Transport of diagnostic specimens

Pathology samples from GP surgeries

• Secure all pathology samples with the relevant request form in a speci-sac
• Store at room temperature (not exceeding 25c) in a secure area away from direct heat and sunlight
• Pathology samples must be delivered to the laboratory on the day that they are obtained via the pathology courier
• If the pathology courier run has been missed, do not store overnight, deliver to the laboratory.

Mandatory regulations

For all transport purposes, pathogens are assigned according to categories A and B.Unless it is known or reasonably believed to contain infectious substance of category A (eg haemorrhagic fevers), all human or animal material is regarded as category B, UN 3373.

Category A

Category A includes higher risk infectious micro-organisms, defined as an infectious substance which is transported in a form that when exposure to it occurs is capable of causing permanent disability, life threatening or fatal disease in otherwise healthy humans or animals.

If sending category A substances please contact the pathology department for further advice.

Category B

Category B includes infectious substances that do not meet the criteria for inclusion in category A, and include human and animal material such as, but not limited to, excreta, secreta, blood and its components, tissue and tissue fluids, and body parts being transported for purposes such as research, diagnosis, investigational activities, disease treatment or prevention. These are assigned to UN 3373 (diagnostic or clinical specimens) and must be packed to Packing Instructions PI650.

High risk samples

All high risk samples and accompanying request forms must be labelled with a 'danger of infection' sticker (pictured right).

High risk samples are defined as coming from the following groups:

• Those known to be Hepatitis B surface antigen, Hepatitis C positive or HIV antibody positive
• Those whose HIV or Hepatitis B status is unknown but who have evidence of AIDS or HIV disease or who are jaundiced.
• Those who fall into the known high risk groups for HIV and/or Hepatitis B
• Those with known or suspected CJD
• Those with known or suspected typhoid fever
• Faeces from patients with known or suspected typhoid, E coli 0157, dysentery
• Sputum or bronchial washing/lavage from suspected or known TB
• Unfixed or incompletely fixed tissue samples and smears from such patients.

Sending specimens by post

All diagnostic samples sent to pathology via the above means are to be deemed and labelled Biological Substance Category B, UN 3373 and must meet PI650:

• Primary inner receptacle sealed and leak proof
• Secondary receptacle sealed and leak proof
• Rigid outer packaging (the outer package must also have one side with the minimum dimensions of 100mm x 100mm)
• Samples/packaging must be labelled with an emergency contact name and the fact that the package is a diagnostic specimen packed in compliance PI650
• When posting only first class post or data post should be used
• All packages must use a visible diamond-on-point label UN3373 (min require dimension of this diamond are 50mm x 50mm)
• Adjacent to the diamond must be the label 'Biological Substance, Category B' and all text MUST be 6mm in height
• PI650 now permits up to 1 litre per primary receptacle with a total of 4 litres per package for liquids and 4kg for solids. Either primary or secondary receptacle must withstand pressure of 95kPa and a 1.2 meter drop test

Transportation of samples using the pneumatic air tube system (internal staff use only)

• All samples must be placed in a sealed bag and accompanied by a form. The plastic bag must be sealed, so that fluid is contained in the event of leakage.
• Place samples in the pod and ensure that the lid is firmly closed. Open pods sent through the system are the main cause for the system failure and breakdown.
• Key in the destination address, eg, the pathology department's address (100).
• Most pods are micro-chipped to return to pathology but for unchipped pods key in the address.
• Place the pod in the system. If there is a delay this may mean that the system is already in use. Each pod takes approximately two minutes to reach its destination. Each pod goes in turn.
• If the system is out of action, make alternative arrangements for transportation of samples, eg, use the porter service or take the samples to the laboratory yourself.
• If the system fails inform the trust’s maintenance department.
• Do not overfill the pods as samples are difficult to remove from the pod and may break.
• Do not put any other samples in the pod with blood culture bottles.
• Do not overfill the pods so that the lid cannot close properly.
• Do not try to send any samples via the air-tube system without putting them in a leak proof pod first.
• Do not send any irreplaceable/ unrepeatable samples in the pod.

In the event of a major breakdown these samples may get jammed in the system and may take up to 24 hours to be retrieved.

Examples of samples that should not be sent in the air tube:

• CSF (all departments )
• samples from neonates
• biopsy material
• histological Samples
• cytology Specimens
• urgent samples for blood transfusion including cross-match
• any sample deemed by the user to be unrepeatable.

Always use a porter for any unrepeatable sample and notify the laboratory that the sample is on its way.

All samples must be suitable for sending. Leaking samples must not be sent.

Transportation of pathology specimens to the laboratory

Staff should be made aware that the samples they carry could contain infectious material, it is important that any leaking samples should not be transported but brought to the attention of the ward or line manager.

The person responsible for sending the specimen must ensure that the sample is correctly labelled and placed in a two pocket, transparent specimen bag. The bag must be sealed correctly and the request form placed in the outer pocket.

The bagged sample/samples are then placed in a leak-proof container with a leak-proof lid. Every ward should have one of these boxes. The box and lid are pre labelled with warning labels, denoting ownership and a contact number. The box contains a plastic liner in order to contain fluid in the event of a spillage or leakage. The lid must always be fastened when being transported to avoid spillage or leakage. Samples should never be carried unprotected in the open hand or given to other members of staff in this way. Patient confidentiality must be observed where sensitive information is displayed on the request form by the use of envelopes or opaque plastic bags.

On arrival at the pathology specimen reception laboratory the box is given to a member of the reception staff, who will remove the contents and return the box.

In the event of an accident or when there is a spillage in the box: either telephone the Blood Sciences Service Manager at St Helier on 0208 296 3360 (landline)or on arrival to Pathology Reception inform a member of staff immediately, who will decontaminate the box prior to its return. Do not touch samples. Out of hours contact a member of the on-call staff for advice.

More infomation on transport of histology samples and 24-hour urine samples.

Samples delivered outside opening hours

St Helier Hospital

Samples should be transferred from the box and into the appropriate baskets outside pathology reception. Blood culture bottles must be taken to A&E and placed in the incubator.

Epsom Hospital

Use the pod system or deliver to the laboratory and place on the bench area at the top of the stairs. Access is restricted; if you do not have the keypad combination, please contact the on-call biochemist, haematologist or microbiologist via the switchboard.

Always alert the on-call staff if a sample requires urgent attention. Blood culture bottles must be placed in the designated metal box and kept at room temperature.