Specimen Handling, Labeling, Processing, and Transport
Core concepts
Label specimens at the point of collection, after the tube is filled, in the presence of the patient. Required elements usually include the patient's full name, a unique identifier, date and time of collection, and the collector's initials or ID. Never pre-label tubes or label them away from the patient. Reject unlabeled tubes; do not label them in the laboratory. Mix additive tubes gently by inversion the recommended number of times; never shake. Respect fill volumes because short draws alter anticoagulant ratios. Separate serum or plasma within the validated time, and follow stability, temperature, and light-protection requirements. Transport timed, cold, and stat specimens according to policy, and maintain chain of custody for legal or forensic specimens.
Question traps
A classic trap is a tube labeled with the wrong patient but collected correctly; the specimen must be recollected, not corrected. Another is refrigerating a specimen that should remain at room temperature, or delaying separation of a glucose or potassium sample. Avoid hemolysis by not shaking, not drawing through a small needle, and not forcing blood through a syringe. Capillary tubes may require sealing and mixing without air bubbles.
Worked rule
If a requisition and a labeled tube disagree, treat the specimen as unlabeled and recollect. If a tube arrives without a label, do not add a label later. The patient's safety depends on traceability from vein to result.