe Hospitals
Specimens: Safe Handling and Transport
This Poster provides guidance for Managers and Staff on the safe handling and transport of pathology specimens sent from all locations to Trust laboratories.
WARNING! Specimens received unlabelled, without a completed request card attached, in incorrect containers, with discrepancies or leaking are unlikely to be processed.
Please ask the specific laboratory or read the laboratory handbooks on the Clinical Intranet for information if in doubt.
Wear appropriate personal protective equipment (PPE)
Examples of PPE include:
Gloves Goggles Respirator Apron/Gown
Identify the patient and the tests required, and use the correct pathology request card(s) for the test(s). Examples:
Dealing with spillages & leakages
Always wear PPE prior to clean up spillages and Histological Specimens
discard PPE after use. Small Spills (<2.5L) Large Spills (2.5L or more)
Wipe up with De-formalizer pad, and then discard it May require drastic measures i.e.:
Never use a mixture of detergents and into a yellow bag for incineration. Temporary evacuation of the area and involvement of
Cellular Pathology disinfectants to clean a spill.
Microbiology, Serology & Virology Clinical Biochemistry & OR the Emergency Services.
Blood grouping & Transfusion Separate forms for Histology, Cytology
Immunology Separate form for MRSA and Neuropathology. Check on Clinical Laboratory Haematology Cover with Formalin control granules for 15 If the spill is >2.5litres or if the area where the spillage
screening intranet Inform other people within the department/ward minutes, then scrape up and discard into a clear occurred is small/poorly ventilated, the Fire Brigade
of the spillage and what has been spilt. plastic bag. Label the bag „Inert mass of urea- should be notified immediately.
formaldehyde. Non-hazardous waste‟.
Biological Specimens (Body fluids)
Non-blood-stained Spills Blood/Blood-stained Spills
Use the correct and sterile container(s) for different test(s) before sampling Small & Large Spills Small Spills Large Spills
1.Use paper towel to soak up spill, and then discard into a 1.Use paper towel to soak up spill, and then discard into 1. Cover spill with chlorine releasing granules
yellow bag for incineration. a yellow bag for incineration. for 5 minutes.
2.Clean contaminated area with detergent and hot water, 2.Clean contaminated area with strong detergent 2. Clean contaminated area with detergent and
and then discard into a yellow bag for incineration. hypochlorite (1%) solution. hot water, and then discard into a yellow bag
Blood-stained/non-blood-stained urine – Never use chlorine releasing agents to clean up the spillage because the resultant fume is a hazard!
Vacuum tubes Charcoal swab 25ml plastic universal Blood culture bottles
(Remember to check the order of
collection of tubes)
(For more information on other types of containers, please refer to the laboratories‟ handbooks on „Clinical Intranet‟)
Please ensure the following points are checked before packaging
● Is the lid of the specimen container sealed / tightened properly?
Label the request card and the specimen container correctly, accurately and legibly Match the patient‟s details on the request card and specimen container with the patient ● Check for any leakages around the specimen container.
● Check the correct request card is used for the requested test (i.e. keep specimen(s) for microbiology separately
● NAME from biochemistry).
● DATE OF BIRTH ● State URGENT on the request card. If necessary inform the laboratory registrars and / or Biomedical Scientists.
● SEX ● NAME ● For interoperative specimens (i.e. frozen sections) and urgent fresh/unfixed biopsies - DO NOT place in formalin,
● NHS NUMBER (10 DIGITS) ● DATE OF BIRTH make sure they are package separately , deliver directly to cellular pathology and inform the laboratory.
● HOSP. NUMBER (7 DIGITS)
● PHYSICIAN’S NAME
● TYPE OF SPECIMEN
● NHS NUMBER (10 DIGITS)
● HOSP. NUMBER (7 DIGITS)
● TYPE OF SPECIMEN
= = Check there is no additional risk to laboratory staff if so label accordingly e.g. Danger of Infection (see below)
● TIME OF COLLECTION Collecting specimens from patients who have had a radioisotope should be avoided. Advice on specimen collection,
● CLINICAL DETAILS
● TEST(S) REQUIRED handling and transport for specimens with a Radioactive risk is available from Medical physics on extension
● TIME OF COLLECTION 25441.
The standard packaging method
(For more information on packaging specimens for transport, please read the Trust policy on „Specimens: Safe Handling & Transport)
+ = + = Label request card and specimen with the „Danger of Infection‟ Sticker if the patient is known or suspected to have
hazard group 3 or group 4 pathogen(s) and state on the request card the risk.
Some Examples: Hepatitis B virus and Hepatitis C virus, Human immunodeficiency virus (HIV), Creutzfeldt-Jakob
Disease (CJD), Brucella spp., Mycobacterium tuberculosis (TB), Salmonella typhi (Typhoid) and Salmonella
Place the specimen container into the plastic bag attached to the request card and seal it properly. Specimens are then placed into a second, large, transparent plastic bag. Please add The bag of specimens can then be put together with other bags of specimens into a rigid paratyphi, Escherichia coli O157, Taenia solium, Histoplasma capsulatum.
sufficient absorbent material to absorb any fluid in case of breakage. transport box.
(If multiple specimens are placed into the same bag, please cushion them to prevent breakage) (For more information on and the name of other hazardous pathogens, please refer to the „Specimens: Safe Handling & Transport Policy‟
(Place all specimens for one specific department into the same secondary bag i.e. all The Pod on the right hand side is for the Pneumatic (Air) System. A limited number of appendix C for category A organisms, and the „Advisory Committee on Dangerous Pathogens‟ for pathogen hazard groups
microbiology specimens in one bag and immunology in another bag) specimens can be placed in it. Ensure specimen is well cushioned with absorbent material. http://www.dh.gov.uk/ab/ACDP/DH_087526)
For large specimen containers:
Depending on the size of the specimen container used. If it is too large it may not fit
= + = securely into a rigid transport box together with other specimens. The specimen
container will need to be placed into another transport box on its own. Ensure the
specimen is well cushioned with absorbent material.
Adhere the request card to the specimen container and make certain it will not fall off. If the specimen container is too large to fit into a transparent plastic bag, please use a
larger plastic bag to contain it. Do not send without a secondary plastic bag.
There are two main methods of transportation within the hospital Taxis are used for URGENT There are four different transportation methods between hospital sites and to/from locations outside hospitals
specimens outside the normal
Highly reliable system that Please use the porter- working hours of SCAS trans- Royal Mail Group plc will not accept a package that contains UN2814 or UN2900 It is the SCAS responsibility A patient may take their own
allows rapid transport of ing service in the event port services. infectious substances/Category A infectious substances. They only accept to maintain a regular trans- specimen(s) to laboratory via public
specimens from wards to of a breakdown or for packages that contain Category B infectious substances that are packaged to port service and to ensure transport as this is outside the “The
Specimen must be double
laboratories. any specimens not Packing Instruction PI650 in appendix D of „Safe Handling & Transport Policy‟ specimen quality is not Carriage of Dangerous Goods and
bagged and the outside bag
(See Estates & Facilities suitable for transport by requirements. compromised due to any Use of Transportable Pressure
clearly labeled „URGENT‟
Intranet Site for the Standard the pneumatic (air) tube excessive delay. Equipment Regulations 2004
before placing in the transport
Operating Procedures) system. („Carriage Regulations‟)”.
box. Please read the Packing Category A specimens need to be transported by specific couriers that meet 6.2
(See Infection Control Instruction PI650 in appendix of the Technical Instructions for Safe Transport of Dangerous Goods by Air A member of staff transporting clinical
Pneumatic (air) tube system Intranet Site for dealing with Portering staff Taxi D of „Safe Handling & Post/Courier published by ICAO. These specimens must be packaged and sent by trained South Central Ambulance Public Transport specimens via public transport as
spillages within the system) Transport Policy‟. laboratory staff who have access to correct packaging and specialist Couriers. Service NHS Trust part of their work must comply with
Please contact the laboratory prior to sending Category A specimens. (SCAS) non-patient the „Carriage Regulations‟.
Contact Numbers: Web Links: References:
Porter‟s desk extensions: The following links can only be accessed within the hospitals‟ computers. National Health Service (NHS) – http://www.nhs.uk Health & Safety at Work Act 1974.
• On the John Radcliffe Hospital site – 40404
Clinical Intranet: Pathology Transport Bags & Packs – http://www.versapak.co.uk
• On Churchill Hospital site – 25024 The Management of Health & Safety at Work Regulations 1999.
• On Horton General Hospital site – 59000 • Microbiology Handbook - http://lmweb.oxnet.nhs.uk/labmed/micro/for_upload/index.htm Pathology Specimen Transport Packaging – http://www.dgpgroup.com
• Haematology Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/HOME003.HTM
Laboratory telephone numbers: • Immunology Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/imm/immunology.htm
The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations 2004 ('Carriage Regulations').
Safety Pack – http://www.saftpack.com
• Biochemistry – 018652 20336 • Cellular Pathology Handbook - http://orhnet.orh.nhs.uk/cellpath/link.asp?pid=0&id=1464
• Cytology – 018652 20509 • Biochemistry Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/HOME001.HTM Royal Mail – http://www.royalmail.com The Control of Substances Hazardous to Health (COSHH) Regulations 2004.
• Haematology – 018652 20336
• Histology – 018652 20490/20491 Health & Safety Executive (HSE) – http://www.hse.gov.uk “Working with ADR: An Introduction to the Carriage of Dangerous Goods by Road” (Department of Transport 2005) - ISBN 1-
• Immunology – 018652 25995 Infection Control Intranet site - http://orh.oxnet.nhs.uk/InfectionControl/Pages/Default.aspx
• Microbiology – 018652 21918
Health Protection Agency (HPA) – http://www.hpa.org.uk
• Virology – 018652 20877 Estates & Facilities Intranet site - http://orh.oxnet.nhs.uk/Estates/Pages/Default.aspx
World Health Organisation (WHO) – http://www.who.int Patient Sample and Request Form Identification Criteria (Institute of Biomedical Science).
Dangerous Goods Regulation (DGR) & International Air Transport Association (IATA) – http://www.iata.org/cargo/dg
Transport of Infectious Substances – Best Practice Guidance for Microbiology Laboratories (Department of Health - June 2007).
South Central Ambulance Serivce NHS Trust (SCAT) – http://www.southcentralambulance.nhs.uk
Transport of Infectious Substances (Department of Health – Revision 3 – November 2006).
Advisory Committee on Dangerous Pathogens (ADCP) – http://www.dh.gov.uk/ab/ACDP/index.htm
Infection at Work: Controlling the Risks (Advisory Committee on Dangerous Pathogens – 2003).
Safe Handling and Transport Version 1: Date Issued 22nd September 2010