Collection Manual: Sputum for Cytology


Description: The objective is a satisfactory amount of sputum for cellular examination. Collection of expectorant from a deep cough from the lungs is required. SALIVA IS OF NO DIAGNOSTIC VALUE.

MATERIALS

CytoLyt™ Solution (pre-filled 120 ml jar. CAUTION: POISON, FLAMMABLE.) Requisition form, biohazard transport bag.

PROCEDURE

1. Complete a requisition form.
White copy to the lab. Lack of data may result in specimen delay or rejection.
Include:
• Clinician name, location and date of service.
• Patient demographics: name, address, phone number, date of birth and social security number.
• Insurance information: copy of insurance card(s) or face sheet.
• Relevant patient history ie, shortness of breath, hemoptysis, weight loss, previously diagnosed pulmonary disease,
  x-ray findings and suspected diagnosis.
• Related treatment including antibiotics, radiation, chemotherapy and surgery.
• Request for silver stain if mycosis or pneumocystis is suspected.

2. Label the jar with the patient’s first and last name.

3. Rinse mouth with water.
• The patient is to gargle and swish water around the mouth.
• The patient is to spit the rinse out. Do not collect the rinse in the specimen jar.
• The rinse minimizes cellular and microbial contamination from the oral cavity.

4. Produce a deep cough.
• Morning specimens shortly after rising yield the best results.
• Instruct the patient to inhale deeply and cough deeply, that is, from the lungs. It may take several attempts.
• If an expectorant cannot be produced the administration of nebulized air, per your office or hospital protocol, is
  recommended. A deep cough yielding expectorant is usually produced within 15 minutes. This may be particularly
  useful for non-smokers and ex-smokers.

5. Collect expectorant in the jar.
• The patient is to spit the expectorant directly into the pre-filled CytoLyt jar. Oral saliva is of no value.
• Alternatively, the patient can do a home collection using a labeled sterile urine container. Instruct the patient to
  refrigerate the specimen until delivered to your office. When received, pour the contents of a CytoLyt jar into the
  urine cup. Indicate on the requisition form that CytoLyt has been added.

6. Verify that the lid is properly seated and tight.

7. Submit in a biohazard transport bag.
• Submit the jar in the zip-loc portion of the transport bag and the requisition form in the outer sleeve.

8. Refrigeration is not required.
Specimens for microbiology or culture should be collected separately of cytology specimens and should NOT be submitted in cytology fixative. Refer to your clinical laboratory for collection procedures.