A CSF analysis examines cerebrospinal fluid to diagnose central nervous system conditions. It involves measuring CSF pressure and analyzing samples for cells, proteins, glucose and other factors. A lumbar puncture is typically done to collect CSF. Analysis helps identify infections, bleeding, tumors and other brain or spinal disorders. Pleural fluid analysis evaluates fluid in the lungs' pleural cavity, distinguishing transudates caused by conditions like heart failure from exudates linked to infections, cancers and other injuries or inflammations. Paracentesis analyzes peritoneal fluid accumulation in the abdomen to determine if it is a transudate or exudate, aiding diagnosis of liver disease, infections and other causes.

1. Examination of
body cavity fluids,
transudates-
exudates.
Dr. Pallavi Pathania

2. Laboratory testing can be performed on many types of fluids
from the body other than blood. Often, these fluids are
tested instead of blood because they can give more direct
answers to what may be going on in a particular part of the
body.

3. Some body fluid analyses include:
–Urinalysis
–Semen Analysis
–Sweat Chloride
–Fetal Fibronectin (fFN)
–Amniotic Fluid Analysis
–CSF Analysis
–Synovial Fluid Analysis
–Pleural Fluid Analysis
–Pericardial Fluid Analysis
–Peritoneal Fluid Analysis

4. – Samples are usually obtained through collection of the fluid in a container
(e.g., urine, semen) or by inserting a needle into the body cavity and
aspirating with a syringe a portion of the fluid (e.g., CSF, pericardial fluid).
For additional general information on how various samples are collected,
see Collecting Samples for Testing.
– Once a sample is obtained, a variety of tests may be performed, including
chemistry tests, microscopic examinations, genetic tests, and infectious
disease tests.
– For certain body fluids, including pleural, pericardial, and peritoneal fluids,
it is important to determine through testing whether the fluid is a
transudate or an exudate because it can help diagnose the disease or
condition present.

5. Transudate
–Caused by an imbalance between the pressure within blood vessels (which
drives fluid out) and the amount of protein in blood (which keeps fluid in)
–It is a clear fluid with a low protein concentration and a limited number of white
blood cells.
–Seen in conditions such as congestive heart failure and cirrhosis
Exudate
–Caused by injury and/or inflammation
–It has a higher than normal protein content and may be cloudy due to increased
numbers of cells.
–Seen in conditions such as infections, malignancies (metastatic cancer,
lymphoma, mesothelioma) or autoimmune diseases

6. Semen
analysis

7. – A semen analysis (plural: semen analyses), also called
"seminogram" evaluates certain characteristics of a
male's semen and the sperm contained therein. It is done
to help evaluate male fertility, whether for those seeking
pregnancy or verifying the success of vasectomy.
– Normal sperm densities range from 15 million to greater
than 200 million sperm per milliliter of semen. You are
considered to have a low sperm count if you have fewer
than 15 million sperm per milliliter or less than 39
million sperm total per ejaculate.

9. – Semen analysis, also known as a sperm count test, analyzes
the health and viability of a man's sperm. Semen is the
fluid containing sperm (plus other sugar and protein
substances) that's released during ejaculation. A semen
analysis measures three major factors of sperm health: the
number of sperm.

10. Sample collection
– Avoid ejaculation for 24 to 72 hours before the test.
– Avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days
before the test.
– Stop taking any herbal medications, such as St. John’s wort and echinacea, as
instructed by your healthcare provider.
– Avoid any hormone medications as instructed by your healthcare provider.
– There are four main ways to collect a semen sample:
– masturbation
– sex with a condom
– sex with withdrawal before ejaculation
– ejaculation stimulated by electricity
– Masturbation is considered the preferred way to get a clean sample.

12. Result

14. Sweat Chloride
The sweat chloride test is a common and simple test used to
evaluate a patient who is suspected of having cystic fibrosis
(CF), the most common lethal genetic disease.
The sweat test measures the amount of chloride in sweat.
Kids with cystic fibrosis can have two to five times the normal
amount of chloride in their sweat. In a sweat test, the skin is
stimulated to produce enough sweat to be absorbed into a
special collector and then analysed.

16. How is the sweat chloride test done?
To produce the necessary volume of sweat, a technique
called iontophoresis is employed. The technique requires
the application of a tiny (painless) electrical current that
medically stimulates maximumsweat production. The
patient's forearm is commonly used.

17. – Getting the Results. Results are usually available in 1–2 days.
If your child has asweat chloride level of more than 60
millimoles per liter, it's considered abnormal and indicates a
high likelihood of cystic fibrosis, though some children with
CF do have borderline or even normal sweat chloride levels.
– A positive sweat chloride test indicates that it is likely that
the infant or person tested has cystic fibrosis (CF). Positive
sweat chloride tests are typically repeated for
verification. ... A negative sweat chloride test means that it
is unlikely the person tested has CF.

19. Fetal Fibronectin (fFN)

24. Amniotic Fluid Analysis
– Amniotic fluid surrounds, protects, and nourishes a
growing fetus during pregnancy. Amniotic fluid
analysis involves a variety of tests that can be performed
to evaluate the health of a fetus. ... The amount
of amniotic fluid increases over time and is constantly
being absorbed and renewed

25. – Amniotic fluid protects the developing baby by cushioning
against blows to the mother's abdomen, allowing for easier
fetal movement and promotingmuscular/skeletal
development. Amniotic fluid swallowed by the fetus helps
in the formation of the gastrointestinal tract.
– An AFI between 8-18 is considered normal. Median AFI
level is approximately 14 from week 20 to week 35, when
the amniotic fluid begins to reduce in preparation for
birth. An AFI < 5-6 is considered as oligohydramnios. The
exact number can vary by gestational age.

27. – Amniocentesis (also referred to as amniotic fluid test) is a
medical procedure
used in prenatal diagnosis of
chromosomal abnormalities and fetal infections, and also for sex
determination, in which a small amount of amniotic fluid, which
contains fetal tissues, is sampled from the amniotic sac
surrounding a developing fetus, and then the fetal DNA is
examined for genetic abnormalities.
– The most common reason to have an "amnio" is to determine
whether a baby has certain genetic disorders or a chromosomal
abnormality, such as Down syndrome. Amniocentesis (or another
procedure, called chorionic villus sampling (CVS)) can diagnose
these problems in the womb. Amniocentesis is performed when a
woman is between 14 and 16 weeks gestation.

28. A process in which amniotic fluid is sampled using a
hollow needle inserted into the uterus, to screen for
abnormalities in the developing fetus.
The needle used for the amniocentesis procedure is
usually 7.5cm long and around 0.8mm wide.

31. Fluids
– CSF
– Pleural Fluid
– Peritoneal Fluid

32. LABORATORY TESTS USED IN
CSF ANALYSIS
This test is done to measure pressures within
the CSF and to collect a sample of the fluid for further
testing. CSF analysis can be used to diagnose certain
neurologic disorders. These may include infections (such
as meningitis) and brain or spinal cord damage.
Cerebrospinal fluid has three main functions:
CSF protects brain and spinal cord from trauma.
CSF supplies nutrients to nervous system tissue.
CSF removes waste products from cerebral metabolism.

34. How much CSF is produced per day?
–The volume of the ventricles is about 25 ml. CSF is
produced at a rate of 0.2 - 0.7 ml per minute or 600-700
ml per day. The circulation of CSF is aided by the
pulsations of the choroid plexus and by the motion of
the cilia of ependymal cells.
–Normal CSF contains 0-5 mononuclear cells. The CSF
pressure, measured at lumbar puncture (LP), is 100-180 mm
of H2O (8-15 mm Hg) with the patient lying on the side and
200-300 mm with the patient sitting up. Brain capillary.

35. CSF
– Cerebrospinal fluid (CSF) is a clear, color-less liquid found in your brain
and spinal cord. The brain and spinal cord make up your central
nervous system. Your central nervous system controls and coordinates
everything you do including, muscle movement, organ function, and
even complex thinking and planning. CSF helps protect this system by
acting like a cushion against sudden impact or injury to the brain or
spinal cord. CSF also removes waste products from the brain and helps
your central nervous system work properly.
– A CSF analysis is a group of tests that look at your cerebrospinal fluid to
help diagnose diseases and conditions that affect the brain and spinal
cord.
– Other names: Spinal Fluid Analysis, CSF Analysis

36. – A CSF analysis may include tests to diagnose:
– Infectious diseases of the brain and spinal cord, including meningitis
and encephalitis. CSF tests for infections look at white blood cells,
bacteria, and other substances in the cerebrospinal fluid
– Autoimmune disorders, such as Guillain-Barré Syndrome and
multiple sclerosis (MS). CSF tests for these disorders look for high levels
of certain proteins in the cerebrospinal fluid. These tests are called
albumin protein and igG/albumin.
– Bleeding in the brain
– Brain tumors

37. – This procedure also called a spinal tap, also known as a lumbar puncture. A
spinal tap is usually done in a hospital. During the procedure:
– You will lie on your side or sit on an exam table.
– A health care provider will clean your back and inject an anesthetic into
your skin, so you won't feel pain during the procedure. Your provider may
put a numbing cream on your back before this injection.
– Once the area on your back is completely numb, your provider will insert a
thin, hollow needle between two vertebrae in your lower spine. Vertebrae
are the small backbones that make up your spine.
– Your provider will withdraw a small amount of cerebrospinal fluid for
testing. This will take about five minutes.
– You'll need to stay very still while the fluid is being withdrawn.
– Your provider may ask you to lie on your back for an hour or two after the
procedure. This may prevent you from getting a headache afterward.

38. – A CSF sample is commonly collected by performing
a lumbar puncture, which is also known as a spinal tap. An
analysis of the sample involves the measurement of and
examination for:
– fluid pressure
– proteins
– glucose
– red blood cells
– white blood cells
– chemicals
– bacteria
– viruses
– other invasive organisms or foreign substances

39. Analysis can include:
•measurement of the physical characteristics and appearance of CSF
•chemical tests on substances found in your spinal fluid or
comparisons to levels of similar substances found in your blood
•cell counts and typing of any cells found in your CSF
•identification of any microorganisms that could cause infectious
diseases
CSF is in direct contact with your brain and spine. So CSF analysis is
more effective than a blood test for understanding CNS symptoms.
However, it’s more difficult to obtain a spinal fluid sample than a blood
sample. Entering the spinal canal with a needle requires expert
knowledge of the spine’s anatomy and a clear understanding of any
underlying brain or spinal conditions that might increase the risk of
complications from the procedure.

42. Pleural fluid

43. Lungs

44. Pleural fluid is a liquid derived from the blood in the tiny blood vessels
(capillaries) in the lungs. It is found in small quantities between the layers of
the pleurae – membranes that cover the chest cavity and the outside of each
lung. It serves as a lubricant for the movement of the lungs during breathing.
A variety of conditions and diseases can cause inflammation of the pleurae
(pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion).
Pleural fluid analysis is a group of tests that evaluate this liquid to determine the
cause of the increased fluid.
The two main reasons for fluid accumulation in the pleural space are:
•An imbalance between the pressure of the liquid within blood vessels, which
drives fluid out of blood vessels, and the amount of protein in blood, which keeps
fluid in blood vessels. The fluid that accumulates in this case is called
a transudate. This type of fluid more commonly involves both sides of the chest
and is most frequently a result of either congestive heart failure or cirrhosis.
•An injury to or inflammation of the pleurae, in which case the fluid that
accumulates is called an exudate. It more commonly involves one side of the
chest and may be seen in infections (pneumonia, tuberculosis), malignancies
(lung cancer, metastatic cancer, lymphoma, mesothelioma),

45. How is the sample
collected for testing?
A sample of pleural
fluid is collected by a
healthcare practitioner
with a syringe and
needle using a
procedure
called Thoracentsis.

47. – Thoracentsis is the removal of pleural fluid from the pleural
cavity with a needle and syringe. The person is positioned
sitting upright with arms raised and supported. A local
anesthetic is applied and then the healthcare practitioner
inserts the needle into the chest (pleural) cavity and the
sample is removed.

48. Thoracentsis

49. Location
A thoracentesis involves the following
steps: You will be placed in a position that
allows the doctor to access the effusion.
Usually, you are asked to
sit upright during the procedure. It is
important to remain still during the
procedure so that the fluid does not shift.
Clip and scrub a generous area
around the 7-8th rib space on
both sides of the chest. Advance
the needle slowly at a 45 degree
angle in the middle of the 7th or
8th intercostal space into the
pleural space. A small amount of
negative pressure should be
applied as the needle passes
through the thoracic wall.

50. How to Prepare for the Test
–No special preparation is needed before the test. An ultrasound, CT scan,
or chest x-ray will be performed before and after the test.
–DO NOT cough, breathe deeply, or move during the test to avoid injury to
the lung.
–Tell your provider if you take medicines to thin the blood.
Procedure
–For Thoracentsis, you sit on the edge of a chair or bed with your head and
arms resting on a table. The provider cleans the skin around the insertion
site. Numbing medicine (anesthetic) is injected into the skin.
–A needle is placed through the skin and muscles of the chest wall into the
pleural space. As fluid drains into a collection bottle, you may cough a bit.
This is because your lung re-expands to fill the space where fluid had been.
This sensation lasts for a few hours after the test.
–During the test, tell your provider if you have sharp chest pain or shortness
of breath.
–The provider may use ultrasound to get a better view of the fluid in chest.

52. – Normally, 10 to 20 mL of pleural fluid, similar in
composition to plasma but lower in protein (< 1.5 g/dL), is
spread thinly over visceral and parietal pleurae, facilitating
movement between the lungs and chest wall.
– It is recommended that no more than approximately 1.5
litres should be drained at any one time or drainage should
be slowed to<500 ml h−1.
– The amount of fluid drained varies depending on the
reasons for performing the procedure. It typically takes 10
to 15 minutes, but it can take longer if there's a lot of fluid
in the pleural space.

53. Paracentesis

54. Peritoneal fluid (ascitic fluid)
analysis
– The peritoneum is a tough semi-permeable membrane lining
abdominal and visceral cavities. it encloses, supports and lubricates
organs within the cavity. Paracentesis is effectively the analysis of
‘Ascites’ – the abnormal accumulation of fluid within the abdomen.
– The peritoneum is important in osmoregulation
– Passive diffusion of water and solute (up to a certain size)
– Maintains osmotic and chemical equilibrium with blood and lymph

55. – Ascites develops either from:
– Increased accumulation
– Increased capillary permeability
– Increased venous pressure
– Decreased protein (oncotic pressure)
– Decreased clearance
– Increased lymphatic obstruction

56. Cause
Transudate (<30g/L protein) (Systemic disease)
– Liver (Cirrhosis)
– Cardiac e.g. RHF, CCF, SBE right heart valve disease and
constrictive Pericarditis
– Renal failure
– Hypoalbuminaemia (nephrosis)
Exudate (>30g/L protein) (Local disease)
– Malignancy
– Venous obstruction e.g. Budd-Chiari, Schistosomiasis
– Pancreatitis
– Lymphatic obstruction
– Infection (especially TB)

57. Indications for paracentesis
– A febrile pt with ascites is assumed to have SBP until
proven otherwise
– New onset ascites—etiology?
– Increasing abdominal pain/discomfort
– Respiratory compromise
– Unexplained leukocytosis, acidemia, renal failure
– AMS

58. Risks of Paracentesis
– Bowel perforation
– Hemoperitoneum (0.01%)
– Hematoma (1%)
– Infection (0.01%)

59. Contraindications
– Coagulopathy is NOT a contraindication
– But don’t do paracentesis if pt is in DIC
– Must be careful if minimal fluid visualized on
U/S
– If peritoneal carcinomatosis, do not do this
procedure yourself
– Gut gets tethered to the anterior abdominal wall
and can’t move away from your needle; you can
perforate it.

60. – A sample of peritoneal fluid
is collected by a healthcare
practitioner with a syringe
and needle using a
procedure
called paracentesis.

62. Site

65. •Clear to pale yellow •Normal
•Milk-coloured (Chylous) •Malignant tumour, lymphoma, TB
•Parasitic infection, hepatic cirrhosis
•Cloudy/turbid •Peritonitis, Primary bacterial infection
•Perforated bowel, appendicitis,
pancreatitis
•Strangulated or infarcted bowel
•Bloody tap •Benign or malignant tumour
•Haemorrhagic pancreatitis, perforated
ulcer
Analysate interpretation
Gross appearance

66. Levels Interpretation
•Triglyceride •Elevated •Malignant tumour, lymphoma, TB
•Parasitic infection, hepatic cirrhosis
•Protein •0.3-4.0g/dL
•>4g/dL
•Normal
•TB, SBP
•Glucose •7-10
•<6
•Normal
•TB and malignancy
•Amylase •50% of serum level
•Increased (Up to 5x serum
level
•Normal
•Pancreatitis, pancreatic pseudocyst,
pancreatic trauma or Intestinal
strangulation
•Alkaline phosphatase •Increased •Small bowel perforation and
strangulation
Paracentesis biochemistry

67. Inferior hypogastric artery

68. After paracetesis, SBP drops
to 90 and hct drops by 4
points...

69. What to send fluid for
– Cell count with diff
– Albumin
– LDH
– Total protein
– Glucose
– Gram stain/cx
– Cytology
– Fungal stain and cx
– Esp. if peritoneal dialysis
catheter.

70. Synovial Fluid Analysis
Synovial fluid analysis is also known as joint fluid analysis. It helps
diagnose the cause of joint inflammation. Each of the joints in the human
body contains synovial fluid. This fluid is a thick liquid that lubricates the
joint and allows for ease of movement. In joint diseases like arthritis, the
synovium of the joint is the main place where inflammation occurs.
Limited mobility in the joint, or pain and stiffness with movement, are
often the first signs of joint disorders. Joint inflammation is more
common as you age.
–Joint conditions like arthritis, gout, infections, and bleeding
disorders can change synovial fluid looks and feels. A sample of this fluid
taken during a procedure called an arthrocentesis can help to figure out
what’s causing your symptoms.

73. Site for aspiration

74. Joint aspiration is a procedure to remove fluid from the space
around a joint using a needle and syringe. This is usually
done under a local anesthetic to relieve swelling and/or to
obtain fluid for analysis to diagnose a joint disorder or
problem. Joint aspiration is most often done on the knee.
However, fluid can also be removed from other joints, such as
the hip, ankle, shoulder, elbow, or wrist.
Other related procedures that may be used to
help diagnose joint problems include X-ray,
bone scan, magnetic resonance imaging (MRI),
computed tomography (CT scan), arthroscopy,
and arthrography. Please see these
procedures for additional information.

77. – Explain the procedure.
– Sign a consent form.
– Tell your healthcare provider if you are sensitive to or are
allergic to any medicines, latex, tape, and anesthetic
agents
– Tell your healthcare provider of all medicines (prescribed
and over-the-counter) and herbal supplements that you
are taking.
– Tell your healthcare provider if you have a history of
bleeding disorders .
– If you are pregnant or suspect that you are pregnant, you
should notify your healthcare provider.
– Generally, no prior preparation, such as fasting or sedation
is needed.
– Based on your medical condition, your healthcare provider

78. – A joint aspiration may be done on an outpatient basis or as
part of your stay in a hospital. Procedures may vary
depending on your condition and your healthcare
provider’s practices.
– Generally, a joint aspiration procedure follows this process:
– remove clothing and will be given a gown to wear.
– Proper positioned so that the healthcare provider can
easily reach the joint that is to be aspirated.
– The skin over the joint aspiration site will be cleansed with
an antiseptic solution.
– If a local anesthetic is used, you will feel a needle stick
when the anesthetic is injected. This may cause a brief
stinging sensation.
– insert the needle through the skin into the joint. You may
feel some discomfort or pressure. Remove the fluid by
drawing it into a syringe that is attached to the needle.

79. – The needle will be removed and a sterile bandage or
dressing will be applied.
– The fluid sample will be sent to the lab for examination.
– Once you are home, it is important for you to keep the
joint aspiration site clean and dry. Leave the bandage in
place for as long as instructed by your healthcare provider.
– The aspiration site may be tender or sore for a few days
after the joint aspiration procedure. Take a pain reliever
for soreness as recommended by your healthcare provider.
Aspirin or certain other pain medicines may increase the
chance of bleeding. Be sure to take only recommended
medicines.
– Notify your healthcare provider to report any of the
following:
– Fever of 100.4°F (38°C) Redness, swelling, bleeding, or
other drainage from the aspiration site
– Increased pain around the aspiration site

81. Pericardial Fluid Analysis
– The heart is located within a protective membrane called
the pericardium. The fluid between the pericardial membranes is
called serous fluid. Normally, only a small amount of fluid is present
because the rates of fluid production and absorption are about the
same. Many abnormal conditions can result in the buildup of fluid
within the pericardium. Specific tests are usually ordered in addition to
a common battery of tests used to distinguish a transudate from an
exudate. Transudates are effusions that form as a result of a systemic
disorder that disrupts the regulation of fluid balance, such as a
suspected perforation. Exudates are caused by conditions involving the
tissue of the membrane itself, such as an infection or malignancy. Fluid
is withdrawn from the pericardium by needle aspiration and tested as.

84. Pericardiocentesis, also called a pericardial tap, is a
procedure in which a needle and catheter remove fluid from
the pericardium, the sac around your heart. The fluid is
tested for signs of infection, inflammation, and the presence
of blood and cancer.
Pericardiocentesis is an invasive procedure. It uses a needle
and catheter to obtain fluid from your pericardium. ... This
can prevent your heart from pumping normally because the
extra fluid causes compression. Pericardial effusion can lead
to a life-threatening condition called cardiac tamponade
Indications
–Evaluate effusion of unknown etiology.
–Investigate suspected hemorrhage, immune disease,
malignancy, or infection.
–

85. ECHO

87. Position.
The patient undergoing pericardiocentesis is
positioned supine with the head of the bed raised to a 30- to
60-degree angle. This places the heart in proximity to the
chest wall for easier insertion of the needle into the
pericardial sac.

88. Location
– The most standard location is through the infrasternal
angle and is also called subxiphoid approach. Another
location is through the 5th or 6th intercostal space at the
left sternal border at the cardiac notch of the left lung and
is also called as parasternal approach.
– Fluoroscopy-guided technique. The fluoroscopic approach
was the first imaging system used for percutaneous
pericardiocentesis. It is performed through the subxiphoid
approach with a needle containing a contrast medium,
directed toward the left shoulder at an angle of 30° to the
skin.

92. Examination of other body
cavity fluids
– Sputum
– Wound discharge etc.
– Analysis of gastric & duodenal content
– Lab Normal values( CBC,ESR, LFT, RFT, TFT, BST, BLOOD
BREA, LIPID PROFILE, PFT CARDIAC ENZYMES, ETC.)

93. Sputum
analysis

96. Sputum analysis
– Sputum is the thick mucus or phlegm that is expelled from
the lower respiratory tract (bronchi and lungs) through
coughing; it is not saliva or spit. Care must be taken in
the sample collection process to ensure that the sample is
from the lower airways and not from the upper respiratory
tract.
– For the best results, collect each specimen first thing in
the morning before eating breakfast. 1. Rinse the mouth
out with water to reduce specimen contamination.

97. – Sputum analysis and culture is the most common method of specific
diagnosis of lower respiratory tract infections. Culture of a properly
screened, expectorated sputum sample will identify the pathogen in most
cases of bacterial pneumonia.
– Expectorated sputa, as well as those obtained by aspiration from the upper
airway, are subject to oropharyngeal bacterial contamination.
– Other techniques, such as transtracheal aspiration, are more "sterile," but
have a much higher incidence of morbidity. Microscopic screening of
expectorated or aspirated sputum samples will reduce the number and
increase the diagnostic accuracy of cultures, resulting in considerable cost
savings.

98. A sputum culture is a test to detect and identify bacteria or fungi
that infect the lungs or breathing passages. Sputum is a thick fluid
produced in the lungs and in the adjacent airways.
Normally, fresh morning sample is preferred for the bacteriological
examination of sputum. It is concluded that sputum should not
be stored at room temperature for longer than 3 days for culture but
it can be stored for 4 weeks without any loss of smear-positivity.
–A smear positive patient is considered infectious. If the
technician sees no TB bacilli, the test is deemed negative. ..
–If you see green or yellow phlegm, it's usually a sign that
your body is fighting an infection. The color comes
from white blood cells. At first, you may notice yellow
phlegm that then progresses into green phlegm. The change
occurs with the severity and length of the potential sickness.

100. The most common pathogens detected with a sputum
culture are bacteria such as Streptococcus pneumoniae,
Haemophilus influenzae, Staphylococcus aureus, and
Klebsiella species. ... The presence of normal upper
respiratory tract flora should be expected in sputum
culture.
Sputum Culture, Stain clean cup with a screw cap. Collect
one sample. For best results, return the sample to the clinic
within two hours. If this is not possible, keep the sample at
room temperature and return it within 24 hours.
To collect a sputum sample, you should do the following:
–Brush your teeth and rinse your mouth without using antiseptic
mouthwash.
–Take a couple of long, deep breaths.
–Breathe deeply again and cough hard until sputum comes up.
–Administer a prescribed sodium chloride 0.9% nebuliser to help to
losen secretions if they are thick and difficult to expectorate
–Spit out the sputum into the sample cup.

101. Wound
discharge
analysis
A bacterial wound culture is a test that detects and identifies bacteria that
cause infections (pathogenic) in a wound. Any wound may become infected
with a variety of bacteria. A culture helps to determine whether a wound has
become infected, which type(s) of bacteria are causing the infection, and
which antibiotic would best treat the infection and help heal the wound.
Wounds may be superficial breaks in the skin such as scrapes, cuts and
scratches or may involve deeper tissues such as incisions, bites, punctures or
burns.
A culture is performed by collecting a sample of fluid, cells or tissue from the
wound and placing it on or in appropriate nutrient media. The media
encourages the growth of bacteria that may be present, allowing for further
testing and identification.

104. A Gram stain is usually performed to help determine the type of
bacteria present and provide a rapid result to the healthcare
practitioner. The shape and color (morphology and staining
characteristics) also help determine what other tests may need to
be performed to definitively identify the cause of infection.
Indication
–A wound that is slow to heal, Heat, redness and swelling at the
site, Tenderness at the site, Drainage of fluid or pus, Fever
How is the sample collected for testing?
–A sterile swab may be used to collect cells or pus from a superficial
wound site. From deeper wounds, aspirations of fluid into a syringe
and/or a tissue biopsy are the optimal specimens to allow for the
recovery of aerobic and anaerobic bacteria.

105. Analysis of
gastric or
duodenal
content.

114. THANKS