To ensure reliability of your lab results, it is necessary that you make adequate preparations and familiar yourself with the procedure of proper collection and storing of specific types of samples. Our role is to help you with that!
Advice for proper preparation of the patient for venipuncture (blood collection)
- For most laboratory blood tests it is necessary to make preparations which involve sample collection in the morning (on an empty stomach), after 12 hours of fasting. This is necessary because food intake in a shorter period before sample collection may result in the increase in glucose, cholesterol, lipids, proteins, iron and other metabolites.
- In order to obtain a credible result, sample collection should, in consultation with the doctor, be conducted after termination of the treatment and wash out period (time required for a drug to leave the body entirely and for setting new basal values) – this particularly applies to the iron therapy, vitamin preparations therapy, hormone therapy and other therapies.
- Before sample collection, one should avoid strenuous physical activities, because they increase levels of specific enzymes (CK and LDH in particular).
- It should be noted that sample collection for prolactin, cortisol, ACTH and catecholamines should be conducted in a state of complete relaxation and rest (lying down) for 20 to 30 minutes. These hormones are prone to strong daily variations, therefore, sample collection time and profile should be determine by the doctor himself.
- Patients receiving an ORAL ANTICOAGULANT THERAPY are advised to give a blood sample in the morning and to continue with their usual treatment after sample collection. This also applies to the patients under any chronic treatment.
Advice for proper urine sampling and collection
- In terms of urine and/or urine culture examination, it is necessary, after personal hygiene with hot water and a soap, to take the first morning flush of urine (medium stream) in a sterile container, and take it to a lab as soon as possible. If you are prevented from doing this immediately, urine may be kept in the fridge for a while, until you reach the lab.
Examination of the urine sample should be conducted within 2 hours from its collection, and maximum within 4 hours if urine was kept in the fridge.
- In terms of analyses conducted on 24-hour (all day) urine, you should drink 6 to 8 glasses of water (about 1.5 liters). Urine may be collected in clean plastic bottles (most suitable are the ones from bottled water). On the first mooring of urine collection, empty your bladder completely, FLUSH urine into the toilet but note the time. Collect ALL urine samples during the day and night in a plastic bottle. Exactly 24 hours from the commencement of urine collection, empty your bladder completely and add all the urine to the previous amount. This last sample will complete your 24-hour urine collection.
Specific 24-hour urine analyses require that the patient collecting urine adds a preservative to it. The analyses requiring addition of preservatives to the first urine collection are as follows:
1. 5- HIAA, VMA,
2. Adrenaline, noradrenaline, dopamine (catecholamines),
3. 17- corticosteroids and 17- ketosteroids,
4. Metanephrine and normetanephrine.
You will receive a bottle of preservative for the above mentioned analyses in the lab (prior to urine collection).
Consult a competent doctor about temporary termination of a current therapy (it is recommended not to receive treatment one day before and on the day of urine collection). Also you should not eat bananas, a pineapple, an avocado, nuts and almonds or drink coffee.
GLUCOSE TOLERANCE TEST
The glucose tolerance test is performed in the lab in the duration from 120 to 180 minutes (depending on the protocol required by the doctor). During the test, the patient should rest and should not eat, drink or smoke. Several days before the test is conducted, the patient should have a well-balanced diet and he/she should not expose himself/herself to strenuous physical efforts. The patient should stop taking specific drugs that affect the glucose metabolism (e.g. corticosteroids), but only in agreement with the doctor.
RECOMMENDATIONS FOR THE PREPARATION OF THE PATIENT FOR THE UREASE BREATH TEST
Before conducting the urease breath test, the patient should consult his/her doctor who could, according to the patient’s medical history and individual characteristics, modify the protocol below.
1. The patient MUST NOT eat or drink anything at least 6 hours before the test. It is best to conduct the test in the morning, when the patient has not taken any food during the previous night and for breakfast. Patients with diabetes are allowed to have a light meal (e.g. a toast and tea).
2. The test is conducted at least 4 weeks after the patient has stopped taking any antibiotics, i.e. 2 weeks after the patient has stopped taking drugs for reducing gastric acid secretion: proton pump inhibitors (Omeprol, Controloc, Lanzul, Nexium) and H2 blockers (Ranisan, Ranital, Ranitidin, Famotidin).
3. Patients with a chronic disease should take their drugs after the test.
4. The ureas breath test may also be taken by pregnant women and feeding mothers.
5. The test is not recommended only to the patients with partial gastrectomy, and in terms of persons under 18, the test may be conducted only with the explicit recommendation of the doctor.
The time required for conducting the test in the lab is about 30 minutes!
OPTIMAL PREPARATIONS AND ADVICE FOR THE PREPARATION OF PATIENTS FOR MICROBIOLOGICAL TESTING
Preparation of patients for the collection of a sample for microbiological processing is particularly important, because this may significantly affect a test result. All the samples should be collected before starting an antibiotic therapy or several days (at least 48 hours) after the patient has stopped taking antibiotics.
Urine culture is the most often conducted analysis in microbiology. Preparation for the collection of urine for urine culture is particularly important for women and young children. It is necessary to wash external genitals with luke-warm water and a soap in a way that the water stream goes from the front to the back. Then, dry the skin with a clean towel or a paper towel, without applying any creams.
Preparation of male patients for the collection of urine for urine culture also implies washing the genitals with luke-warm water and a soap. With children, it is particularly important to pay attention to retract the foreskin and wash around the urethra. Since the first bit of urine stream practically washes away bacteria from the skin and bacterial flora from the urethra, only the middle portion of the urine stream should be collected in a sterile container, whereas it is enough to fill the cup up to one-third of its volume.
When collecting urine in a uricult, it is necessary to fill the container with urine first, and then immerse culture media in urine, take them out after a few seconds, pour off all the urine from the container, and then return the media to the container and seal it with a lid.
With children, it is also desirable to provide them with the conditions to urinate directly into a sterile container. If this is not possible, wash their genitals, position a bag and control if the child has urinated. Then, remove the bag and take it to the lab.
Whenever possible, a urine sample should be collected in the morning, and the patient should not urinate during the previous night before he/she gives a sample.
Considering that urine is a good culture medium for bacterial growth, the sample should be taken to the lab as soon as possible, or kept in the fridge until it has been taken to the lab…
If hygiene of external genitals was not done well or if urine was held at an atmospheric temperature for too long, a large number of mixed bacteria of skin, vaginal or gut flora will appear in the culture.
For the purpose of testing chlamydia, mycroplasma or ureaplasma presence in urine, it is necessary to collect the first part of the urine stream (first morning urine) which usually collects urethral epithelial cells which contain these microorganisms.
This primarily applies to men, because with women cervical smears are taken for the isolation of these microorganisms.
In case of a doubt that urethritis was caused by bacteria, chlamydia, mycroplasma or ureaplasma, a urethral smear should be taken in the morning before urination, and if this is not possible, then at any time during the day, but leave at least 2 hours between the last urination and smearing.
Throat smears should be taken in the morning, before brushing teeth and food or water intake. If it has to be taken during the day, leave at least 2 hours between the last food and drink intake.
Nasal smears should be taken before starting an antibiotic treatment and the patient should try not to flush his/her nose at least 3-4 hours before smearing. It would be best if the patient could collect nose secretion for the microbiological examination, particularly if it is thick and coloured, because this supports a bacterial infection, in contrast to transparent and watery secretion, which usually supports a viral infection.
When taking a smear from a child’s throat or nose, parents should hold their child in the lap, place one arm over child’s both arms, another hand on child’s forehead and support his/her head while a health care professional is taking smears.
Sputum for microbiological analysis is best taken in the morning, before eating food or rinsing the mouth with a disinfectant and, of course, before starting an antibiotic therapy. The patient should previously rinse his/her mouth with tap water, and then cough up from the depth of his/her lungs as much sputum as he/she can to a sterile container. A smear should be taken from the oral cavity simultaneously with conducting an analysis of the sputum. There are criteria on the basis of which a microbiologist may conclude by observing a sample under a microscope whether the sample is adequate, or whether instead of bronchial secretion sputum was provided, in which case the sample may not give a valid result and, therefore, it should not be processed any further.
Genital smears :
- Vaginal and cervical smears
The woman patient should not have a sexual intercourse 24 hours before giving a smear.
- Urethral smears
The man patient should not urinate at least 1 to 2 hours prior to giving a smear.
Spermogram and spermoculture
For the spermogram, it is necessary to undergo abstinence in the duration of 3 to 5 days.
A semen sample is given in the lab or taken to the lab in special transport suitcases at 37°C within 20 minutes.
The patient should urinate before giving a semen sample for spermoculture.
Perianal impression is taken with a cellophane tape from the folds around the anus, in which manner eggs of small worms in children are collected, which the female worm laid there during the night. The child should be washed the previous evening, but no creams or powders should be applied. A sample should be taken in the morning before the patient eliminates waste.
FREQUENTLY ASKED QUESTIONS
Learn more about us and our organization through some frequently asked questions
1. What is the purpose of biochemical laboratories?
Biochemical laboratories are used for conducting tests and analyses required by the doctor (which may also be done at a personal request) and which are necessary for diagnosis, treatment and monitoring of patient’s health.
2. Where are you located?
Resavska Street 60, Tadeuša Košćuška Street 30, 11000 Belgrade.
3. What are the working hours?
7am – 8pm on weekdays and 7am – 2pm on Saturdays.
4. How should I prepare for the test? Can I eat before the test?
Each patient undergoes different regimes depending on the type of an analysis to be conducted.
5. Is there a visiting nurse service for the patients who are unable to go to the lab?
Yes. There is a planned Visiting Nurse Service – in order to make the system operate properly and to be able to meet your every requirement, it is advisable to contact us at least one day ahead. There is also an Emergency Visiting Nurse Service – we will do our best to reach you in the shortest possible period in all emergency situations.
6. Can I get infected with hepatitis and AIDS virus during the blood test?
Absolutely not. Sterile needles packed individually go directly into the blood vessel and are disposed of immediately afterwards. When you do the blood test, nothing enters your body. In other words, blood is collected in special vacuum tubes, and when a sterile needle enters the blood vessel, the blood from the vein directly enters and fills the tube.
7. Why do you require so much information about the patient?
We have to make sure to identify every patient by his/her name, date of birth, address, etc. Lab analyses values have different reference frames depending on the gender and age, therefore, it is necessary to know this. For example, a lab result of an analysis which is normal for a 60-year old person may fall out of the range of normal values for a 5-year old one. If the doctor asks for specific analyses, we must have the information about your last meal and the last time you took a drug.
8. How are data processed and stored in the lab?
Once you have arrived to the lab, out personnel will enter all your data, information about the institution and doctor who referred you to conduct analyses. Every time you will obtain a unique lab protocol number which is supported with a unique bar code (used for marking all your samples). Analysis are conducted on the primary blood sample, using the bar code, which contributes to the full automation and control of the analytical process and reduces the possibility of an error (human factor) occurrence to a minimum. A large data base enables us to keep all your results and monitor your health on a long-term basis and in a systematic manner. Results are sent electronically or you may collect them personally in the lab.
9. How long does it take to get the results?
Depending on the type of a test determined by the doctor, different time is required for different results. Most results are obtained on the same day, however, some analyses require longer time. For example, routine blood tests may be completed in a few hours, whereas, for example, blood cultures require 48 hours.
10. Will you inform me on the results?
Due to the possibility of an error and misinterpretation, results are not communicated over the phone. Results may be forwarded directly to your e-mail, e-mail of your doctor or you may collect them personally. If you would like to receive an explanation of the results, our specialists will evaluate the findings of the analyses performed.
11. What do analyses mean to the doctor?
You could be tested for various reasons related to the problem you reported to your doctor – it may be to check the condition which has already been diagnosed or it maybe to check how you respond to the already prescribed treatment. These are only some of the reasons for which the doctor may require lab testing. There is a great number of tests as well as different test combinations. For these reasons, our personnel may not provide any information about the reasons of the doctor’s referral to conduct a test. Your doctor is the only person who can give you all the required and valid information.
12. What may be required from me to do in the lab?
Lab tests are most often based on blood and urine samples. It is necessary to collect a small amount of blood and the necessary amount of urine. For most lab blood tests, it is necessary to make preparations which imply collecting a sample (on an empty stomach) in the morning, after 12 hours of fasting. This is necessary because is the food is taken in a shorter period before blood collection, it will increase concentrations of glucose, cholesterol, lipids, proteins, iron and other metabolites.
13. How long do I have to stay in the lab?
Most often, the patient needs to stay in the lab from 10 to 20 minutes. Some tests require longer time or you will be scheduled to return to the lab.
14. Should I tell the doctor that I have never done the blood test before or that I am nervous about the test?
Please do. We will do everything to make you feel comfortable and tell you in advance what you could expect from the sampling. Nowadays, blood tests procedures are very simple, painless and fast.
15. If I have previously done the blood test and it was difficult, should I mention this?
Please do. Our personnel are highly professional, but we do not neglect the fact that you know your body best. Please let us know if you have had any problems so far. We will do our best to make sure that everything is done in the best possible way.
16. How much blood do you collect? Will I feel tired after the blood test?
The amount of blood to be taken depends on the number and type of analyses required by the doctor. Modern laboratory equipment enables us to use the minimum amount of blood for most of the tests. This is why you will feel good after the blood test and you will be able to continue with your common daily activities.
17. In what way do you take care of the waste?
Our lab adheres to strict waste disposal rules. These rules ensure safety at work and environment protection. Contaminated laboratory waste is packed and transported to a designated place in accordance with specific procedures.