Pertussis Testing Video: Collecting a Nasopharyngeal Aspirate Clinical Specimen


NARRATOR: It is essential
to use correct technique when collecting
and transporting specimens for laboratory testing. This video will demonstrate
how to correctly collect and transport
a nasopharyngeal aspirate. Before performing the procedure, make sure you have the following
materials on hand… gloves… a paper surgical mask for
covering your nose and mouth — there is no need
for an N95 mask — a biohazard bag
for disposal of used tubing… facial tissues
for patient use… eye protection to protect you from coughs, sneezes,
or splashes… a shipping container with cold
packs, and a biohazard label. When collecting
a nasopharyngeal aspirate, you’ll need
a bulb-style aspiration kit or syringe-style aspiration kit. Once you have
the necessary supplies on hand, you can collect the specimen. When collecting
the nasopharyngeal aspirate, follow these steps. First, put on your mask
and eye protection. Following hand-washing,
put on your gloves. Open the sterile aspirate kit and attach the tube
to the syringe. If necessary, slowly expel
excess saline through the tube until a volume of 3 milliliters
remains in the syringe. Lubricate the tube with lubricating jelly
supplied in the kit. Before you begin the procedure, ask the patient if he or she
has a deviated septum or nasal obstruction and have them blow their nose to remove any excess mucus
from the nasal cavity. The patient should be
in a supine position for specimen collection. The patient’s head
should be tilted back with their neck extended to allow for the pulling of
the aspirate in the nasopharynx. Instruct the patient
to hold their breath and not to swallow during
the procedure if possible. Tell the patient
the procedure will not hurt but may be uncomfortable or cause them to tear
or even sneeze. The distance from the nose
to the ear gives an estimate of the distance the tube
should be inserted. Insert the tube about 3 to 4
inches — less for a child — into a nostril, aiming posteriorly along
the floor of the nasal cavity until reaching the posterior
wall of the nasopharynx, being careful
not to insert it upwards. If an obstruction
is encountered, try the other nostril. Using a smooth motion,
and without moving the tube, quickly push and then pull
the syringe plunger to expel and aspirate
the saline. This must be done quickly
to prevent the fluid from draining
down the patient’s throat. If you feel resistance
while aspirating, the tube might be suctioned against the wall
of the nasopharynx. If this occurs,
retract the tube very slightly and then continue
withdrawing the saline solution by pulling back on the plunger. Carefully remove the tube
from the nose. Offer the patient a tissue
if necessary. Detach the tube
from the syringe. Tightly screw the syringe cap
onto the syringe to contain specimen
during transport. Then dispose
of the used equipment as according to biohazard waste
disposal guidelines. Transport the aspirate specimen
to the lab in the cap syringe using cold packs to maintain the specimen
at 4 to 8 degrees Celsius. Do not freeze the specimen
in the syringe. Plating for culture
will need to be completed within 24 hours
of specimen collection, so timely transportation
to the laboratory is essential. A message
from the U.S. Department of Health and Human Services and the Centers for Disease
Control and Prevention — CDC.

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