ANNEX F
MANILA DOCTORS HOSPITAL LABORATORY DEPARTMENT PROCEDURE ON SARS
Laboratory
Biosafety Procedures for Specimens from Patients with Severe Acute Respiratory
syndrome (SARS)
A. Objective
1.
To provide a set
of infection control or biological safety procedure for laboratory workers to
prevent transmission of SARS to themselves, their co-workers, and other
patients and clients of the hospital.
B.
Scope
1. This procedure covers
the collection, handling, processing and transport of specimens obtained from
patients who are under surveillance for SARS, suspect for SARS or probable SARS
patient.
C.
Case Definitions
1.
Patient under Surveillance for SARS- patients with
history of travel to high –risk places and/or exposure to persons with possible
SARS but with out symptoms.
2.
SARS Suspect Patient- patients with history of
travel to high – risk places and/ or exposure to persons with possible SARS but
with symptoms of high fever, respiratory syndrome, dry cough.
3.
Probable SARS Patient- patients described under
SARS suspect patients with laboratory findings and radiolographic evidence of
infiltrates consistent with pneumonia or respiratory distress syndrome on chest
X-ray that increase the suspicion of SARS.
4.
Confirmed SARS Patient- patients with a positive
confirmatory test for the SARS virus.
D.
Procedure
1.
Collection of Specimen (Blood for Hematology
Examination)
1.1. All
laboratory personnel are required to observe standard precautions in collection
and handling of potentially infectious laboratory specimens.
1.2. Phlebotomist
and other laboratory workers should wear personal protective equipment (PPE)
including disposable gloves, long laboratory coats, eye protection and surgical
mask or face shield to provide a barrier to mucosal surface exposure. The PPE
can be obtained from the Nursing Service Supervisors in the Wards/ Floors and
the Ward Clerk at the ER.
1.3. A
single Med. Tech. wearing PPE should handle the request from collection to
processing and disposal of the specimen.
1.4. Careful
attention should be given to hand hygiene after removal of gloves and specially
before touching the eyes or mucosal surfaces.
1.5. After
collection, all specimens are properly labeled and should be placed in a
plastic box or receptacle which is further enclosed in a clear plastic
resealable bag with a biohazard sticker. The box and bag serves to prevent
leakage of contents in case there is breakage of glass tubes or spoilage.
1.6. The
specimens with accompanying requests forms are to be brought immediately to the
laboratory after collection.
2.
Specimen Reception, Handling and Processing
2.1. Minimize
the number of personnel in the Hematology Section. If possible, only the Med.
Tech who collected the specimen is the only person within the room.
2.2. The same Med. Tech. verifies the
identification on the request form and logs it in a separate logbook for
SARS/other Hazardous specimens.
2.3. Procedure for Hematology Examination
2.3.1.
Remove the
EDTA tube from the specimen bag.
2.3.2.
Run the
specimen on the 3500 in closed tube mode
3.
Post
Analytical Handling and Waste Disposal
3.1. Decontaminate analyzer at the end of the test. Run 5% Na Hypochlorite in rinse
mode.
3.2. De-gown and decontaminate accordingly
3.3. Autoclave all complements and specimen and
place in yellow bag.
3.4. Decontaminate all working surfaces
4.
Transport of
Specimen to Referral Laboratory
4.1. Coordinate by phone with referral laboratory
(San Lazaro or RITM)
4.2. Specimen is packaged as described after
collection (refer to 1.4.)
4.3. Specimen is brought as soon as possible to
referral laboratory.