Oxford Radcliffe Hospitals

NHS Trust

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

Microbiology, Serology & Virology
Blood grouping & Transfusion
Immunology Separate form for MRSA
screening
Small Spills (<2.5L) Large Spills (2.5L or more)
discard PPE after use.
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. OR the Emergency Services.
Clinical Biochemistry &
Separate forms for Histology, Cytology Cover with Formalin control granules for 15 If the spill is >2.5litres or if the area where the spillage
Laboratory Haematology
and Neuropathology. Check on Clinical
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
plastic bag. Label the bag Inert mass of urea- should be notified immediately.
of the spillage and what has been spilt. 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
Examples:
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
for incineration.

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 patients 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
from biochemistry).
State URGENT on the request card. If necessary inform the laboratory registrars and / or Biomedical Scientists.
For interoperative specimens (i.e. frozen sections) and urgent fresh/unfixed biopsies - DO NOT place in formalin,

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make sure they are package separately , deliver directly to cellular pathology and inform the laboratory.

Check there is no additional risk to laboratory staff if so label accordingly e.g. Danger of Infection (see below)

Collecting specimens from patients who have had a radioisotope should be avoided. Advice on specimen collection,
handling and transport for specimens with a Radioactive risk is available from Medical physics on extension 25441.
MATCH?

The standard packaging method

(For more information on packaging specimens for transport, please read the Trust policy on Specimens: Safe Handling & Transport)

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Place the specimen container into the plastic bag attached to the request card and seal it properly.
(If multiple specimens are placed into the same bag, please cushion them to prevent breakage)
For large specimen containers:
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Specimens are then placed into a second, large, transparent plastic bag. Please add
sufficient absorbent material to absorb any fluid in case of breakage.
(Place all specimens for one specific department into the same secondary bag i.e. all
microbiology specimens in one bag and immunology in another bag)
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
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.
transport box.
(For more information on and the name of other hazardous pathogens, please refer to the Specimens: Safe Handling & Transport Policy
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
specimens can be placed in it. Ensure specimen is well cushioned with absorbent material. http://www.dh.gov.uk/ab/ACDP/DH_087526)

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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
Highly reliable system that
allows rapid transport of
specimens from wards to
laboratories.
(See Estates & Facilities
Intranet Site for the Standard
Operating Procedures)
(See Infection Control
Pneumatic (air) tube system Intranet Site for dealing with
spillages within the system)
Taxis are used for URGENT
specimens outside the normal
Please use the porter- working hours of SCAS trans-
ing service in the event port services.
of a breakdown or for
Specimen must be double
any specimens not
bagged and the outside bag
suitable for transport by
clearly labeled URGENT
the pneumatic (air) tube
before placing in the transport
system.
box. Please read the Packing
Instruction PI650 in appendix
Portering staff Taxi D of Safe Handling &
Transport Policy.
There are four different transportation methods between hospital sites and to/from locations outside hospitals
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
infectious substances/Category A infectious substances. They only accept to maintain a regular trans- specimen(s) to laboratory via public
packages that contain Category B infectious substances that are packaged to port service and to ensure transport as this is outside the The
Packing Instruction PI650 in appendix D of Safe Handling & Transport Policy specimen quality is not Carriage of Dangerous Goods and
requirements. compromised due to any Use of Transportable Pressure
excessive delay. Equipment Regulations 2004
(Carriage Regulations).
Category A specimens need to be transported by specific couriers that meet 6.2
of the Technical Instructions for Safe Transport of Dangerous Goods by Air A member of staff transporting clinical
Post/Courier published by ICAO. These specimens must be packaged and sent by trained South Central Ambulance Public Transport specimens via public transport as
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.
transport service

Contact Numbers: Web Links: References:

Porters 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
On Churchill Hospital site 25024 Clinical Intranet: Pathology Transport Bags & Packs http://www.versapak.co.uk
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
904763-47-2.
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