Transport must be managed carefully in order to maintain integrity of the sample, giving attention to temperature, preservation needs, special transport containers, and time limitations. It is also important to ensure the safety of those handling the material before, during, and after transport.
SAFETY REQUIREMENTS
Laboratories that mail or transport samples by air, sea, rail, and road between local, regional, and reference laboratories or between laboratories in other countries must adhere to a number of regulations. These regulations are designed to deal with transportation accidents and spills, reduce biohazards, and keep samples intact for testing.
Regulations for transporting samples stem from various sources, such as national transport regulations, the International Civil Aviation Organization (ICAO) guidelines via the International Air Transport Association (IATA), rail and road traffic authorities, and postal services. Private courier companies may impose their own rules. Compliance with industry standards and regulations is obligatory, with severe penalties for violators, endangering the safety of courier, carrier, and lab personnel, as well as passengers.
The United Nations expert committee, comprising voting reps from 30+ countries and non-voting advisors, issues recommendations on dangerous goods transportation. Many nations adopt these regulations as their own, while some may introduce variations. National authorities should outline their specific requirements.
SPECIMEN PREPARATION FOR TRANSPORTATION
1. Ensure all specimens are placed in a primary container with two patient identifiers. Primary containers can be blood tubes, urine cups, formalin containers, blood culture bottles, or any suitable sealed container for testing.
2. Place the specimen in a secondary leak-proof container labeled biohazard to contain it in case the primary container breaks during transit. Secondary containers include biohazard bags or other leak-proof containers with a biohazard label. Once sealed in a secondary container, handling without gloves is permissible.
3. Protect paperwork accompanying the specimen from contamination and keep it separate from the specimen.
4. If specimens are refrigerated or frozen before transport, label the appliance as biohazard and restrict access to the area.
5. Use a third rigid container for climate control to protect specimen integrity during transportation.
TRANSPORTATION OF SPECIMENS WITHIN THE HOSPITAL
o Utilize the hospital-wide pneumatic tube system for delivering properly prepared specimens to the laboratory. Small specimens can be sent through this system.
o Note: Do not send heavy specimens or those with glass primary containers through the tube system, except for blood culture bottles. Specific requirements apply when sending blood culture bottles through the tube system.
OUTPATIENT LABORATORY TO MAIN LABORATORY
o Use the pneumatic tube system to transport specimens from the outpatient to the main laboratory, especially for STAT specimens or small sample quantities. For larger sample portions, a large plastic receptacle holding the primary containers should be used.
TRANSPORTATION OF SPECIMENS OUTSIDE THE HOSPITAL
o Prepare specimens with a biohazard label for transportation from outside the hospital. Use a rigid third container, like a cooler, to safeguard specimens from temperature fluctuations.
ACCIDENTS OR SPILLS
o Notify the laboratory immediately in case of an accident or spill during transportation. Laboratory personnel will take necessary actions to contain the spill or inform the appropriate authorities.
RECEIVING SPECIMENS IN THE MAIN LABORATORY
o Inspect specimens for contamination or breakage before removing them from the secondary container. Wear gloves when handling specimens and during manipulations of the primary container.
In medical laboratories, samples are often categorized into different groups based on their potential risks and handling requirements. The categories typically used are Category A, Category B, and Category C. Here is how samples in each category are transported within the laboratory:
1. Category A samples:
Courier services: Category A samples, which are considered to pose the highest risk, are usually transported by specialized couriers trained in handling hazardous materials. These couriers follow strict protocols to ensure the safe and secure transportation of these samples.
Dedicated transport vehicles: Laboratories may have dedicated transport vehicles equipped with biohazard containment units to transport Category A samples safely. These vehicles are designed to prevent any potential contamination during transportation.
Air transport: For urgent or long-distance transport of Category A samples, air transport may be used to ensure quick and secure delivery.
Track and trace systems: Given the high-risk nature of Category A samples, track and trace systems are crucial to monitor and ensure the secure transportation of these samples.
2. Category B samples:
Courier services: Category B samples, which have a moderate risk level, may also be transported using specialized courier services trained in handling biohazardous materials.
Dedicated transport vehicles: Laboratories may use dedicated transport vehicles with appropriate containment measures for Category B samples.
Refrigerated containers: If Category B samples require specific temperature control, refrigerated containers may be used for their transportation.
Track and trace systems: Track and trace systems can help monitor the movement of Category B samples and ensure they reach their destination safely.
3. Category C samples:
Courier services: Category C samples, which are considered to have a lower risk level, may be transported using standard courier services.
Dedicated transport vehicles: While dedicated transport vehicles may not always be necessary for Category C samples, they can still be used if needed.
Air transport: Depending on the specific requirements, air transport may be used for Category C samples if they need to be transported over long distances.
Track and trace systems: Even for Category C samples, track and trace systems can provide added security and oversight during transportation.
Proper handling and transportation of samples in medical laboratories are essential to maintain sample integrity, ensure accurate test results, and prevent any potential risks associated with bio-hazardous materials.
Here are some links to resources on sample transportation guidelines in clinical laboratories:
1. CLSI: https://clsi.org/
2. CAP: https://www.cap.org/