PMLS

HISTORY OF CLINICAL LABORATORY SCIENCE

Around 300 BC

• Ancient Greek physician first had the examinations of human body fluids

1880

  • Very important breaking point in appreciating the significance of laboratory testing wherein, in this year emerged the causative agents of tuberculosis, diphtheria, and cholera and its detections in the late 1890s.

ORIGINAL CREDENTIALIZING AND PROFESSIONAL ORGANIZATIONS

1922

  • The American Society for Clinical Pathology (ASCP) was founded

1928

  • The American Society of Clinical Pathologist (ASCP) created the Board of Registry (BOR) to certify laboratory professionals. Individuals who passed the BOR’s registry exam were referred to as “Medical Technologist” identified by the acronym MT (ASCP).

1977

  • The autonomous certification agency, the National Certification Agency for Medical Laboratory Personnel (NCA) was formed.

September, 2009:

  • NCA and ASCP merged into a single professional agency which referred to as “Medical Laboratory Scientist” (MLS)

300BC – 180AD

  • Hippocrates, considered the “father of medicine” and author of the Hippocratic Oath, and Galen, Greek philosopher, instigated a rudimentary and qualitative assessment of diseases through measurement of body fluids (also called the FOUR HUMORS – blood, phlegm, yellow bile, black bile)

URINE

  • One of the body fluids that underwent examination

  • Hippocrates advocated the advocated the tasting of urine, listening to the lungs, observing outward appearances

  • He concluded that the appearance of bubbles, blood and pus in urine indicated kidney disease

Uroscopy

  • “water casting” in Medieval Europe was widely practiced. Patients submitted their urine specimen in decorative flasks

900AD

  • The first book detailing the characteristics of urine was written.

Early 11th Century

  • Medical practitioners were not allowed to conduct physical examination of the patient’s body so they relied solely on the patient’s description of symptoms and their observations.

18th Century

  • Mechanical techniques and cadaver dissection were used to provide a more objective and accurate diagnosis and to understand the insides of the body.

19th Century

  • Physicians began using machines to diagnose and conduct therapy.

  • John Hutchinson: Spirometer, measures vital capacity of the lungs

  • Jules Herisson: Sphygmomanometer

Early 20th Century

  • Improvement of basic sciences, integration of scientific and technological discoveries such as ELECTRON MICROSCOPE used for visualization of small cells including tumor cells and these discoveries persisted through robotics, keyhole surgery procedures, genetic engineering, and telemedicine (information technology)

HISTORY OF MEDICAL TECHNOLOGY ON THE PHILIPPINES

6TH Infantry Division of the US Army

  • Established the first clinical laboratory in the Philippines located at Quiricada St., Sta. Cruz, Manila

  • Now known as Manila Public Health Laboratory

Dr. Pio de Roda

  • Re-organized the abandoned laboratory when the US army left, with the help of Dr. Mariano Icasiano who was a Manila City Health Officer at the time

  • Along with Dr. Prudencia Sta. Ana, they conducted a training program for aspiring laboratory workers and organized a six-month formal syllabus for the training program with certificate for the trainees upon completion. Eventually, Dr. Tirso Briones joined them.

1954

  • Approval of the four-year course in Bachelor of Science in Medical Technology by the Bureau of Private Education

  • Manila Sanitarium and Hospital (MSH) opened the first school of Medical Technology under the management of Mrs. Willa Hedrick

  • The Philippine Union College (now Adventist University of the Philippines) acquired the MedTech School of MSH

Dr. Jesse Umali

  • First graduate of the Medical Technology program, now an OB-gynecologist

1957

  • MedTech program was initially offered as an elective for Pharmacy students in UST

1961

  • MedTech was officially declared as a program in UST

INVENTIONS: REFER TO THE BOOK FOR ADDITIONAL INFO

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NATURE OF THE MEDICAL TECHNOLOGY

Purpose of Medical Technology:

  • To improve the detection, diagnosis, treatment, and monitoring of diseases which holds linkages with many other disciplines for specific diagnostic or therapeutic purposes. Its nature is contextual, interdisciplinary, interdependent, and system-based.

Clinical Laboratory

  • Performs the testing in detection, diagnosis, and treatment of diseases.

  • An essential component of health institutions.

  • 70% of all decisions performed by medical doctors are based on laboratory test results, thus serves as the integral partner of medical doctors

  • The place where specimens collected from individuals are processed, analyzed, preserved, and properly disposed.

Clinical Laboratory Scientists

  • The one who does perform these tests, usually look for the presence of bacteria, parasites, and other microorganisms in the body. They also prepare specimens for examination, to count cells, and look for abnormal cells in the blood and other body fluids.

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MEDICAL TECHNOLOGY PRACTICE DEFINED

R.A. 5527 (Medical Technology Act of 1969)

  • The act governing medical technology profession in the Philippines.

ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS

  1. Perform Clinical Laboratory Testing

  • MedTech must be capable of performing the most basic to the most advanced laboratory tests.

  • Should be able to conduct tests such as urinalysis and stool examination, should be able to perform hematologic, microbiologic, serologic, chemical and other procedures in the different areas of laboratory science.

  1. Perform Special Procedures

  • Perform special procedures in diagnosing diseases. These may include the operation of advanced diagnostic equipment. Special procedures can also include molecular and nuclear diagnostics.

  1. Ensure Accuracy and Precision of Results

  • Should be conscious of the accuracy and precision of both the testing process and its results. Accuracy and precision impact the interpretation of the results by the physician to provide proper medication in the treatment of diseases.

  1. Be Honest in Practice

  • MedTech must value honesty, particularly in conveying or reporting the results of any laboratory procedure. Should act according to the Medical Technology profession’s Code of Ethics and his or her pledged Oath of practice.

  • A medical technologist must be honest at all times in the conduct of test procedures to come up with accurate and precise results.

  1. Ensure Timely Delivery of Results

  • Must be aware of the urgency of delivering results on time, especially in cases that require urgent treatment.

  • When physicians request immediate result, one should take notations on “STAT” or even observe the source of the requests

  • Always be alert to fully address the needs of the patient.

  1. Demonstrate Professionalism

  • Must be able to perform his or her functions according to the professional Code of Ethics for medical technology professionals.

  • Should be aware of the laws and regulations governing the practice of medical technology and should not exploit its function beyond its boundaries.

  1. Uphold Confidentiality

  • Ensuring confidentiality is one of the core duties within the medical practice

  • Confidentiality requires health care providers to keep a patient’s personal health information private unless the patient consents to release the information.

  • MedTech must be aware at all times of the value of confidentiality and the entirety of the ethical codes of their profession.

  1. Collaborate with Other Health Care Professionals

  • A requirement to collaborate with other health care practitioners in order to build a well-functioning team. Collaboration is the act of working together in order to achieve a desired outcome. Teamwork is a must.

  1. Conduct Research

  • MedTechs must also be engaged in research activities to update their skills.

  1. Involvement in Health Promotion Programs

  • A Medical technology professional must be actively involved in reaching out to the community, such as:

  1. Cooperate with other health care professionals in health promotion campaigns such as promoting the ideal attitudes on hygiene, community sanitation, waste segregation, and disease prevention

  2. Implement and pre-planned programs of health promotion campaigns

  3. Offer free laboratory testing such as blood typing, urinalysis, fecalysis, blood sugar testing, cholesterol testing, and other tests beneficial to the entire community.

  4. Collaborate with other health care professionals once diagnoses are done.

DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL

Pathologist

  • A duly registered physician who is specially trained in methods of laboratory medicine and always considered to head a clinical laboratory and monitor all laboratory results. A laboratory result without the signature of a pathologist may not be considered valid.

Medical Laboratory Technicians

  • A person certified by and registered with the Board of Medical Technology and qualified to assist a medical technologist and/or qualified pathologist in the practice of medical technology.

  • Qualifications:

  • Fail to pass the medical technology licensure examination given by the Board of Medical Technology but obtained a general rating of at least 70% and provided finally that a RMLT when employed in the government shall have civil service eligibility not lower than the second grade.

  • Passed the civil service examination for medical technicians given on March 21, 1969

  • Finished a two-year college course and has at least one (1) year experience of working as a medical lab technician; provided that for every year of experience in college., two (2) years of work experience may be substituted; and provided further, that the applicants has at least ten (10) years of experience as medical laboratory technician as of the date of approval of this decree.

Phlebotomist

  • An individual trained to draw blood either for laboratory tests of for blood donations.

  • Arterial collection can only be performed by a specially trained phlebotomist. Phlebotomy is a skill confined not only to medical technologists but to other health care practitioners as well, provided that they were given certificates.

  • In the Philippines, an RMT is required to be skilled in phlebotomy, although in other countries, phlebotomist need not get a degree.

Cytotechnologist

  • A lab personnel who works with the pathologist to detect changes in body cells which may be important in the early diagnosis of diseases. They select and section minute particles of human tissues for microscopic study using microtome and other equipment.

Histotechnologist

  • Also referred to as histotechnician, who is responsible for the routine, processing, and staining of biopsies and tissue specimens for microscopic examination by a pathologist.

Nuclear Medical Technologist

  • Works alongside nuclear physicians. They apply their knowledge of radiation physics and safety regulations to limit radiation exposure, prepare and administer radiopharmaceuticals, and use radiation detection devices that measure the quantity and distribution of radionucleotides deposited in the patient or in the patient’s specimen.

Toxicologist

  • Studies the effects of toxic substances on the physiological functions of human beings to develop data for use in consumer protection and industrial safety programs.

SECTIONS OF THE CLINICAL LABORATORY

Clinical Chemistry

  • Intended for the testing of blood and other body fluids to quantify essential soluble chemicals including waste products useful for the diagnosis of certain diseases.

  • Blood and urine are specimens used in this section.

  • FBS, Lipid Profile, SGPT, SGOT, Liver Profile, Creatinine, BUN, BUA, TPAG, Electrolytes

Microbiology

  • Subdivided into four sections: Bacteriology, Mycobacteriology, Mycology, and Virology.

  • At present, the work in this section is more focused on the identification of bacteria and fungi on specimens received.

  • Although not as automated as clinical chemistry, automated instruments are available such as those used for blood culture and antimicrobial susceptibility testing.

Hematology and Coagulation Studies

  • Deals with the enumeration of cells in the blood and other body fluids.

  • Complete Blood Count, Hemoglobin, Hematocrit, WBC Differential Count, Red Cell Morphology and Cell Indices

  • Coagulation studies focus on blood testing for the determination of various coagulation factors.

Clinical Microscopy

  • Determines the macroscopic appearances of urine such as: color, clarity/transparency, pH, specific gravity and the microscopic examination to detect cells, parasites and bacteria and to quantify these.

  • In this section, stool or fecal sample is also examined to identify presence of parasitic worms or ova.

Blood Bank/ Immunohematology

  • Main activities performed here are the blood typing and compatibility testing

  • Also performed are the screening of all antibodies and identification of antibodies

  • Considered the most critical in the clinical laboratory

Immunology and Serology

  • Analyses of serum antibodies in certain infectious agents are performed.

  • Serologic tests such as, Hepa B, Syphilis, DRT and some antibody screening tests.

  • Automated analyzers and kits are commonly used in this section