global requirements of clinical biochemistry lab

7/28/2019 Global Requirements of Clinical Biochemistry Lab

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Global requirements of clinical

biochemistry labPrepared by: mazen fahad mazen musaid


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Introduction :

Clinical biochemistry lab :It is a discipline of medical lab and also known as

(Clinical chemistry ,chemical pathology, medical

biochemistry or pure blood chemistry) is the area ofpathology that is generally concerned with analysis of body

fluids.


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this large array of tests can be further subcategories into sub

specialties:

- general or routine chemistry .

- endocrinology : the study of hormone .- enzymology : the study of the enzymes.

- pharmacology or toxicology : the study of drugs.

Clinical Biochemistry Test compromise over one third of allhospital investigation . Clinical biochemistry is that branch

of laboratory medicine in which chemical and biochemical

method are applied to study of disease .


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Most studies are confined to blood and urine because the

relative ease in obtaining such specimen , although

analysis are made on other body fluid such CSF and

gastric aspirate .

Most current laboratories are now highly automated and

use assays that are closely monitored and quality

controlled.

Some techniques that applied including the use and

measurement ofenzyme activity , spectrophotometry ,

electrophoresis and immunoassay.


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Clinical biochemistry laboratory

organization

Core lab :

- found virtually in all hospital

- operates 24h 7 days a week

- highly automated environment- instrument with multi-analytes capabilities

- high volume test , many test you can do in

this type of lab .


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Core lab instruments:

In this lab we use auto analyzer, based on the procedure which is called

automation ,self regulation , where the specimen is accurately pipetted

by a mechanical probe and mixed with a particular volume of the

reagent and results are displayed in digital forms and also printed by a

printer.

The automated instruments not only save the labour and time but allow

reliable quality control, reduce subjective crrors and work economically

by using smaller quantities of samples and reagents.


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there are many type of auto analyzer :

A- continuous flow analyzer:

In these systems, the samples and reagents are passed sequentially

through the same analytical pathway and separated by means of air

bubbles.B- discrete analyzer:

1-Batch analysers 2- stat analyzer.

1- batch analyzer:

These are convenient to analyse specimen in batches such as of

sugar, urea creatinine etc.

can be automated and semiautomated.


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Semi automated batch analyzer:

the initial step you will do by your self ,pipitting ,mixing , incupation .

ADV:

1- cheap &compact.

2- cheap sample analysis since the amount of reagent 0.5 ml.

3- Enzyme determinations by kinetic methods are performed

accurately in 1 to 3 minutes.

4-The enzymatic reagents are not corrosive and involve monostep

testing.2- stat analyzer(random access analyzer)

'Stat' (means immediate reporting or emergency determination

analysers.


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Electrolytes analyzer:

Atomic absorption spectroscopy: It is a modification of the flame

photometer in that it measures the amount of light absorbed by the

nebulized sample while moving from ground state to excited state.

Ion selective electrodes:measure the potential difference between two

electrodes. Specific electrodes are used for the determination of

sodium, potassium and chlorides.The requirement is for an ion selective

membrane to separate the solution of known activity from the detecting

system.


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Special lab :

- less frequently ordered test

- labor intensive and often manual method

- general not-stat tests

- lower volume test

This type of lab not available in on auto analyzer

because:

- the demand is not there.

- the test is not easily automated (extraction step).


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Instruments are usually batch analyzers. Either

research instruments or diagnostic instruments that

perform 1 specific test on multiple samples.

More training involved with test protocols and

instrumentation than Core Lab instrumentation.

Longer time required to reach competency.


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Special Chemistry Instrumentation

and Analytical Methods

Electrophoresis: Used to separate serum proteins into 5 distinct bands

Used to separate Lipoproteins into 4 distinct bands

Often used to separate isoforms of enzymes

HPLC :Used to measure vitamins and hemoglobin variants

Infrared Spectroscopy :

Used to analyze components of Kidney stones


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Radioimmunoassay (RIA) Used less and less but still employed for those analytes present in

minute amounts (pmol) in the blood (ie. testosterone)

GC-MS (Gas chromatography-massspectroscopy) and/or LC-MS (liquidchromatography- mass spectroscopy. Used for quantitative drug measurement


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Point of Care Testing (POCT): Instruments located outside of chemistry laboratory such as CCU, ER,

ICU or satellite centre (clinic).

Why we use like these instruments? Tests are of urgent importance, and results will affect the immediate

management of the patient

Instruments are available that can perform certain tests at remote

locations, such as at the bedside on in a clinical care unit.


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Some of test that can performed :

Blood test ,electrolyte, urinalysis, blood gases,cardiac marker

(troponin,t), drug screen.

POC are nearly always more expensive, than the same tests

performed in the central laboratory.

Many are immunoassay based. Can be qualitative or quantitative


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POCT INSTRUMENTATION

Cardiac Markers Drug Screen Urinalysis

Visual qualitative tests

Results must be recorded

and reported manually

Can be qualitative, semiquantitativeand/or quantitative.Hard copy of result

generated

Possible to interface hospital LIS


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Lab Safety

The lab is an exciting place but it can be a dangerous place if the safe

procedure is not followed.

KNOW YOUR SURROUNDING !

Should be aware of potential harms that can be caused by any object inthe surrounding

Hazard in lab:

Any object or material in a lab that can cause injury to human or harm

the environment is called hazard.


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Depending upon the nature of hazardous substance the hazards are of

3 types:

1. Physical hazard

2. Chemical hazard

3. Biological hazard

Physical hazard

Flammable

Combustible Compressed Gas

High voltage equipments

Sharp


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Chemical hazard

Corrosives

Oxidative

Toxic

Poisonous

Corrosive :

A chemical that causes visible destruction of or irreversible alterations of

living tissue by chemical action at the site of contact.

ex: amines , acids


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Oxidizers : Reactive chemical that releases oxygen and accelerates combustion.

They may be corrosives, irritants, toxins, sensitizers, etc.

ex: Oxygen, peroxides. Toxic :

A chemical capable of adversely affecting a body. Capable of

adversely affecting one or multiple organs of the body.

ex:

Xylene - Kidney, Liver, Central nervous system.

Isocyanates - Lungs.


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Poisons:

Poisons are likely to cause death or serious injury if they are

swallowed, inhaled, or come in contact with the skin. May interfere with

oxygen distribution in the bloodstream.

Can enter the body through inhalation, absorption, or ingestion.ex:

Methanol, carbon monoxide


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Carcinogens

A substance capable of causing or producing cancer in humans oranimals.

Exposure to a carcinogen can, over time, cause changes in cell divisionwithin the body that leads to uncontrolled cell growth.

ex: Formaldehyde, silica, benzene


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Personnel protection:

After knowing about the nature of substances around the primary mean

of safety is protecting your self

For this personal protective equipment (PPE) is desired

The basic concept of PPE lies in

how the hazard contact our body?

Ingestion swallowing

Inhalation breathing

Absorptionskin contact


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To secure the contacts with our

body

We should have following as

Personal Protective Equipment

A-Safety Glasses

B -Gloves

C -Apron

D -Face Shield E - Respirator


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!Still require Safe Practice

Despite having all PPE we are still require to practice safely in labsince PPE never protects us completely from hazards

Instruction for using chemical safety: Never touch, taste, or smell any chemical that you do not know is

harmless.

If you are instructed to smell fumes, do so by gently waving your hand

over the container so that the fumes are brought to you. Do not bring the container to your nose.

Do not inhale the fumes directly from the container.


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Labels

Name of material

Suppliers

Name/addressHealth hazard

Physical hazard


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Importance of Labeling

To identify hazards in your

work area.

Labels must be on every bag, barrel, bottle, box, can, cylinder, drum,

storage tank, etc.

Notify your supervisor or safety representative if there are no labels ona container.


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Material Safety Data Sheets

Data sheet containing information about the hazards associated with achemical.

All manufacturers, distributors, and consumers must have MSDS.

All hazardous materials MUST have a corresponding MSDS.


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Electrical Equipment Safety

Be careful not to shock yourself or another person.

Turn off all power sources when setting up circuits or repairing

equipment.

Do not use metal articles such as rulers, metal pencils or pens; do

not wear rings, metal watchbands, or bracelets when working withelectrical equipment.


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General Lab Rules

Read all directions for doing an investigation before beginning.

Be alert and listen for directions. Ask questions if you are unsure

of anything.

Never perform activities that are not authorized by the teacher.

Do not handle equipment without permission.


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First aid

Be aware of the locations of the first-aid kit, but allow the

teacher to administer first aid to an injured student

Report all accidents to your teacher immediately.


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Thank you&all the best

global requirements of clinical biochemistry lab

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