Sputum collection rules. “Sputum collection for laboratory tests Collect sputum for general and bacteriological analysis

Collection of sputum for general analysis - determination of macro- and microscopic composition, quantity and appearance sputum.

Target: diagnostic.

Indications:

Equipment: direction, a clean, dry, wide-mouthed transparent glass jar with a lid, gloves, a container with disinfectant.

in the morning at 8 o'clock on an empty stomach, brush your teeth and rinse your mouth thoroughly with water (if the gums are bleeding, do not brush your teeth, but rinse with boiled water). Then take a few breaths and cough up sputum into a container in the amount of 3-5 ml, without touching the edges of the container, close the lid.

Deliver to the clinical laboratory within 2 hours.

Note: prolonged standing of sputum leads to the reproduction of microflora and the lysis of cellular elements.

Taking sputum for examination for the presence of Mycobacterium tuberculosis (on BC by flotation method)

Target: diagnosis of tuberculosis (KK - Koch's bacillus).

Indications: as prescribed by a doctor, diseases of the bronchopulmonary system.

Equipment: direction, a clean, dry, wide-mouthed dark glass jar with a lid (pocket spittoon), gloves, a container with disinfectant.

Nursing information to the patient: from 8 o'clock in the morning, cough up sputum during the day into a container (at least 15-20 ml), and store it in a cool place (indicated by the nurse). If sputum is not enough by the morning of the next day, then it can be collected for another 2 days.

Note: with scanty sputum, it is collected within 1-3 days and delivered to the clinical laboratory in a special container for transportation.

Taking sputum for bacteriologicalresearch (for microflora)- identification of causative agents of inflammatory diseases respiratory system(Staphylococcus aureus, viridescent streptococcus, etc.) and determination of their sensitivity to antibiotics.

Target: diagnostic.

Indications: as prescribed by a doctor, diseases of the respiratory system.

Equipment: direction, a sterile wide-mouth container with a lid (taken in a bacteriological laboratory), gloves, a container with a disinfectant solution.

Patient preparation: the study is carried out before the start of antibiotic therapy or 3 days before taking sputum, it must be canceled.

Nursing information to the patient: in the morning at 8 o'clock on an empty stomach, after thorough oral hygiene (brush your teeth and rinse your mouth well), cough up 2-3 sputum into a container (do not allow saliva to enter), without touching its edges with your hands or mouth. Then the container with sputum must be closed with a lid

Deliver to the bacteriological laboratory no later than 1-1.5 hours after collection.

Note: the sterility of dishes is preserved for 3 days in a kraft bag.

Memo for the patient when prescribing a general clinical study of feces.

A general clinical examination of stool is prescribed by your doctor. The purpose of the study is to objectively assess the digestive capacity of various parts of your body. digestive tract.

To obtain reliable results, you need to prepare yourself for this study: 3 days before fecal sampling, it is advisable for you to exclude food products containing iron (meat, fish, all green vegetables), do not take laxatives and do not do enemas.

You can purchase a ready-made container for collecting feces at a pharmacy, or prepare it yourself at home, for this, the glass container and lid must be thoroughly washed with water and soda, then poured over with boiling water and dried (do not wipe). The container should not contain traces of soap or detergent, fibers from the fabric, as this may distort the analysis data.

Collect feces should be in the morning after sleep, immediately after defecation, preferably in a warm form. Close the container with a lid and take it with a referral to the clinical laboratory.

It is very important that you strictly follow the indicated recommendations, as only in this case reliable results will be obtained.

SITUATIONAL TASKS

Bacteriological examination of sputum makes it possible to detect pathogens of various diseases. The presence of tuberculosis mycobacteria in the sputum is important for the diagnosis. Sputum for tank - research for sowing is collected in a sterile dish (wide-mouthed). The dishes are issued by the tank - laboratory.

ATTENTION!!!

If there is not enough sputum, it can be collected up to 3 days, keeping it in a cool place.

Sputum on the tank - sowing in tuberculosis patients for the reliability of the result is collected within 3 days, in different sterile containers (3 jars).

If it is necessary to prescribe antibiotics, sputum is examined for sensitivity to them. To do this, the patient in the morning, after rinsing his mouth, coughs and spits sputum several times (2-3 times) into a sterile Petri dish, which is immediately sent to the laboratory.

ATTENTION!!!

Give clear instructions to the patient about the use of sterile utensils to collect sputum for analysis:

a) do not touch the edges of the dishes with your hands

b) do not touch the edges with your mouth

c) after expectoration of sputum, immediately close the container with a lid.

THEN item 7

To the tank - laboratory

Sputum for microflora and

sensitivity to

antibiotics (a/b)

Sidorov S.S. 70 years old

3/IV–00 signed m/s

Sputum analysis for bacteriological examination.

Target: to ensure high-quality preparation for the study and timely receipt of the result.

Training: informing and educating the patient.

Equipment: sterile jar (spittoon), direction.

Execution sequence:

Explain to the patient (family member) the meaning and necessity of the upcoming study and obtain his consent to the study.

A) in stationary conditions:

briefing and provision of laboratory glassware to be carried out the night before;

B) in outpatient and inpatient settings explain to the patient the features of preparation:

brush your teeth thoroughly the night before;

in the morning after sleep, rinse your mouth thoroughly with boiled water

Instruct the patient on how to handle sterile laboratory glassware and how to collect sputum:

Cough, open the lid of the jar (spittoon) and spit out sputum without touching the edges of the jar;

Close the lid immediately.

Ask the patient to repeat all the information, ask questions about the technique of preparation and collection of sputum.

Indicate the consequences of violating the nurse's recommendations.

A) on an outpatient basis:

Give a direction for the study by filling it out in the form;

Explain to the patient where and at what time he (the family) should bring the bank and referral.

B) in a hospital setting:

Indicate the place and time where to bring the jar (spittoon);

Deliver the collected material to the bacteriological laboratory no later than 1.5 - 2.0 hours after the collection of the material.

Storage of material even in cold conditions is unacceptable!

Taking feces for analysis.

A great help in recognizing a number of diseases, including gastrointestinal ones, is the study of feces. Determination of the basic properties of feces by examination makes it possible to draw a number of diagnostic conclusions and is available to the sister.

The daily amount of feces healthy person depends on the quality and quantity of food, and on average it is 100 - 120 g. If absorption is impaired, and the speed of movement through the intestines is increased (enteritis), the amount of feces can reach 2500 g, with constipation, feces are very small.

Fine- bowel movements are performed once a day, usually at the same time.

ATTENTION!!!

For research, it is better to take feces after an independent act of defecation in the form in which it is excreted.

bacteriologically

macroscopically

Kal explore microscopically

chemically

Macroscopically determined:

A) color, density (consistency)

B) shape, smell, impurities

Colour–fine

with mixed food - yellowish-brown, brown;

with meat - dark brown;

with milk - yellow or light yellow;

the newborn is greenish-yellow.

REMEMBER!!! The color of feces can change:

Fruits, berries (blueberries, currants, cherries, poppies, etc.) - in a dark color.

Vegetables (beets, carrots, etc.) - in a dark color.

Medicinal substances (salts of bismuth, iron, iodine) - in black.

The presence of blood gives the feces a black color.

Consistency(density) feces are soft.

With various pathological conditions feces can be:

mushy

moderately dense

2. semi-liquid

   putty (clayey), often gray color and depends on a significant admixture of undigested fat.

The shape of the feces- Normally cylindrical or sausage-shaped.

With spasms of the intestines, feces can be ribbon-like or in the form of dense balls (sheep feces).

Smell of feces depends on the composition of the food and the intensity of the processes of fermentation and decay. Meat food gives a pungent odor. Dairy - sour.

Purpose: to study the microflora of the lungs and determine its sensitivity to antibiotics.

Equipment: sterile Petri dish with nutrient medium (blood agar, sugar broth).

The patient brushes his teeth.

The nurse prepares a referral to the laboratory in advance.

Before the procedure, she puts on an additional gown, mask, cap, glasses (especially if HIV infection is suspected or diagnosed).

The patient makes 5-6 coughing shocks in the direction of a Petri dish with a nutrient medium placed vertically at a distance of 5-10 cm.

The nurse closes the Petri dish with a lid and provides
prompt delivery to the laboratory.

Used to diagnose tuberculosis special method isolation of tuberculosis pathogens.

Sputum collection for Mycobacterium tuberculosis nurse performs as follows:

Purpose: diagnosis of pulmonary tuberculosis. The flotation (accumulation) method is applied.

Equipment: a clean, dry spittoon or jar with a lid.

The patient collects sputum for 3 days in one container.

The container (spittoon) is stored in a cool place:

After 3 days, the nurse delivers the spittoon to
laboratory.

After examination, sputum is burned in muffle furnaces.

Sputum is collected for atypical (tumor) cells as follows:

Objective: Diagnosis of neoplastic lung diseases.

Equipment: sterile dry spittoon.

Fresh morning sputum is sent for research.

The day before, the nurse warns the patient about the time and
analysis technique. In the morning she gives him a sterile, dry, labeled spittoon.

In the morning the patient brushes his teeth.

Expectorates phlegm (5 ml is sufficient) without touching the edges
spittoons.

Tightly close the spittoon with a lid, put it in a cool place.

The nurse completes the referral and quickly delivers the sputum to the laboratory, as tumor cells are rapidly destroyed.

Examination of feces. For a number of diseases gastrointestinal tract and not only shows the study of feces. Cal is the end product resulting from complex biochemical processes and absorption of end products of digestion in the intestine.

The study of feces can be carried out:

General clinical;

bacteriological methods.

General clinical methods for the study of feces

Rules for collecting material for a general clinical study. Preliminary preparation of the subject for a general analysis of feces (macroscopic, chemical and microscopic) consists of eating food with a dosed content of proteins, fats and carbohydrates for 3-4 days (3-4 bowel movements). These requirements are met by the Schmidt or Pevsner diet. It is best to examine the feces after self-defecation, aiming to ensure that the feces are fresh or have stood in the cold for no more than 12 hours. The feces should be delivered in a clean, dry and transparent glass dish. When preparing a patient for research on occult bleeding, fish, meat, all kinds of green vegetables, tomatoes, eggs, medications containing iron (i.e., substances that give false positive reaction for blood).

physical properties.

The amount is normally 100–250 g on average. It increases with diseases of the pancreas. Density - feces can be formed, mushy and liquid. The consistency of the formed feces is soft and dense. Form - the formed feces normally have a cylindrical shape. In a spastic state, the feces may have a ribbon-like shape. Color - the color of feces is influenced by endogenous and exogenous pigments and pathological impurities. The reaction is normal in practically healthy people who are on a mixed diet, the reaction of feces is neutral or slightly alkaline (pH 6.8–7.6) and is due to the vital activity of the normal bacterial flora of the large intestine. Sharply acidic (pH less than 5.5) occurs with fermentative dyspepsia. The smell of normal feces depends on the presence of skatole and indole.

Chemical properties. Protein. AT stool ah healthy human protein is not. Blood. positive reaction blood (hemoglobin) indicates bleeding from a weak part of the digestive tract. Urobilinogen (stercobilinogen) is normal per day 40–280 mg. Bilirubin - Normally, bilirubin is found in the meconium and feces of a child who is on breastfeeding up to 3 months of age. From 9 months and older, only stercobilinogen, stercobilin, is present in the feces.

Microscopic studies. Prepared for microscopic studies the following drugs: preparation - a drop of fecal emulsion. Mucus, leukocytes, erythrocytes, columnar epithelium, helminth eggs, protozoan cysts and vegetative individuals are examined. The drug is a drop of fecal emulsion with Lugol's solution of extracellular or intracellular starch and iodophilic flora. The drug is a drop of fecal emulsion with a drop of 20–30% acetic acid for the diagnosis of fatty acid salts. The drug is a drop of fecal emulsion and a drop of 0.5% aqueous solution methylene blue for the diagnosis of neutral fat and fatty acids.

At microscopic examination identify : tripelphosphates- colorless, trapezoidal shape; their presence indicates an increase in the processes of decay in the colon; Charcot-Leiden- colorless, having the shape of an elongated rhombus, are found in helminthiases and colitis caused by protozoa, allergic colitis; bilirubin- small sticks, folding into bundles, appear with dysbacteriosis and enterocolitis; hematoidin - golden yellow in the form of rhombuses or long needles. Appear with gastrointestinal bleeding; elements of the intestinal mucosa: mucus, leukocytes, erythrocytes, columnar epithelium, malignant tumor cells. Normally, single cells can be found in the mucus covering the formed feces. columnar epithelium and single leukocytes. An increase in the number of leukocytes, erythrocytes, cylindrical epithelium is characteristic of inflammation of the intestinal mucosa; microflora: makes up 1/3-1/4 of the feces. Under microscopy in pathological conditions (fermentative dysbiosis), along with with starch and digested fiber can be found iodophilic flora, colored in dark color Lugol's solution. yeast cells, found in preparations stained with Lugol's solution, indicate dysbacteriosis. The study of microflora can be carried out bacteriologically and virologically.

Taking feces for testing for eggs of worms and if you suspect infectious diseases has its own characteristics. For research on eggs of worms, feces are taken in a warm form immediately after emptying the intestines from several (at least 3) different places and delivered to the laboratory no later than 30 minutes later. If enterobiasis is suspected glass rod make a scraping from the folds of the anus and place it in a drop of glycerin or isotonic sodium chloride solution on a glass slide. To take feces for dysentery, it is necessary to prepare a special test tube with a mixture of glycerin and ammonia, inside which is placed a glass rectal tube. The patient is laid on his left side and with rotational movements a tube of 5-6 cm is carefully inserted into the anus. The tube is removed and lowered into the test tube without touching the walls. Close the tube and send it to the laboratory with the appropriate referral.

Kal on occult blood. For research on occult blood, the patient is prepared for 3 days, excluding meat and fish dishes, as well as drugs containing iodine, bromine and iron. On the 4th day, the taken feces are sent to the laboratory for examination.

In diseases of the ENT organs, one of the frequent diagnostic procedures is taking a swab from the pharynx and nose. The nurse performs the manipulation as follows:

Taking a swab from the pharynx. Equipment: sterile metal brush, glass vial, spatula. For sowing, take detachable ulcers or plaque from the tonsil or palatine arches.

1. Seat the patient in front of a light source, ask him to open his mouth wide;

2. With a spatula in the left hand, press the root of the patient's tongue;

3. With your right hand, remove the shaving brush from the test tube outer part plugs and, without touching the mucous membrane, brush over the temples and palatine tonsils;

4. Be careful not to touch outer surface test tubes, insert a shaving brush with material for inoculation into a test tube;

Taking a swab from the nose. Equipment: sterile metal brush, glass vial, spatula.

1. Seat the patient (the head should be slightly thrown back);

2. Take a test tube in left hand, right hand extract a shaving brush from it;

3. With the left hand, lift the tip of the patient's nose, with the right hand, insert the shaving brush with light rotational movements into the lower nasal passage on one side, then on the other;

4. Carefully without touching the outer surface of the test tube, insert the swab with the material for inoculation into the test tube;

5. Fill in the direction (full name of the patient, "Smear from the pharynx", date and purpose of the study, name medical institution);

6. Send a test tube with a referral to the laboratory.

Phlegm is mucus that is produced directly by the organs of the respiratory system. It should be noted that daily our bronchi and lungs produce up to 50 ml of mucous secretion, if sputum is going to be more common to talk about pathology. Sputum examination allows you to study the composition of mucus. Sputum analysis not only speeds up the diagnostic process, but is also the most correct method for studying the biochemical composition of mucus.

To whom and why appoints an analysis?

In addition to the mucus secreted by sputum, it also contains pathogenic microorganisms that can become causative agents of diseases of the upper respiratory tract. Mucus analysis allows you to:

A sputum examination is prescribed for all patients who complain for a long time of an increased amount of mucus discharge. In addition, the basis for the appointment of the analysis can serve as:

1. Suspicion of chronic or acute diseases upper respiratory tract.

2. Monitoring the effectiveness of the therapy.

During the study, laboratory assistants study the color, quantity, viscosity, chemical, physical and bacteriological composition of sputum. Basically, you can get the result within three days. The patient receives a form in which the estimated sputum data are indicated. Today, the study is conducted by both private and public medical institutions.

We managed to find out that biochemical research sputum is assigned for the diagnosis of evaluation pathological process lungs and airways. Sputum may be secreted when various pathologies, and its amount can be different, ranging from 75 ml per day with bronchitis, and ending with 12 liters of mucus, with putrefactive processes in the respiratory tract.

Sputum may include:

• cellular elements of the blood;
• microorganisms of various etymologies;
• tumor cells;
• worms;
• organisms of the class Protozoa.

The secreted sputum can serve as a distributor of many diseases. For example, tuberculosis and Escherichia coli. Microorganisms from sputum can be transmitted by shaking hands that have been touched by the hand.

Sputum is collected for the following tests:

Mucous, astringent substance with or without cough, indicates the presence of pathology of the upper respiratory tract. On the early stage important to pass necessary examinations, and not the last place in the diagnosis of diseases is played by the study of sputum.

Collection of sputum for bacteriological examination algorithm of actions

To obtain the most correct and reliable data, the procedure for collecting sputum for research must be performed in accordance with established rules. Biochemical analysis sputum can be taken both in the laboratory and at home. After collection, the biomaterial must be delivered to the medical facility as soon as possible.

Sputum collection steps:

If necessary, a sterile jar of sputum can be stored in the refrigerator for 3 hours. Remember, the jar must be closed after the test, and it must not be exposed to direct sunlight.

Inhalation, or breathing over steam, will help to collect sputum correctly. As ingredients for inhalation, you can use potatoes, sea salt, collection of medicinal herbs.

Remember, a prolonged cough that is accompanied by sputum is a signal for action. Do not debug a trip to a specialist. Only timely and competent treatment will give you good health and excellent well-being.

You need to know the rules for collecting sputum, since a more accurate determination of the results of the analysis depends on this. That will contribute to the correct and correct determination of the patient's diagnosis.

Many diseases most often have several pronounced symptoms. Not enough to define a disease external signs, additional analyzes are needed. Sputum production can be an alarming indicator of respiratory involvement. It is the main sample for testing for tuberculosis, which is why it is so important to follow the rules for collecting sputum.

Watch a short video about sputum collection and tuberculosis.

Also, these secretions of the body when coughing can help determine a more complete picture of the course of the entire disease. Sputum collection is in a simple way taking the analyzed material from the human body, which helps to do without surgical intervention.

Why carry out this procedure

A severe cough may indicate serious illness respiratory organs, and sputum is excreted already with certain pathological infections. Depending on the different composition The components contained in it can determine the exact nature of the disease.

The importance of testing should not be underestimated, it is necessary to follow the rules that are required when collecting sputum. After all, with the help of this study, you can learn a lot important information and promote correct and timely .

Sputum when coughing is collected for two tests:

1. General analysis - for the study of bronchial organs, detection of pathologies and neoplasms.
2. Tuberculosis analysis - to determine the mycobacterium infection.

The respiratory organs play a significant role in the human body, so if you have a cough that does not go away for a long time or there are suspicions of such serious illness like tuberculosis, then, without delay, you need to contact a specialist and pass the necessary tests.

What you need to know when collecting sputum

The procedure itself can be broadly divided into three main parts:

• Preparation for sampling;
• direct execution of actions;
• final part.

First of all, in order to comply with all the rules when collecting sputum, both for general analysis and for tuberculosis, it is necessary to have a special container for this procedure. She must be small size, clean, better sterilized, with a wide inlet and a well-closing lid.

Disposable container for collecting sputum for analysis.

Such special disposable jars for collecting the analyzed sample are sold at the pharmacy, it is more expedient to purchase them there. It is also necessary to consult a doctor and have a ready-made referral issued for presentation in the laboratory.

AT medical institutions sputum collection is organized in specially equipped rooms, the main function of which is to provide good ventilation. When carrying out the procedure itself, you will need to open a window or window and ensure that there are no other people in this room. Hospital workers should hang a special sign on the door of such an office and enter it only with respiratory protection, i.e. in respirators. Do not forget that tuberculosis, for which this procedure is also carried out, is an infection transmitted by airborne droplets, so all precautions are mandatory.

Other types of containers for biological material.

If the patient is unable to this procedure in a specially designated office or the hospital is not equipped with one, then he carries it out on his own. It is better to choose a place with a good air flow: on the street or at home with an open window. You also need to make sure that there are no other people around you.

The doctor will have to explain to the patient the day before all the rules that he needs to know about collecting sputum. Inform about the time of receipt of the analyzed material in the medical institution where it will be sent, this is most often the morning hours, and instruct about the main exceptions. Before the procedure, you can not:

• Eating;
• drink any liquids;
• use any medical and medicinal;
• smoke.

After preparation, it is necessary to carry out the procedure in a certain sequence of actions, namely:

1. Rinse your mouth thoroughly with water.
2. Next, we take two deep exhalations and inhales, between each new breath you need to hold your breath for a couple of seconds, then inhale and cough well.
3. Spit out the sputum into a jar so that everything is inside.
4. Close the vial tightly and deliver to the laboratory as soon as possible.

Important. It is necessary to ensure that it is sputum that is in the container, and not saliva.

What can such an analysis show?

Koch's wand in sputum analysis.

The study of a sputum sample is carried out in specialized laboratories. To determine the diagnosis, look at its external composition and make bacteriological analysis. Organoleptically, you can determine the color, smell and consistency of the sample taken for analysis.

The study of the material under a microscope allows you to identify individual components of the composition, which will be an indicator of certain types of inflammation of the respiratory system. To obtain an accurate result, you need to collect the material at least three times, and in some cases more. This analysis will help identify the disease, and prevent the infection from developing.

Depending on all indicators of sputum analysis, diseases such as:

• Acute or chronic bronchitis;
• oncological disease;
• allergy;
• inflammation, indicating tuberculosis or pneumonia.
• abscess.

Also, this procedure may be prescribed to track the results of a treatment already started.

Correctly compare and explain all the data of the analysis and the patient should only be a doctor. But it is worth preparing for a long wait, since this qualitative analysis of the definition of lung diseases takes quite a long time.