specimen collection of nasopharyngeal swab and...

SPECIMEN COLLECTION OF NASOPHARYNGEAL SWAB AND OROPHARYNGEAL SWAB

RESEARCH INSTITUTE FOR TROPICAL MEDICINE

SUPPLIES/EQUIPMENT NEEDED

• COVID-19 Case Investigation Form (CIF) and RITM linelist• Virus Transport Media (VTM) or Universal Transport Media (UTM) or

Sample Storage Reagent (Sansure)• Nasopharyngeal swab, Sterile Dacron/Rayon swab with pliable shaft• Oropharyngeal swab, Sterile Dacron/Rayon swab with plastic shaft• Sterile tongue depressor• Test Tube rack• Resealable plastic bags (zip lock)• Laboratory sealing film (parafilm)• Masking tape• Permanent tube marker• Scissors• PPE (Laboratory gown, gloves, N95mask, goggles)• Refrigerator

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COLLECTION KIT

• Virus Transport Medium

• Nasopharyngeal swab

• Oropharyngeal swab

COPAN SAMPLE COLLECTION KIT⚫ Universal Transport Medium (UTM)

or equivalent

⚫ Copan Flocked Swab or equivalent

breakpoint

Sample Storage Reagent (Sansure) and OPS

5

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DIRECTIONS FOR USE OF SWAB

• Swabs should not be used if

▪ there is evidence of damage or contamination

▪ the expiration date has passed

▪ the swab package is damaged

▪ there are other signs of deterioration

• During sampling, the swab shall only come in contact with thesuspected infection.

• Do not use excessive force when collecting swab samples frompatients as this may result in accidental breakage of the swab shaft.

• Swabs are for single use only.

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Swab held correctly

Swab held incorrectly

TECHNICAL NOTES: CORRECT

HANDLINGOF SWAB

Correctly held swab can slide

out of the way.

Incorrectly held swab can injurepatient.

RELEVANTANATOMY:THE RESPIRATORYSYSTEM

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AREA FOR NASOPHARYNGEAL SWAB SAMPLING

TARGET

SITE FOR

NPS

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THE ORAL CAVITY

Sensitive to

gag reflex

TARGET SITE

FOR OPS

To gain access to the

oral cavity, use a

tongue depressor

GUIDELINES PRIOR TOSPECIMENCOLLECTION

INFECTION CONTROL

GUIDELINES

•Personal protective equipment:wear N95 mask and disposablegloves.

•When completed, dispose of allPPE and other contaminatedmaterials in the appropriatetrash bin.

•Wash hands thoroughly withsoap and water or alcohol basedhand gel before AND after theprocedure.

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SPECIMEN COLLECTION POLICIES

• Specimens shall be collected within 10 days fromonset of illness.

• Only qualified and trained staff shall perform the procedures.

• Do NOT use wooden and cotton swabs.

• Check for integrity of the OPS/NPS swabs anddo not use beyond expiration.

• Use only the approved kits for specimen collection.

SPECIMEN COLLECTION POLICIES

•Correctly identify the patient and label the UTM tube prior tocollection.

•Label the tube with the patient’s full name, age and dateof collection. The information on the label must MATCHthe information on the CIF.

•Remove possible visual obstructions.

•Strictly follow infection control guidelines prior to eachprocedure. (Protect yourself from the patient)

SPECIMEN COLLECTIONPROPER

NASOPHARYNGEALSWAB (NPS)

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• Using the swab, visuallymeasure* from the base ofthe nostril towards theauditory pit.

• Divide the length into halfin order to know into whatextent will be inserted intothe nostril (usually 5–6 cmin adults) to ensure that itreaches the posteriorpharynx.

*Alternatively, you may use a ruler for more

accurate measurements

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NPS: STEP 2

• With the patient

seated, tilt the

head slightly

backwards. Insert

the swab into the

nostril parallel to

the palate

NPS: STEP 3

•Insert the swab intothe nasal cavity untila slight resistance ismet.

•Rotate the swab andapply a little force totake large quantitiesof mucosa

•Repeat in the othernostril using sameswab

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NPS: STEP 4

• Place the NPSimmediately in theUTM tube to avoiddrying of the swab.

• Break/Cut the end ofthe shaft that sticksout of the tube (breakpoint) and close thetube tightly.

• Secure the cap withParafilm to preventleakage duringtransport

NPS: STEP 5•Transport the specimento the laboratory andimmediately store insiderefrigerator(2- 8C) .

• If site is far from arefrigerator,use athermo bag/boxwith 4-6 icepacks

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SPECIMEN COLLECTIONPROPER

OROPHARYNGEALSWAB (OPS)

OPS: STEP 1•Have the patientseated comfortably.

•Have the patientopenhis mouth.

•With gloved hands,hold down thetongue with a steriletongue depressor

•Have the patient say͞AAH͟ to elevate theuvula

OPS: STEP 2

•Use a sweeping motionto swab the posteriorpharyngeal wall andtonsillar fossa.

•Avoid swabbing thesoft palate.

•Do not touch thetongue with the swabtip.

OPS: STEP 4

•Place the OPSimmediately in thesame UTM with NPS.

•Cut the end of theshaft that sticks out ofthe tube and close thetube tightly.

•Secure the cap withParafilm to preventleakage duringtransport.

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BEST PRACTICES

✓ Ask patient to remove extra secretions beforeprocedure.

✓ Ask patient to close his or her eyes.

✓ Visually estimate the depth of insertion.

✓ Label the tube first PRIOR to collection.

✓ REMEMBER: Your safety first and foremost.

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SPECIMEN COLLECTION POLICIES

Sample Storage Reagent(Sansure)

Room temperature or 2-8C