Blood Collection for Biochemical Analysis, Changes Occurring in Blood after Collection, and Management of its Disposal.

Blood Collection for Biochemical Analysis

• Blood collection for biochemical analysis is carried out to assess various physiological parameters and to diagnose health conditions. The procedure should be performed by trained healthcare professionals to ensure accuracy and minimize the risk of contamination. The following steps are followed in blood collection for biochemical analysis.

• 1. Preparation: Ensure availability of all necessary equipment and supplies for blood collection such as sterile needle, vacutainer tube, alcohol swab, adhesive bandage, tourniquet, and gloves. Ensure the patient is in a comfortable position, preferably seated or lying down.

• 2. Patient preparation: Verify the patient’s identity by asking for the name and checking identification. Explain the procedure of blood collection to the patient. Obtain patient consent for blood collection. Ensure the patient is comfortable and relaxed. Apply the tourniquet above the selected site. It helps to locate veins easily.

• 3. Select the site for blood collection: The site is selected carefully for venipuncture. The most common site is the antecubital fossa (inner elbow). Veins in the antecubital fossa are easily visible. Choose a vein that is visible, straight, and free from any sign of infection or damage.

• 4. Hand Hygiene and Gloves: Wash hands thoroughly and wear disposable gloves to maintain aseptic conditions.

• 5. Skin Disinfection: Clean the skin over the selected venipuncture site with an antiseptic swab in a circular motion. Allow it to air dry or wipe with a sterile gauze.

• 6. Needle Insertion: With the patient’s arm extended and veins exposed, use a sterile needle to puncture the vein. Be sure to hold the needle bevel up. Once blood flow is established, release the tourniquet.

• 7. Blood Collection: Use appropriate blood collection tubes. Tubes may contain adhesives to prevent clotting or separation of blood clotting.

• 8. Needle Removal: Once the required amount of blood is collected, withdraw the needle gently. Apply pressure to the puncture site with sterile gauze or cotton ball to prevent bleeding.

• 9. Labelling: Label each blood collection tube with the patient’s name, date, and any other required information.

• 10. Post-Collection Care: Instruct the patient to keep the puncture site elevated and apply continuous pressure until the bleeding stops. Dispose of used needles and other materials in designated biohazard containers.

• 11. Transporting Samples: Handle blood samples carefully to prevent hemolysis and contamination. Transport samples to the laboratory promptly. Follow appropriate storage conditions during transportation.

Changes Occurring in Blood After Collection

• Several changes occur after blood collection. These changes may affect the accuracy of laboratory test results. The following changes may occur after blood collection.

• 1. Clotting: Blood naturally begins to collect after exposure to air. Blood clotting interferes with several blood test procedures. Anticoagulants are used to prevent blood clotting during blood collection and after blood collection.

• 2. Serum Separation: Blood serum is a liquid portion of the blood after blood clotting. Blood clotting during blood collection or after blood collection separates the blood components like serum and blood clots. The blood sample shall not be suitable for some blood tests like complete blood counts.

• 3. Hemolysis: The breakdown of red blood cells and the release of their contents into blood plasma are called hemolysis. Hemolysis may occur during blood collection, transportation, and storage. This occurs if the blood sample is not handled carefully. Hemolysed blood samples shall not be suitable for the blood test procedures.

• 4. Changes in Blood Cell Morphology: Blood cell morphology changes over time. The Delay between blood collection and blood analysis may cause changes in blood cell morphology. For example, red blood cells may shrink or swell in certain conditions.

• 5. Cellular Metabolism: Blood cells are the living cells. Metabolism occurs inside blood cells even after blood collection. If samples are exposed to extreme conditions or blood samples do not have sufficient nutrients, metabolism in blood cells may be affected. This causes the death of blood cells. Blood samples containing dead blood cells are not suitable for some blood tests.

• 6. Temperature Changes: Blood samples should be stored at the appropriate temperature. If blood samples are exposed to extreme temperatures, it will affect the stability of the blood.

• 7. Bacterial contamination: Sterile blood collection equipment should be used. Otherwise, it will contaminate the blood samples. This will alter the blood sample composition.

• Management of Blood Sample Disposal:

• The management of blood sample disposal is a crucial step of healthcare waste management. It ensures the safety of healthcare workers, patients, and the environment. Proper disposal procedures prevent the spread of infections and minimize environmental impacts. The following are the general guidelines on the management of blood sample disposal.

• 1. Segregation: Segregate waste at the point of generation. Clearly distinguish the type of waste like regular waste, sharps, and biomedical waste.

• 2. Use of Biohazard containers: Collect blood samples in appropriate containers. Label it as biohazard waste containers. These containers should be leak-proof, puncture-resistant, and labeled with biohazard symbols.

• 3. Safe Handling: Handle blood samples with care to avoid spills and contamination. Use personal protective equipment (PPE) during the collection and disposal process.

• 4. Sharp disposals: Dispose of needles, lancets, and other sharps in puncture-resistant containers designed for sharps disposal. These containers should be clearly labeled.

• 5. Avoid Overfilling: Do not overfill containers. It will prevent spillage or injuries during handling. Follow the recommended fill level of containers and guidelines provided by waste management regulations.

• 6. Decontamination: Decontaminate any reusable equipment or surfaces that come into contact with blood samples. Use appropriate disinfectant according to protocols.

• 7. Transportation: Transport biohazardous waste safely and securely. Follow regulations for the transportation of hazardous materials. Ensure containers are sealed and labeled appropriately during transportation to prevent leakage.

• 8. Local Regulation and Guidelines: Follow the guidelines from local regulatory bodies, regional regulatory bodies, and national regulatory bodies for the disposal of biohazardous waste.

• 9. Incineration or Autoclaving: Regulatory bodies decide specific methods to ensure complete destruction of infectious materials. The method may be incineration or autoclaving. Complete combustion of organic matter at very high temperatures is called incineration. Sterilization of materials by high-pressure saturated steam is called autoclaving.

• 10. Record keeping: Maintain accurate records of waste disposal activities. Ensure availability of records showing type and quantity of waste generated, date of disposal, person name to dispose of, etc.

• 11. Training and Education: Provide proper training to healthcare personnel on proper waste management practices, segregation, and disposal of blood samples. Ensure staff is aware of the potential risks associated with improper disposal.

Dr Pramila Siingh

Different types of Hazards- Biological, Chemical, fire, and apparatus. Safety measures needed in Basic chemistry and clinical biochemistry laboratory.

Hazards are conditions or situations to cause harm, damage, or adverse effects to people, property, or the environment. There are several types of hazards. The following are the most common types of hazards in chemistry and biochemistry Biological, Chemical, fire, and apparatus hazards.

• Biological Hazards: Biological hazards are also known as Biohazards. These hazards arise from exposure to living organisms or their byproducts. These hazards can cause harm to human health, other living organisms, or the environment. These hazards include microorganisms, toxins, allergens, and other biological materials. Biohazards exist in medical laboratories, healthcare facilities, agriculture, and natural environment.

Types of Biological Hazards:

• 1. Microorganisms: Bacteria, viruses, fungi, and parasites are biological hazards. These are pathogenic microorganisms that cause infections and diseases in humans and animals.

• 2. Toxins: Toxins are the metabolic waste product of the microorganisms. They can harm if ingested, inhaled, or come in contact with the human or animal skin.

• 3. Allergens: Allergens are biological materials that trigger allergic reactions in susceptible individuals. Examples are pollen, insects’ venom, etc.

• 4. Biological Materials: Substances derived from living organisms, including blood, tissues, and genetic materials can transmit infection.

Common Sources of Biological Hazards:

• 1. Healthcare Facilities: Bloodborne pathogens, infectious diseases, and biological materials used in medical procedures.

• 2. Laboratories: Handling of microorganisms, cell cultures, and biological samples.

• 3. Agriculture: Exposure to animal waste, zoonotic diseases (Diseases transmitted from animal to human), and agricultural dust.

• 4. Waste Management: Improper disposal of biomedical waste containing infectious materials.

• 5. Natural Environment: Exposure to vectors carrying infectious agents, such as mosquitoes transmitting diseases like malaria.

Prevention and Control:

• 1. Personal Protective Equipment (PPE): Use of gloves, masks, goggles, and other protective gear to prevent direct contact with biological materials.

• 2. Vaccination: Immunization against specific infection to reduce the risk of infection.

• 3. Proper Hygiene: Hand washing and proper sanitation practices to minimize the spread of microorganisms.

• 4. Engineering Control: Implementation of safety measures like proper ventilation.

• 5. Biological Safety Cabinet: Biological safety cabinets provide a controlled environment for handling of biological materials safely.

Regulatory Compliance: Various regulation and guidelines govern the handling, transportation, and disposal of biological hazards. Compliance with these regulations is crucial to enure safety and minimizing risks.

Chemical Hazards: Chemical hazards are substances that cause harm to human health, the environment, or property due to their chemical properties. These hazards are found in various places like medical laboratories, industrial facilities, homes, workplaces, etc. Chemical hazards include toxic substances, corrosive materials, flammable compounds, and other chemicals. They may harm if not handled, stored, or disposed of properly.

Types of Chemical Hazards:

• 1. Toxic Substances: Chemicals that cause harm to living organisms are called toxic substances. They harm after their inhalation, ingestion, or contact with skin. Examples are heavy metals, pesticides, etc.

• 2. Corrosive Materials: Substances that cause damage to living tissues or materials through chemical reactions are called corrosive materials. Examples are acids and strong bases.

• 3. Flammable and Combustible Materials: Substances that ignite easily and support combustion are called flammable and combustible materials. Examples of certain gases.

• 4. Explosive Materials: Compounds that undergo rapid and violent decomposition, releasing energy are called explosive materials.

• 5. Carcinogens: Chemicals that cause cancer are called carcinogens.

Sources of Chemical Hazards:

• 1. Industrial Processes: Chemical manufacturing, processing, and handling in industries such as petrochemicals, pharmaceuticals, and manufacturing.

• 2. Laboratories: Various chemicals used in research, testing, and analysis.

• 3. Household Products: Cleaning agents, pesticides, and other chemicals used in everyday household activities.

• 4. Agriculture: Pesticides, fertilizers, and chemicals used in farming.

• 5. Transportation: Hazardous materials transported by road, rail, air, or sea.

Preventive Measures

• 1. Risk Assessment: Identification and assessment of potential chemical hazards in the workplace or environment.

• 2. Personal Protective Equipment (PPE): Use appropriate protective gear like gloves, goggles, respirators, etc.

• 3. Substitution: Replacing hazardous chemicals with less harmful alternatives.

• 4. Engineering Controls: Implementing ventilation systems, enclosures, or other engineering measures to reduce exposure.

• 5. Training and Education: Providing information and training to individuals working with or around chemicals on safe handling practices.

Regulations and Standards: Compliance with regulations and standards to ensure proper handling, labeling, transportation, and disposal.

Fire Hazards

The conditions, materials, or situations that increase the risk of a fire occurrence leading to harm to people, property, and the environment are called fire hazards.

Ignition Sources: The factors that initiate a fire are ignition sources. They include

• 1. Open Flames: Candles, matches, lighters, and other sources of naked flames.

• 2. Electrical Equipment: Overloaded electric circuits, faulty appliances, and damaged wires that produce heat. These are considered as electrical hazards. It also includes a spark.

• 3. Sparks: Generating during electric welding, grinding, and other industrial processes.

• 4. Heat Sources: Radiators, stoves, furnaces, and other devices that produce heat.

The following are the reasons of fire hazards

• 1. Combustible Materials: Combustible materials are substances that can catch fire and burn. Examples are

  • · Flammable Liquids: Gasoline, solvents, and certain chemicals.

  • · Combustible Gases: Propane, natural gas and others.

  • · Solid Combustible: Wood paper. cardboard, textiles, and other materials.

• 2. Poor Housekeeping: Accumulation of flammable materials contributes to fire hazards. Poor housekeeping practices can obstruct escape routes and allow fires to spread quickly.

• 3. Faulty Electrical systems: Electrical hazards include damaged wiring, overloaded circuits, and faulty appliances. Electrical malfunctions are a common cause of fires in homes and workplaces.

• 4. Smoking: Discarded cigarette butts and smoking materials can ignite combustible materials leading to fires. Smoking in designated areas and proper disposal of smoking materials are essential for fire safety.

• 5. Lack of Fire Prevention Measures: Inadequate fire prevention measures like the absence of or faulty fire extinguishers, fire alarms, and emergency exists to increase the severity of fires.

• 6. Lack of Training and Awareness: Insufficient training and awareness regarding fire safety and emergency procedures contribute to fire harm due to fire hazards.

• 7. Industrial processes: Certain industrial processes require flammable materials and machinery that contribute to fire hazards.

• 8. Hot Work Operation: Welding, curring, and other industrial processes generate sparks and heat. They possess fire hazards.

• 9. Environment Conditions: Weather conditions like hot work operations generate sparks and heat. It possesses fire hazards,

Prevention of fire hazards: Fire hazard prevention includes the adoption of fire safety regulations, promoting awareness, and education. Common prevention strategies include regular maintenance of electrical systems, proper strategies and handling of flammable materials, installation of fire detection and suppression system, and conducting fire drills and training for occupants. Fire hazards should be carefully assessed and appropriate measures should be implemented to minimize the risk of fires. It ensures the safety of individuals and property.

Apparatus Hazards

Dangers associated with the equipment and instruments used for experimental and analytical purposes are apparatus hazards. These hazards can harm laboratory personnel, the experimental process, and the integrity of the data. The following are some common apparatus hazards in chemistry and biochemistry laboratories

• 1. Glass wares: Glassware like beakers, flasks, pipettes, etc break during washing and handling causing cuts and injuries. Rapid rise change in temperature like placing hot glassware in cold water causes thermal stress. This leads to breaking glass apparatus.

• 2. Pressure Equipment: Autoclaves, reactors, and other pressure vessels are hazardous if not operated carefully and within specified pressure.

• 3. Mechanical Hazards: Several pieces of equipment like a stirrer, mixer, etc if not properly guarded and carefully operated can cause hazards.

• 4. Electrical Hazards: Electronic instruments like spectrophotometers, electrophoresis units, etc malfunctioning damaged cords or improper grounding can cause electric shock to the operator.

• 5. Chemical Hazards: Contamination and corrosion are the main chemical hazards. Improper cleaning of glassware and equipment can cause cross-contamination of chemicals. This will affect the results of tests. Chemical reactions between substances and apparatus materials cause corrosion. This affects the working of equipment.

• 6. Chemical Fumes Hoods Hazards: Their improper use results in exposure to hazardous vapors. That will be harmful to the personnel.

• 7. Biological Hazards: Contaminated apparatus used in biological research and analysis affects the operator as well as the result of the research and analysis. Their proper decontamination is essential.

• 8. Heat-Related Hazards: Hotplates, Bunsen burners, ovens, furnaces, etc generate heat. Their malfunctioning or overheating causes burns, fire, or substance decomposition.

• 9. Radiation Hazards: Radioactive materials and apparatuses like the Geiger Muller counter for radioactive materials require careful handling. They are radiation hazards if not properly shielded and safety precautions observed.

• 10. Laser Hazards: Lasers used in the laboratory pose a risk of eye injuries and skin burns if not operated and maintained carefully.

• 11. Sharp objects Hazards: Sharps in the laboratory include needles, syringes, blades, knives, etc. They possess the risk of puncture injuries and exposure to hazardous substances.

• 12. Carcinogenic Hazards: Improper handling of carcinogenic liquids is hazardous. They cause cancer in the operator.

Prevention: The apparatus hazards should be effectively managed in the laboratories. This requires safety measures like regular instrument maintenance, proper training to personnel, use of personal protective equipment (PPE), adherence to standard operating procedures, education and training, and routine risk assessments.

Assuring Good Laboratory Practices (GLP) in Basic Chemistry

Assuring Good Laboratory Practices (GLP) in basic chemistry is essential to ensure the reliability and integrity of experiment results. GLP is a set of principles and standards that guide the conduct of non-clinical safety studies. The following points are considered to ensure GLP in basic chemistry.

• 1. Training and Qualification: Ensure laboratory personnel are adequately trained and qualified for their assigned task. Maintain records of training, qualification, and experience for each individual.

• 2. Standard Operating Procedures (SOPs): Develop and implement SOPs for all laboratory activities like sample preparation, analytical procedure, and equipment operation. SOPs should be well-documented, regularly updated, and accessible to all relevant personnel.

• 3. Documentation and Record Keeping: Documents all aspects of laboratory work, including raw data, calculations, observations, and results. Keep accurate and detailed records of equipment calibration, maintenance, and any deviations from established procedures.

• 4. Instrumentation Calibration and Maintenance: Regularly calibrate and maintain laboratory instruments to ensure the accuracy and reliability of measurements. Document all calibration procedures, calibration frequency, and calibration results.

• 5. Quality Control (QC) Checks: Implement routine quality control checks by using known standards and reference materials. Document quality control procedures and results. Take corrective actions if deviation is identified.

• 6. Sample Handling and Storage: Establish procedures for proper sample handling, storage, and disposal. Clearly label all samples and ensure they are stored in appropriate conditions to maintain their integrity.

• 7. Data Integrity: Implement a data protection system. Use electronic signatures, secure data storage, and backup systems. Ensures to implementation ALCOA principles (Attribute, Legible, Contemporaneous, Original, and Accurate principles).

• 8. Personnel Hygiene and Safety: Promote and enforce good laboratory hygiene practices to ensure the safety of personnel and the integrity of experiments. Provide appropriate personal protective equipment (PPE) and ensure its proper use.

• 9. Internal Audits and Inspections: Conduct regular internal audits to assess compliance with GLP standards. Address any non-compliance issues promptly and implement corrective measures.

• 10. External Audits and Accreditation: Consider seeking external accreditation from regulatory bodies or organizations to demonstrate compliance with GLP standards. Participate in external audits to validate and improve laboratory practices.

Dr Pramila Singh