Clinical Chemistry

3.

Specimen Collection and Handling

3.1.

Pre-analytical Variables

3.1.1.

Patient Identification

3.1.1.1.

Verification Procedures

3.1.1.2.

Error Prevention

3.1.1.3.

Chain of Custody

3.1.2.

Patient Preparation

3.1.2.1.

Fasting Requirements

3.1.2.2.

Medication Restrictions

3.1.2.3.

Posture and Timing

3.1.2.4.

Exercise Effects

3.1.2.5.

3.1.3.

Specimen Collection Technique

3.1.3.1.

Venipuncture Procedure

3.1.3.2.

3.1.3.3.

Needle Selection

3.1.3.4.

Capillary Collection

3.1.3.5.

Aseptic Technique

3.1.3.6.

Collection Order

3.1.4.

Tourniquet Application

3.1.4.1.

3.1.4.2.

Effects on Test Results

3.1.4.3.

Duration Limits

3.2.

Types of Specimens

3.2.1.

3.2.1.1.

Collection Tubes

3.2.1.2.

3.2.1.3.

Indications for Use

3.2.1.4.

Processing Requirements

3.2.2.

3.2.2.1.

Clotting Process

3.2.2.2.

Separation from Cells

3.2.2.3.

Clot Activators

3.2.2.4.

Processing Time

3.2.3.

3.2.3.1.

Anticoagulant Use

3.2.3.2.

Separation from Cells

3.2.3.3.

Advantages over Serum

3.2.4.

3.2.4.1.

Random Specimens

3.2.4.2.

Timed Collections

3.2.4.3.

First Morning Void

3.2.4.4.

Collection Methods

3.2.4.5.

3.2.5.

Cerebrospinal Fluid (CSF)

3.2.5.1.

Indications for Collection

3.2.5.2.

Collection Technique

3.2.5.3.

Handling Requirements

3.2.5.4.

Safety Considerations

3.2.6.

Other Body Fluids

3.2.6.1.

3.2.6.2.

3.2.6.3.

Peritoneal Fluid

3.2.6.4.

3.2.6.5.

Pericardial Fluid

3.3.

Anticoagulants and Preservatives

3.3.1.

3.3.1.1.

Mechanism of Action

3.3.1.2.

Applications and Limitations

3.3.1.3.

Concentration Requirements

3.3.2.

3.3.2.1.

Mechanism of Action

3.3.2.2.

Applications and Limitations

3.3.2.3.

Types of Heparin

3.3.3.

3.3.3.1.

Mechanism of Action

3.3.3.2.

Applications and Limitations

3.3.3.3.

Ratio Requirements

3.3.4.

Sodium Fluoride

3.3.4.1.

Mechanism of Action

3.3.4.2.

Applications and Limitations

3.3.4.3.

Combination with Other Additives

3.3.5.

Other Preservatives

3.3.5.1.

3.3.5.2.

3.3.5.3.

Hydrochloric Acid

3.4.

Specimen Processing and Storage

3.4.1.

3.4.1.1.

Principles of Centrifugation

3.4.1.2.

Types of Centrifuges

3.4.1.3.

Timing and Speed

3.4.1.4.

Safety Considerations

3.4.1.5.

3.4.2.

3.4.2.1.

Techniques and Equipment

3.4.2.2.

Avoiding Contamination

3.4.2.3.

Volume Requirements

3.4.2.4.

3.4.3.

Temperature Requirements

3.4.3.1.

Room Temperature Storage

3.4.3.2.

3.4.3.3.

3.4.3.4.

Dry Ice Storage

3.4.3.5.

Liquid Nitrogen Storage

3.4.4.

3.4.4.1.

Factors Affecting Stability

3.4.4.2.

Light Sensitivity

3.4.4.3.

3.4.4.4.

Analyte-Specific Stability

3.4.4.5.

Freeze-Thaw Cycles

3.5.

Specimen Rejection Criteria

3.5.1.

3.5.1.1.

Causes and Prevention

3.5.1.2.

Impact on Test Results

3.5.1.3.

Degrees of Hemolysis

3.5.2.

3.5.2.1.

Causes and Prevention

3.5.2.2.

Impact on Test Results

3.5.2.3.

Interference Mechanisms

3.5.3.

3.5.3.1.

Causes and Prevention

3.5.3.2.

Impact on Test Results

3.5.3.3.

Clearing Methods

3.5.4.

Insufficient Quantity

3.5.4.1.

Minimum Volume Requirements

3.5.4.2.

Handling Short Samples

3.5.4.3.

Priority Testing

3.5.5.

Improper Labeling

3.5.5.1.

Labeling Standards

3.5.5.2.

Error Correction Procedures

3.5.5.3.

Unlabeled Specimens

3.5.6.

Clotted Specimens

3.5.6.1.

Causes and Prevention

3.5.6.2.

Impact on Testing

3.5.7.

3.5.7.1.

Sources of Contamination

3.5.7.2.

Detection Methods

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4. Analytical Techniques and Instrumentation