Page 208 - pathology_services_handbook_5th_edition_2018

b) Nasopharyngeal wash

• Fill syringe (about 3 ml ) with sterile, non-bacteriostatic saline.
HTAA, KUANTAN • Attach a sterile catheter to syringe tip. Slowly push saline through the tube and
let a drop or two come out of the tip for lubrication.
• The patient’s head should be tilted back with their neck extended to allow for
the pooling of the aspirate in the nasopharynx.
• Insert the catheter straight back along floor of nasal passage until reaching the
posterior wall of the nasopharynx.
• Quickly push and then pull the syringe plunger to inject the saline and withdraw
the fluid.
• Inject aspirated specimen into a sterile container.
• Transport specimen to the laboratory immediately.

Note:
• Wear appropriate PPE eg: gloves, mask and goggles while doing the procedure.
• Write relevant clinical history eg: suspect pertussis/whooping cough.
• Inform microbiologist staff of the suspected case before taking specimen.

3. Throat swab

In the majority of cases, throat swab is obtained to isolate Group A/C/G Streptococcus
which causes pharyngitis and Corynebacterium dipthteriae which causes dipthteria.

i. Depress tongue gently with tongue depressor and rub the sterile swab over
the tonsillar areas and the mucosa on the posterior pharyngeal wall behind the
uvula.
ii. Gently turn the swab so that its whole surface comes in contact with the
inflamed mucosa or lesion.
iii. Avoid touching the oral mucosa or tongue with the swab.
iv. Place the swab in Stuart transport media immediately.

Note:
• Inform microbiologist of any case of suspected diphteria.
• Write relevant clinical history and diagnosis on the request form.

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