specimen collection

WHMIS

Workplace Hazardous Materials Information System; Canada's national system designed to provide workers with information about hazardous products through labels, Safety Data Sheets (SDSs), and worker education.

GHS

Globally Harmonized System of Classification and Labelling of Chemicals; an international standardized system created to classify chemical hazards and communicate hazard information via consistent labels, pictograms, and safety documents.

Three Pillars of WHMIS

The core framework of WHMIS consisting of: 1) Labels (point-of-use information with pictograms, signal words, and statements), 2) Safety Data Sheets (comprehensive 16-section reference documents), and 3) Worker Education/Training (safe handling, storage, and emergency response).

Supplier Label

A mandatory label affixed by the manufacturer or distributor to the original hazardous product container containing six required elements: Product Identifier, Hazard Pictogram(s), Signal Word, Hazard Statement(s), Precautionary Statement(s), and Supplier Identifier.

Workplace Label

A label applied in the workplace when a product is transferred (decanted) to another container, produced/made on-site, or when the original supplier label becomes missing or unreadable; requires: 1) Product Name, 2) Safe Handling / Precautionary Statements, and 3) Reference to the SDS.

Biohazardous Infectious Material Symbol

A uniquely Canadian WHMIS pictogram featuring a circular border enclosing a biohazard trefoil; identifies biological materials and microorganisms capable of causing infection, disease, or death in humans or animals.

Signal Words (WHMIS)

Standardized prompts on labels indicating the relative degree of hazard severity: 'DANGER' indicates high or more severe hazards, while 'WARNING' indicates lower or less severe hazards.

Safety Data Sheet (SDS)

A standardized 16-section document provided by chemical suppliers that details a product's chemical properties, hazards, safe handling procedures, exposure controls, personal protective equipment (PPE), first-aid measures, and disposal instructions.

TDG

Transportation of Dangerous Goods; federal regulations governing the safe handling, offering for transport, and transportation of dangerous goods in Canada to protect people, property, and the environment.

Class 1 Dangerous Goods

Explosive substances and articles capable of producing a mass explosion, projectile hazard, or fire through rapid chemical release; divided into six divisions.

Class 6.2 Infectious Substances

Substances known or reasonably believed to contain pathogens (bacteria, viruses, fungi, parasites) capable of causing infectious disease in humans or animals during transport.

Category A Infectious Substance

An infectious substance transported in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals upon exposure; designated as UN2814 (affecting humans) or UN2900 (affecting animals).

Category B Biological Substance

An infectious substance that does not meet the criteria for inclusion in Category A; assigned the proper shipping name 'Biological Substance, Category B' and identified by UN3373.

Class 7 Dangerous Goods

Radioactive materials that spontaneously emit ionizing radiation capable of posing hazards to health and the environment; divided into categories based on radiation emission levels.

Triple Packaging System

The mandatory transport containment system consisting of three layers: 1) a leak-proof primary receptacle, 2) a leak-proof secondary packaging enclosing absorbent material sufficient to absorb the total liquid volume, and 3) a rigid, durable outer packaging.

Dry Ice (UN1845)

Solid carbon dioxide ($CO_2$) classified as a Class 9 miscellaneous dangerous good; sublimates directly from solid to gas at $-78.5^\circ\text{C}$, creates frostbite hazards, and requires vented non-airtight packaging to prevent hazardous pressure accumulation.

CANUTEC

Canadian Transport Emergency Centre; the 24-hour federal advisory agency contacted during transport emergencies involving dangerous goods for technical guidance on containment, cleanup, and response.

Word Root

The foundational element of a medical term that establishes its core clinical meaning, typically denoting a body part, organ, tissue, or body system.

Combining Vowel

A connecting vowel (most commonly 'o') inserted between two word roots or between a root and a suffix starting with a consonant to ease pronunciation.

Prefix

A word component added to the beginning of a medical term that alters or qualifies its meaning by indicating location, quantity, timing, quality, or condition.

Suffix

A word component attached to the end of a medical term that specifies a pathology, procedure, condition, symptom, or part of speech.

Anatomical Position

The standard universal reference stance in medicine: standing erect, facing forward, arms resting at sides, palms facing forward (supinated), and feet flat and parallel.

Body Planes

Imaginary two-dimensional flat surfaces passing through the body: Sagittal (divides into left and right), Frontal/Coronal (divides into anterior and posterior), and Transverse/Horizontal (divides into superior and inferior).

Supine

A patient body position lying flat on the back with the anterior surface and face oriented upward.

Prone

A patient body position lying flat on the abdomen with the posterior surface facing upward.

Proximal vs. Distal

Directional anatomical terms used for limbs: proximal signifies closer to the trunk or point of attachment; distal signifies farther from the trunk or point of attachment.

Medial vs. Lateral

Directional terms defining horizontal relationship: medial signifies situated toward the vertical midline of the body; lateral signifies situated toward the side or away from the midline.

Tourniquet

An elastic band compressed around an extremity (placed 3 to 4 inches above the antecubital fossa) to temporarily restrict venous return, distending veins to facilitate palpation and venipuncture.

Bevel

The angled, slanted opening at the tip of a blood collection needle that must face directly upward during vein entry to ensure smooth penetration and blood entry.

Rubber Sleeve (Multisample Needle)

The retractable elastomer sleeve enclosing the posterior end of a multisample venipuncture needle that acts as a one-way valve, sealing the needle to prevent blood leakage when tubes are changed.

21-Gauge Needle

The standard color-coded green needle commonly selected for routine adult venipuncture; larger gauge numbers represent smaller needle bore diameters.

Winged Infusion Set (Butterfly Needle)

A blood collection device consisting of a short needle with bilateral plastic wings connected to flexible tubing and a luer lock; designed for small, fragile, pediatric, or hand veins.

Hematopoiesis

The physiological process of blood cell formation and development, occurring primarily within the bone marrow.

Plasma

The pale-yellow liquid component of unclotted, anticoagulated blood, making up approximately $55\%$ of whole blood volume; contains water, clotting factors (including fibrinogen), proteins, nutrients, and electrolytes.

Serum

The clear, amber liquid remaining after whole blood has clotted (typically $30\text{ to }60\text{ minutes}$) and centrifuged; identical to plasma except that fibrinogen and most coagulation factors have been consumed in the clot.

Buffy Coat

The narrow, grayish-white intermediate layer visible between the plasma and packed red blood cells after anticoagulated blood is centrifuged; composed of leukocytes (white blood cells) and thrombocytes (platelets).

Light Blue-Top Tube

A blood collection tube containing the anticoagulant sodium citrate, which binds calcium to prevent clotting at a critical $9:1$ blood-to-anticoagulant ratio; used in the Coagulation department for tests such as PT/INR, aPTT, and D-dimer.

Gold-Top (SST) Tube

A serum separator tube containing a silica clot activator and a thixotropic polymer gel that forms a barrier between cells and serum upon centrifugation; used in Clinical and Special Chemistry for metabolic panels, hormones, and drug monitoring.

Light Green-Top (PST) Tube

A plasma separator tube containing lithium heparin anticoagulant and separator gel; enables rapid STAT chemistry analysis without awaiting blood clot formation.

Lavender-Top Tube

A tube containing $K_2\text{EDTA}$ or $K_3\text{EDTA}$, an anticoagulant that chelates calcium and preserves cell morphology and counts; used primarily in Hematology for CBC, ESR, and blood smear preparation.

Gray-Top Tube

A collection tube containing potassium oxalate (anticoagulant) and sodium fluoride (antiglycolytic agent that inhibits glucose metabolism); used in Chemistry for fasting glucose, glucose tolerance tests, and lactate analysis.

Yellow-Top (ACD) Tube

A specialty vacutainer tube containing acid-citrate-dextrose (ACD) that maintains red blood cell viability and cellular DNA integrity; used in immunology, cytogenetics, HLA tissue typing, and molecular studies.

Order of Draw

The standardized sequence of blood collection tube fills (Blood Cultures/SPS $\rightarrow$ Sodium Citrate $\rightarrow$ Serum/SST $\rightarrow$ Heparin/PST $\rightarrow$ EDTA $\rightarrow$ Sodium Fluoride/Oxalate) designed to prevent cross-contamination of additives.

Additive Carryover

The inadvertent transfer of chemical additives from one collection tube to another via the needle during multisample blood collection, producing erroneous test results such as falsely elevated potassium from EDTA.

Clotted Specimen

An unusable whole blood or plasma specimen in which delayed or inadequate gentle mixing (inversion) after collection permitted fibrin strands or microclots to form, falsely lowering cell counts.

Short Draw

An underfilled blood collection tube resulting from premature vacuum loss, collapsed vein, or early needle withdrawal, disrupting the necessary ratio of blood to chemical additive.

Chain of Infection

The unbroken six-step epidemiological cycle necessary for an infectious disease to spread: 1) Infectious Agent, 2) Reservoir, 3) Portal of Exit, 4) Mode of Transmission, 5) Portal of Entry, and 6) Susceptible Host.

IPAC

Infection Prevention and Control; evidence-based institutional policies, procedures, and practices implemented to prevent the transmission of infectious pathogens among patients, healthcare workers, and visitors.

Point-of-Care Risk Assessment (PCRA)

An ongoing, proactive assessment performed by a healthcare worker prior to and during each patient interaction to determine the infection risks and identify the necessary PPE and barrier controls.

Dysbiosis

An imbalance or disruption in the normal flora microbial communities of the human body, frequently precipitated by antibiotic therapy or immunosuppression, allowing opportunistic pathogens to proliferate.

Healthcare-Associated Infection (HAI)

An infection acquired by a patient during the course of receiving healthcare treatment that was neither present nor incubating at the time of admission, typically developing $48\text{ hours}$ or more post-admission.

Standard Precautions

The minimum baseline level of infection control practices applied to all patients at all times across all healthcare environments, treating all blood, body fluids, non-intact skin, and mucous membranes as potentially infectious.

Contact Precautions

Transmission-based isolation measures used in addition to routine practices for patients colonized or infected with epidemiologically significant organisms (e.g., MRSA, VRE, C. difficile); requires gown and gloves for all room entries.

Droplet Precautions

Transmission-based isolation measures applied to patients infected with pathogens spread through large respiratory droplets generated by coughing, sneezing, or suctioning; requires surgical mask within 2 meters (6 feet) of the patient.

Airborne Precautions

Transmission-based isolation measures used for patients infected with aerosolized microbes that remain suspended in air currents over long distances (e.g., TB, measles, varicella); requires negative pressure ventilation and a fit-tested N95 respirator.

Negative Pressure Room

An airborne infection isolation room maintained at negative air pressure relative to surrounding hallways (air flows inward, never outward), featuring at least 12 air changes per hour and HEPA-filtered or direct outdoor exhaust.

Reverse (Protective) Isolation

Isolation protocols designed to protect highly immunocompromised patients (e.g., severe neutropenia, bone marrow transplants) from environmental and human-borne pathogens carried by healthcare workers or visitors.

Surgical Mask

A loose-fitting, fluid-resistant physical barrier placed over the nose and mouth to block large-particle droplets, splashes, or sprays, and reduce wearer respiratory emissions.

N95 Respirator

A tight-fitting, particulate-filtering respiratory protective device certified to filter at least $95\%$ of airborne particles, requiring individual quantitative/qualitative fit testing and a user seal check prior to entering airborne isolation areas.

Bouffant Cap and Surgical Hood

Disposable head coverings used to contain shed hair and dander to prevent specimen contamination in sterile procedural environments.

PPE Donning Sequence

The established protocol for putting on personal protective equipment: 1) Hand Hygiene, 2) Gown, 3) Mask / N95 Respirator, 4) Protective Eyewear / Face Shield, and 5) Gloves (pulled over the gown cuffs).

PPE Doffing Sequence

The careful, standardized protocol for removing personal protective equipment to prevent self-contamination: 1) Gloves, 2) Gown, 3) Hand Hygiene, 4) Protective Eyewear, 5) Mask/Respirator, and 6) Final Hand Hygiene.

Percutaneous Exposure

Occupational penetration of the skin barrier by a contaminated sharp instrument (such as a needle, scalpel, or broken glass) carrying infectious blood or other potentially infectious materials.

Biosafety Level 2 (BSL-2)

The containment level under which clinical and diagnostic medical laboratories operate, suitable for handling moderate-risk indigenous agents (e.g., HBV, HIV, Salmonella) that cause disease through percutaneous exposure, ingestion, or mucous membrane contact.

Median Cubital Vein

The large, well-anchored, superficial vein running diagonally across the center of the antecubital fossa; the primary vein of choice for routine adult venipuncture.

Hematology Department

The clinical laboratory department responsible for analyzing whole blood cell components, coagulation factors, and blood-forming tissues to diagnose anemias, leukemias, and clotting abnormalities.

Transfusion Medicine / Blood Bank

The laboratory department responsible for blood typing (ABO/Rh), screening for irregular antibodies, crossmatching donor units, and ensuring safe storage and distribution of blood products for transfusion.

Cytogenetics Department

The laboratory division focused on analyzing the structure, number, and abnormalities of human chromosomes through karyotyping, fluorescence in situ hybridization (FISH), and microarray analysis.

Molecular Diagnostics Department

The department that utilizes nucleic acid extraction and amplification methods (e.g., PCR, RT-PCR) to identify genetic mutations, infectious agents, and oncological markers.

Clinical Chemistry Department

The high-volume department performing qualitative and quantitative biochemical analyses on serum, plasma, urine, and other body fluids to assess organ function, metabolites, enzymes, and electrolytes.

Histology Department

The specialized section of pathology that receives, processes, embeds in paraffin, sections using microtomes, and stains biopsy and surgical tissue specimens for microscopic examination.

Point-of-Care Testing (POCT)

Diagnostic testing conducted immediately at or near the site of patient care (e.g., bedside glucose, rapid troponin, blood gases) using portable analyzers to deliver rapid results.

Class II Biological Safety Cabinet

A ventilated containment enclosure that provides personnel, environmental, and product protection using an inward air curtain, HEPA-filtered laminar air over the work surface, and HEPA-filtered exhaust.

Class III Biological Safety Cabinet

A totally enclosed, gas-tight containment cabinet operated under negative pressure with attached heavy-duty rubber gloves; provides maximum protection against high-risk Risk Group 4 pathogens.

BSC Purge Time

The mandatory period (typically $3\text{ to }5\text{ minutes}$) during which a biological safety cabinet blower is run without activity before and after use to clear airborne contaminants and establish laminar air currents.

Chemical Fume Hood

A ventilated laboratory workspace designed solely to draw toxic chemical vapors, fumes, and volatile gases away from the operator and exhaust them outside; provides personnel protection only and no product protection.

Standard Operating Procedure (SOP)

A formally approved, written document providing step-by-step instructions to ensure laboratory procedures are conducted consistently, accurately, and safely in accordance with quality and regulatory standards.

1:10 Bleach Solution

A broad-spectrum disinfectant prepared by mixing 1 part household sodium hypochlorite (bleach) with 9 parts water; must be prepared fresh daily ($24\text{-hour}$ expiration) due to rapid chemical degradation.

Dilution Formula

The mathematical formula $C_1 \times V_1 = C_2 \times V_2$ used to calculate the starting concentration ($C_1$), initial volume ($V_1$), final concentration ($C_2$), and total final volume ($V_2$) when preparing working laboratory solutions.

Fire Triangle

The three interdependent elements required for combustion to occur: Fuel (combustible material), Oxygen (supporter of combustion), and Heat (ignition energy); removing any one element extinguishes the fire.

P.A.S.S. Technique

The memory acronym for operating a portable fire extinguisher: Pull the locking pin, Aim the nozzle at the base of the fire, Squeeze the handle, and Sweep from side to side.

Fire Blanket

A safety device made of woven fiberglass designed to extinguish flames on a person's clothing or smother small contained fires by cutting off the oxygen supply.

ALARA Principle

As Low As Reasonably Achievable; the universal radiation protection safety standard based on minimizing exposure through three key strategies: Time, Distance, and Shielding.

Emergency Eyewash Station

An emergency decontamination fixture that must be activated immediately to flush foreign matter or chemicals from both eyes continuously for a minimum of $15\text{ minutes}$ with clean, flowing water.

Emergency Safety Shower

An emergency safety fixture designed to deliver high-volume water to drench the entire body and clothing for at least $15\text{ minutes}$ following large chemical splashes or clothing fires.

NFPA 704 Diamond

The standardized chemical hazard identification system consisting of four color-coded quadrants: Blue (Health), Red (Flammability), Yellow (Instability/Reactivity), and White (Special Hazards), rated on a scale from 0 (minimal) to 4 (severe).

Picric Acid (Dry)

A laboratory chemical that, when allowed to dry out and dehydrate below its safe hydrated threshold, becomes extremely unstable, shock-sensitive, and explosive.

Centrifuge Spill Protocol

The emergency response procedure requiring the centrifuge lid to remain sealed for at least $30\text{ minutes}$ following a broken tube to allow hazardous aerosols to settle before initiating cleanup in a BSC.

Cytotoxic Waste

Waste contaminated with antineoplastic or chemotherapy drugs capable of causing toxic, mutagenic, or teratogenic cellular damage; segregated into labeled, puncture-resistant red containers with cytotoxic warnings.

Sharps Waste

Any discarded object capable of lacerating or puncturing the skin (needles, lancets, scalpels, broken glass); must be disposed of immediately in rigid, puncture-resistant, biohazard-labeled sharps containers filled no more than three-quarters full.

Near Miss

An unplanned event or hazardous condition that had the clear potential to cause injury, illness, or property damage but was intercepted or did not produce harm.

Laboratory Incident Report

A formal documented record completed immediately following an exposure, injury, equipment failure, chemical spill, or near miss to capture factual details and initiate corrective actions.

Accessioning

The clerical and pre-analytical laboratory process of receiving, verifying, documenting, and assigning a unique numeric identifier (accession number) to a patient specimen to ensure traceability.

Hemolysis

The premature rupture or lysis of erythrocytes, releasing free intracellular hemoglobin into surrounding serum or plasma and causing pink-to-red discoloration that interferes with spectrophotometric testing.

Hemoconcentration

An artificial increase in the concentration of blood cells, proteins, and large molecules resulting from localized plasma loss, typically caused by leaving a tourniquet tied for longer than 1 minute.

Syncope

A transient loss of consciousness (fainting) caused by temporary cerebral hypoperfusion, requiring immediate cessation of venipuncture and safety positioning.