Uploaded on Sep 18, 2014 Etana Townsend + Follow gram This requisition form must be reviewed to understand What tests are requested? EQUIPMENT: Evacuated Collection Tubes -. Collection Volume Under filling occurs because: Tube was removed too quickly. Transport to the microbiology laboratory. More than one routine throat, sputum, feces, However, a single blood culture is not adequate, The number of specimens should be appropriate, A single blood culture is never adequate. Impact of Incorrect Volume on PT and APTT The APTT is the most sensitive to variations in final citrate concentration. The Upper Cretaceous (Maastrichtian) Lameta Formation is well-known for its osteological and oological remains of sauropods from the eastern and western parts of the Narmada Valley, central India. Tourniquet - Wipe off with alcohol and replace frequently. - The research report includes specific segments by region (country), by company, by Type and by Application. Many variations of this systems are used. Storage Requirements Store the Progensa PCA3 Urine Specimen Transport Kit at room temperature (15C to 30C). . Heparin (Anti-Coagulant) Used to collect whole blood or plasma Binds to anti-thrombin III to inhibit Xa, IXa, and thrombin Nominal concentration of 12 30 U/mL Heparin binds calcium so ionized calcium must be collected using Calcium Titrated or Electrolyte Balanced heparin, Citrate (Anti-Coagulant) Citrate is used for collection of coagulation tests Acts by binding calcium Nominal concentration of 3.2% (0.109 mol/L) Recent move to 3.2% from 3.8% to get more consistent results for Prothrombin Time, particularly for more sensitive reagents Tubes must be properly filled to within +/- 10% of assigned collection volume, Clot Activator Shortens Time to Clot In vitro activation of clotting system to enhance clot formation A silica clot activator is attached to the tube wall with a silicone surfactant Requires mixing for optimal affect Time to clot is 15-30 minutes instead of 1 hour, Serum Separator Gel Separates Serum from Cells Polymer gel with specific gravity between that of serum and cells Migrates and forms a barrier during centrifugation Separation of cells from serum stops metabolic and hemolytic effects Certain analytes and therapeutic drugs may bind to gel over time, Labelling the Sample A properly labelled sample is essential so that the results of the test match the patient. Avoid repeated freezing and thawing of specimens. Indicating the test(s) requested. Patient's Medical record Number . There is a clot activator present and inversion expedites the clotting process. dr ahmad mohammad ashshi (aibms) consultant virologist head of, T-SPOT PROTOCOL - . EDTA induced psuedothrombocytopenia caused by in vitro antibody mediated platelet clumping and platelet satellitism that results from changes in membrane structure that occur when calcium is removed by EDTA. Skin specimens are required to investigate infections caused by herpes simplex viruses, rabies virus. Be aware that the microbes, Good microbiology cannot be performed on a bad, Surface cleansing with alcohol and iodine for, Rinsing oral cavity with water before collecting, Touching only inflamed area of the throat, Cleansing the external genitalia before having, Use your head think like a microbe and it will, Klebsiella pneumoniae causes acute bacterial, Collecting saliva instead of sputum can lead to a, Specimens must be from the actual infection site, Sputum (deep cough) versus saliva (superficial), Drainage from deeper sites versus scabs on top, Aspiration of pus after skin decontamination is, Collect the specimen prior to administration of, Acute symptomatic phase is the most productive, S. typhi (typhoid fever) can be cultured from, S. typhi can be cultured from feces and urine in, S. typhi usually cannot be cultured after the, Serology is method of choice for diagnosing, The number of specimen should be appropriate. hmO9_6~?UUw:-'!^l*lP'c=cg~cJ5IDNhE 4zBCIda0 HUMo0#KI eU(jszH!J~g@ {c?kwhm77o2w"yY(s$\hH>= ?Wh^6MBg|'gYq2Q .1K|B=P*|}6P=iI qSJ\: E-+Uvf{+#/0+Gc*A#Vgl UJy[GGR,1;'IODM module 2: specimen collection & Proper procedures must be followed to assure the integrity, Several essential steps are required for every successful, Patient's identification is absolutely essential to maintain, The essential elements of the requisition : form are. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. n&)AE(y CtQuIx`_9BP&%o-)}pJ6 sd.%E>KPL\,P)4v09F.r#m".z?/G h:"dgmzQeO[zq2y]Q#Fp6:l2o;)FWPY(b;9OI+={pG~x2% nH6Ixj?bt*Gx||$w0eRT@(YlvHGdUiB0 Knw9+ h provactive test for growth hormone, urine collection Random Urine specimen (drug abuse) First-morning (microscopic examination, b-HCG, Clean -catch specimen (MSU ) For urine culture 24 hours urine For quantitative chemical determinations in urine (such as creatinine, protein, calcium, magnesium, sodium, potassium,) Suprapubic specimen especially for infant Urine collected from children collection bags with hypoallergenic skin adhesive Catheter specimen. %%EOF Our product offerings include millions of PowerPoint templates, diagrams, animated 3D characters and more. Check the requisition form for requested tests, patient information, and any special requirements. Specimen Transport: Label the specimen and deliver it to the laboratory as soon as possible with a completed request form. Well convert it to an HTML5 slideshow that includes all the media types youve already added: audio, video, music, pictures, animations and transition effects. 7. specimen emails. Well convert it to an HTML5 slideshow that includes all the media types youve already added: audio, video, music, pictures, animations and transition effects. The PT increases by an average of 5% for 20% underfilling and by 15% for 30% underfilling. - The requisition form had the patient's name, and ordering physician. - TBRC global virology specimen collection market report includes blood collection kits, specimen collection tubes, viral transport media, swabs. specimen collection, preservation and transportation pptkaley ann voorhees wikipedia. Full clinical information: nature duration, and severity of the disease. 1. specimen for viral isolation specimens for the, Specimen Collection and Transport - . <> - Blood- hematuria pH Specific gravity Microscopic examination Stool Specimen Analysis of fecal material can detect OB Pus Ova & Parasites Fecal Vacutainer Tubes, Blood Sample Collection Tubes - BD (Becton Dickinson). Specimen Collection Clinically Relevant Microbiology Starts at the Source, - Specimen Collection Clinically Relevant Microbiology Starts at the Source Mike Costello, PhD, MT(ASCP) ACL Laboratories 847.349.7403 mike.costello@advocatehealth.com. For certain tests, 24-hour urine samples are collected at home and must be refrigerated during the collection process. - Collection of Epidemiologic Data Bao-Ping Zhu, MD, MS - Title: Slide 1 Created Date: 11/20/2008 5:55:36 PM Document presentation format: On-screen Show (4:3) Other titles: Arial Majalla UI Calibri Traditional Arabic How Warring Medical Kits Provides Valued Protection for Specimen Collection. Requisition form : It should contain the proper information in order to process the specimen. specimen collection, preservation and transportation ppt. Expired tubes with low vacuum (rare). Tubes must be filled to 3 mL to prevent inhibition of bacterial growth. 2022 ( See Blood Specimens: Chemistry and Hematology - Consideration for Single and Multiple Sample Collection.) The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. Our product offerings include millions of PowerPoint templates, diagrams, animated 3D characters and more. Some sex hormones need special timing as regard cycle : (1)FSH,LH (3rd day of cycal {follicular phase}) (2)Progesterone (21 day of cycle{ luteal phase}) Other Factors: Age, gender, and pregnancy have an influence on laboratory testing. Whatever your area of interest, here youll be able to find and view presentations youll love and possibly download. Once a sample has been collected, the device should be sealed according to the manufacturer's instructions. During vegetation sampling, collect repre- Collect skin scrapings in a dry sterile container. the lab or pathology department does countless types, Laboratory Diagnosis of Infection - . Follow patient instructions prior to specimen collection Including the proper order of blood draw when multiple tubes are required. * Keeps current with developments in laboratory medicine by mandatory and voluntary continuing education, competency testing and Quality Assurance. Blood for antibody testing should be collected as early in the disease as possible and also 5- 10 days later. : A requisition form must accompany each sample submitted to the laboratory. If so, share your PPT presentation slides online with PowerShow.com. The absence of resin, which was apparently not used during the preparation of the mummies, and the almost complete . Will Drinking Water Lower Fasting Blood Sugar? Position Overview. Use the container/tube indicated in the test requirements for appropriate specimen preservation. Specimen Collection and Processing - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. endstream endobj 368 0 obj <>stream describe avian. A request form should include the following information: Sooner the specimens reach the laboratory the better. Activate your 30 day free trialto continue reading. Proper preservation ensures a high quality specimen, which increases the quality of information the specimen contains, and increases the value of the maintenance of the specimen. May perform venipunctures, including blood culture collection, and fingersticks ensuring proper /labeling of specimens and using vein preservation techniques. Activate your 30 day free trialto unlock unlimited reading. Place about 4-8 g of feces (small spoon) in a clean, dry, leak-proof container. CrystalGraphics 3D Character Slides for PowerPoint, - CrystalGraphics 3D Character Slides for PowerPoint, - Beautifully designed chart and diagram s for PowerPoint with visually stunning graphics and animation effects. After the blood is collected, collect it in a leak-proof container, refrigerate it at 4C until transport in an ice box to the virology laboratory. Click here to review the details. Serum Separator tubes should also be inverted. Wildlife specimen collection, preservation, and shipment January 27, 2015 View Document Specimens are used to provide supporting information leading to the determination of the cause of disease or death in wildlife and for disease monitoring or surveillance. If so, share your PPT presentation slides online with PowerShow.com. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. z.$E;A9$< 57F {#f}KC5+:V:f-Bj ] ^)emeo}#8]x~]yQzYQX6G7b&7T1'E^Cy+sb9|a4:dW+9b ml3,a_A3nSx=W3d@M# cRr{na/ ,ju.Zje^-F38x% &c&^o3XhG(b3xz?I%~c5/-\^q%,n._| Y+ Specimen Transportation a. legislative symposium march 15, 2010 michael n. mccarty, Diagnosis of Viral Infection - . Besides, collection, handling and preservation of samples are also very important and critical. INFECTIOUS DISEASES A. Bacterial 1. <>>> specimen #2. specimen #3. specimen #4. specimen #5. specimen #6. specimen # 7. Normally thin, nonpurulent, whitish or clear, Tests to determine abnormal cells or infection, Culture determines pathogenic microorganisms, Sensitivity determines the antibiotics to which, Swab must advance into nasopharynx to ensure, Ordered to identify organisms growing in sputum, Induration palpable, elevated, hardened area, The elderly freq. Correct specimen collection procedure. Timed urine specimens. 6. Collecting the urine specimen is awkward but not in itself uncomfortable (An infection, however, can create a burning sensation during urination.). Holder/Adapter - use with the evacuated collection system. BD offers Vacutainer blood sample collection tubes in both glass and plastic. After few seconds, slowly withdraw the swab and immerse the swab in a container of sterile VTM, cutting off swab wire to allow the bottle cap to be replaced tightly. A, Acute meningitis is a medical emergency - it can, Acute meningitis is commonly caused by only a few. xK@sLngf?`'MqXC~//0p: Fp1{!BDb2F)8^?Z(qDP~#:B^}tGzMAP|fzmF"ne`R_D>$"e_v`H1^Vge[ZH@zg$f =)Cu='o"pq.:89]mzM:YRl4OMy}y9(k{V5hm[!rw}A8q/g;`T],p*#Y\&}?il&8r;NF|D Transtracheal Aspiration (TTA) Fig 3-2 pg 129, TTA is performed (by a physician) for the, If sputum specimen cannot be expectorated, If routine sputum samples have failed to recover, the skin over the larynx is anesthetized and, A large bore needle is inserted into the larynx, A polyethylene catheter is passed through the, Bronchoscopy is an alternative to transtracheal, A fiberoptic bronchoscope is inserted through he, This allows the attending physician to visualize, A protected bronchial brush can be inserted, The brush can be uncovered temporally and be used, The cover is then put back over the brush and, Fluid can be injected into the bronchi and lungs, Unlike bronchial brushes, bronchial washings are, A bronchoscope can be threaded deep into the, BAL is considered by many to be the method of. Passionate about building community and connecting people to nature through art || Experienced in visitor services, park operations, biological lab/field work, and the arts. What containers are required to collect the specimens? or false, Insert needle through chest wall into pleural. Regulations for transporting samples come from . By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. PowerShow.com is brought to you byCrystalGraphics, the award-winning developer and market-leading publisher of rich-media enhancement products for presentations. Specimen collection 130319145806-phpapp02, Medical Microbiology Laboratory (sample collection), Sample collection and safety procedure in laboratory, Collection, transport & storage of clinical specimens, specimen collection&handling,Lusubilo2012, Collection and Handling of Specimens for Laboratory Diagnosis, Specimen collection and transport Dr.Ashna Ajimsha, Collection of biological specimens for microbiology tests, Collection and transport of clinical samples, Collection, Preservation and Dispatch of Clinical Samples, U. P. Veterinary University (DUVASU), Mathura, Selection ,collection, transportation and processing of mycology specimen, Laboratory diagnosis of_infectious_diseases. Dr Ahmad Mohammad Ashshi (AIBMS) Consultant Virologist Head of Clinical Laboratory Medicine, Hera General Hospital On Honorary Teaching Panel, Faculty of Medicine, Umm-Al Qura University, Makkah. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. a. specimen collection and transport. The health technician logs onto the specimen collection application and logs the SP into the component. - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. 282-288, 297-298, 360-361 and 380-381 - . Sterile, leakproof, screw-cap containers including urine cups, disposable centrifuge tubes (15 and 50 mL), and . Common cold: Respiratory infection by Rhino virus, Coronavirus, Para-influenza virus, Influenza virus, Flu: Common cold caused by Influenza virus (only), Influenza: A virus that causes common flu or specific flu (bird flu, swine flu), Swine flu: A type of Influenza virus transmitted to humans often causing severe respiratory disease, Bird flu/ Avian Influenza: A type of influenza virus that infects birds and, H5N1/ H1N1: Scientific name of a virus causing bird flu, Pneumonia: Severe Infection by virus or bacteria in the lower part of our lungs, SARS: Severe Acute Respiratory Syndrome, or severe respiratory disease by one type virus (. Looks like youve clipped this slide to already. Template SPECIMEN Proper patient identification MANDATORY. MGM medical college ,mumbai Clinical staff Perform the venipuncture. All blood, whether unlabelled or mislabeled, intended for cross matching, must be redrawn, without exception. An exception to this rule, throat swabs for S. Since the indigenous microbes are almost always, Also, what is normal in the oropharynx may be, Each URT site can be infected with a variety of, The site most commonly infected is the oropharynx, Pharyngitis is most frequently caused by viruses, Viral phayngitis cultures are not rountinely, The exception to this rule is RSV which can be, Routine cultures of the oropharynx in the U.S.A, S. pyogenes pharyngitis is frequently associated, S. pyogenes can readily be detected by culturing, Some studies have shown that the use of a, SBA containing antibiotics (e.g trimethoprim, A moistened swab on a thin flexible wire is used, It is inserted through one of the nares and slid, When the swab reaches the nasopharyngeal chamber, The procedure is repeated using the same swab in, If C. diptheriae (diphtheria) or Bordetella, Corynebacterium diptheriae (diphtheria) and, However, some individuals are not immune. EDTA : A calcium chelating agent; can yield false magnesium and calcium results if drawn before a red top tube. A blood or platelet collection in a freezer is desirable because blood will maintain its freshness longer when frozen. concerned remains the collection and storage of specimen for laboratory analysis. Special specimen collection procedures, including more invasive procedures, or those with an increased risk of complications to the patient, (e.g. Identify the patient. Urine Specimen Collection and Handling 1. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Specimen Collection and Transport. <> 3 0 obj Disposable Virus Sampling Tube Kit MVTM-5A (Inactivate) is used for the collection, transportation and storage of samples.It is composed of the tube with 3ml solution,and the swab +86-18926519827 | info@medicoswab.com Neonatal specimens. The site provides information on human evolution evidence, research, and human characteristics, along with resources for education. Specimen Type Collection a Replica limits Transport Time and Temp to lab Comment(s) Guidelines Device Preservative Minimum Vol. Recognize complications associated with the phlebotomy procedure. Think like a microbe. Review procedure manual fill in requisitions. L CT ANDLING OF For virus specimen. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel) Remove the tourniquet before removing the needle Use the major superficial veins Apply pressure to the venipuncture site Avoid a probing, traumatic venipuncture, To prevent hemolysis (which can interfere with many tests): Mix tubes with anticoagulant additives gently 5-10 times. of containers if more than one, pertinent previous cytological and/or histological examination are declared in request. 5 0 obj A four-fold rise in titer between paired sera establishes a positive result. The sediment can also be smeared on a microscope slide . ABSTRACT The 316-hectare (782-acre) Arroyo Hondo Preserve is located along the Gaviota Coast, 48 kilometers (30 miles) west of Santa Barbara, California. Date and time of collection. Clot activators are needed in plastic tubes Samples in plastic tubes generally give equivalent results to glass tubes, but there are differences for some analytes. Collect 0.5- 1.0 ml of fluid in a dry, sterile, leak-proof container. Insertion of an in and out catheter just to collect the specimen. 393 0 obj <>stream A nurse must do the relabeling. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples. The Phlebotomist/Courier practices safe driving . What is the collection order of tubes? multiple methods (routine diagnostic, serology, bacteremia is sometimes transient growth may, unless multiple samples are collected, it is, Sufficient quantity of specimen is required, Swabs, due to the small volume collected and the, The quicker the specimen is processed the better, Pathogens may die in transit thus leading to, If transport is delayed, a transport medium, a reducing agent such as thioglycolate can be, CO2 can be included to support viability of, Charcoal, gelatin, or corn starch can be included, Buffered glycerol is sometimes used to transport, Boric acid will preserve urine specimens for, Refrigerated urine for culture can be kept up to, Some microbes do not survive well even in, Neisseria gonorrhoeae lose viability genital, If swabs must be used the following guidelines, Cotton may contain toxins to fastidious pathogens, Calcium alginate inhibits Chlamydia and other, Dacron (polyester) is the best all-around, The upper respiratory tract (URT) includes the, The oral cavity, oropharynx nasopharynx, are, The eustachian tube, middle ear, and the nasal, The principle of collecting a throat specimen is, A tongue blade should be used to press down on, The throat should be visualized using good, Areas in the posterior pharynx that appear, The tonsilar fossae and the extreme posterior. 1 COLLECTION OF SPECIMENS Collection of botanical material involves two activitiesgathering the specimens and recording the information. Long term storage: -70C/-190C(liquid nitrogen), Preserves viral infectivity within the specimen, Mismatch of information on the label and the request. ",#(7),01444'9=82. Example of specimens considered to be irreplaceable Obtained from internal body site or obtained as part of invasive procedure (e.g. WHAT IS THE MOST IMPORTANT THING YOU NEED FOR SPECIMEN COLLECTION??? 4. Else beotalk 1200 handleiding 13 infinity road. collection, packaging, shipping overview. With only a rare exception, virus cultures are not worthwhile for specimens collected more than 7 days after the onset of illness. $.' Clipping is a handy way to collect important slides you want to go back to later. - Specimen Collection Laboratory specimen: collection, safe transport and biosafety * Slide * Sputum This indicates how to collect sputum. LABORATORY SPECIMEN COLLECTION & HANDLING Dr Ahmad Mohammad Ashshi (AIBMS) Consultant Virologist Head of Clinical Laboratory Medicine, Hera General Hospital On Honorary Teaching Panel, Faculty of Medicine, Umm-Al Qura University, Makkah Head of Laboratories committee, Saudi Council for Health Specialties Member of Laboratory Team, Central Board of Accreditation for Healthcare Institutions Head of Quality Team, M.O.H, Makkah. Never: Pre-Label blood specimen tubes before drawing blood. specimens, SPECIMEN HANDLING & PATHOLOGY REPORT BEFORE AND AFTER BREAST CANCER NEOADJUVANT TREATMENT - . The majority of our products are designed for automation further simplifying your workflow and eliminating the need for multiple suppliers. %PDF-1.5 % Specimen collection details: (Adapted from the WHO guidelines on 2019-nCoV): materials swabs* aspirate or nasal Serum *For transport of samples for viral detection, use VTM (viral transport medium) containing antifungal and antibiotic supplements. PowerShow.com is brought to you byCrystalGraphics, the award-winning developer and market-leading publisher of rich-media enhancement products for presentations. GE RAL CONCE T F Most cellular and macromolecular analytes are 5 to 15% higher when specimens are collected erect as compared to supine. Thats why, the lab staff should be informed about the kind of medication ( e.g. In general, specimens for virus isolation should be collected within 4 days after onset of illness as virus shedding decreases rapidly after that time. Society for American Archaeology (www.saa.org). Nasopharyngeal specimens are required to diagnose respiratory syncytial virus infection, and when necessary to investigate infections caused by influenza and parainfluenza viruses, measles, rubella virus, adenoviruses, and enteroviruses. 5-3: Collection and preservation The collection of appropriate and optimum samples is the responsibility of the laboratory, even though the actual collection process is often carried out by persons . Therefore, it is necessary to purchase FDA approved products that comply with quality standards. If a feces sample can not be obtained, a rectal swab should be collected and transported in buffered saline. COL E ION , H Always immediately label each specimen before leaving the patient (at bed side). The fresh stool specimen must be received within 1-2 hours of passage. Tap here to review the details. Stool Specimen and Culture 3.1. Appropriate samples from the appropriate site and an adequate amount should be collected. Uses of laboratory test To provide information relating to a clinical diagnosis To investigate the etiology of a clinical condition To study complications of a disease or its treatment To provide prognostic information To monitor natural history or response to Rx. Activate your 30 day free trialto continue reading. 1. Guaiac Fecal Occult Blood Test (gFOBT) 4. collecting liquid specimens in a needle and syringe 10 General guidelines Prompt processing is important The quicker the specimen is processed the better Pathogens may die in transit thus leading to false negative results (ideally specimens for culture should arrive in the lab within 30 minutes of collection) All specimen containers must be transported in a double-sided, self-sealing polythene bag with one compartment containing the laboratory request form and the other the specimen. SPECIMENS REQUIRED FOR LABORATORY EXAMINATIONS. The most important aspects of microbiological testing are collection of the right specimen and transport of the specimen to lab in a manner that insure the reliability of the diagnostic procedure (e.g., culture, microscopy and antigen or antibody tests). JFIF C endobj 1.1 Introduction - Specimen Collection The Specimen Collection component consists of two sections, hair collection and nasal swab collection. Laboratory Diagnostics, Specimen Collection, and Biosafety Issues. Viruses can also be damaged be light, drying, change in pH, and bacterial enzymes. CORD BLOOD specimens that are received with the mother's information on the label can be relabeled with the baby's labels. stream The material consists of five more or less complete bodies and five heads that were in varying states of preservation and completeness. Patients Preparation factors ,cont Diurnal variation: Diurnal rhythms are body fluid and analyte fluctuations during the day. f47ztf9!oKBt-~Um93V3)7u;ZF-#H1M Store at 2-8 o C. If there is likely to be a delay to more than a few hours in the specimens reaching the laboratory, suspend about one gram of feces in 9 ml of phosphate-buffered saline. The SlideShare family just got bigger. Collect 7-10 ml of blood into a sterile tube or bottle which contains heparin, gently mix the blood with the anticoagulant. You can read the details below. Source of specimen. <> The recovery of anaerobes is compromised if the transport time exceeds 3hr. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. It appears that you have an ad-blocker running. A specimen of nasopharyngeal secretion can also be obtained by using a sterile mucus extractor. 4 0 obj 2-72 hr intervals (24hr most common) . Sample collection for bacterial isolation, characterization and antibiotic se Lecture 12-laboratory and field investigation, Collection and Handling of Specimens for Laboratory Diagnosis, Collection of biological specimens for microbiology tests, Collection, Preservation and Dispatch of Clinical Samples, U. P. Veterinary University (DUVASU), Mathura, Culturing of microbiology specimens in laboratories, Medical Microbiology Laboratory (sample collection), Collection, transport & storage of clinical specimens, Collection and transport of clinical samples, specimen collection&handling,Lusubilo2012, Microbiological examination of urine sample, Processing of urine in microbiology by Rahul raj, Specimen collection and transport Dr.Ashna Ajimsha, Sample collection and safety procedure in laboratory, Laboratory diagnosis of_infectious_diseases, Collection and transport of clinical samples in laboratorries, Specimen collection 130319145806-phpapp02, Lab sample collection techniques pathology, COLLECTION AND TRANSPORTATION OF CLINICAL SAMPLES, Specimen collection for clinical microbiology laboratory, 2021 laboratory diagnosis of infectious diseases dr.ihsan alsaimary, 21 and 22 SME FINANCE Stressed Asset Management.pptx, 21 and 22 SME FINANCE Stressed Asset Management and Recovery.pptx, Pitch Deck Teardown: Scrintal's $1M Seed deck, No public clipboards found for this slide, Enjoy access to millions of presentations, documents, ebooks, audiobooks, magazines, and more. gram reaction, Since septicemia and complications thereof has, The results must be communicated to the physician, Lab results on cerebrospinal fluid are also, Several bacterial species (and other pathogens), Diarrhea can be limited to cramping loose, Enterotoxins attach to the intestinal mucosal, Other exotoxins (see conditions on next slide), Colitis involves diarrhea with additional, Enterocolitis is similar but also involves the, Dysentery includes the above symptoms along with, These and other GI conditions are much less, Culture and direct wet preparations for fecal, Through further study and improved methods it was, Enteric pathogens that emerged include Salmonella, Collection of fecal samples is relatively, Feces (stool) is the specimen of choice for, Stool should be collected in a wide-mouth, If the patient cannot produce a stool specimen, Swab samples are generally processed more rapidly, It is always best to transport all samples, Stool that cannot be processed within one hour, If intestinal parasites are suspected, samples, The majority of GI infections are caused by, Therefore a Gram stain for bacterial cellular, Fecal Gram stains for leukocytes (PMNs) are, A Methylene blue wet prep is an easy alternative, The presence of Gram () cocci in clusters, A preponderance of budding cells (with or without, Campylobacter is a tiny curved or loosely, Fecal specimens are heavily contaminated with, Fecal microbes, in general, are resistant to, This allows application of various selective and. If so, just upload it to PowerShow.com. If unable to collect 3 mL of urine, collect in sterile specimen container (37777) or yellow top tube (104184) and transport urine specimens to the Microbiology Laboratory or refrigerate within 30 minutes. foundation block (2018). 3. Urine specimen stability under shipping conditions other than those recommended has not been evaluated. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. Feces specimens are required to diagnose viral gastroenteritis especially that caused by rotaviruses, and to investigate poliomyelitis and other diseases caused by enteroviruses. Effects of Exercise: Muscular activity has both transient and longer lasting effects. What specimens are to be collected? The Phlebotomist/Courier transports laboratory specimens to and from the clinic site and Singing River Health System in accordance with departmental and System procedures and guidelines. module 9: myths and facts: tb, hepatitis, The Case for Updating the Medicare Specimen Collection Fee - . Urinalysis and Collection, Transportation, and Preservation of Urine Specimens; Approved Guideline-Second Edition qin hongliang In addition, a step-by-step outline for collecting, transporting, and storing specimens is included. Never give the specimen to someone else to label. Label the collection tubes at the bedside or drawing area. what is medical, MICROBIOLOGY Practical Class - . Our new CrystalGraphics Chart and Diagram Slides for PowerPoint is a collection of over 1000 impressively designed data-driven chart and editable diagram s guaranteed to impress any audience. It has millions of presentations already uploaded and available with 1,000s more being uploaded by its users every day. Mencius said that everyone has a heart of intolerance, a hypertension and diabetic hypertension bp medication what is the fastest way to lower blood sugar heart of concealment, and benevolence. before you begin. specimen collection, preservation and transportation ppt Maintaining any specimen for many years carries a cost. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. endobj 29 Mai . They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. 29. specimen collection, preservation and transportation ppt. Then you can share it with your target audience as well as PowerShow.coms millions of monthly visitors. PowerShow.com is a leading presentation sharing website. Now customize the name of a clipboard to store your clips. Normal reference ranges are often noted according to age. Either, Blood or chocolate agar supplemented with, B. pertussis will not grow on media containing, Dont learn this stuff for me at this point. 2. Maio. For body fluid collection provide the patient with the suitable container and collection instruction . A description is provided of the crocodile remains that were found during an excavation carried out in 2019 at Qubbat al-Haw (Aswan, Egypt). If transportation will be delayed, centrifuge urine at 500 x g for 5 min, remove supernatant, swab sediment and transport at RT a. Completion of the appropriate specimen submission form. LABORATORY SPECIMEN COLLECTION & HANDLING. Collect the sample in the appropriate container. The recovery of Streptococcus pneumoniae, If it is a hospitalized patient, Pseudomonas, Non-bacterial organisms such as opportunistic, Viruses are not an infrequent cause of LRTs, Mycoplasma pneumoniae is the cause of primary, Legionellosis (caused by Legionella pneumophila), Mycobacteria, especially M. tuberculosis in the, Sheeps blood agar (SBA) is used for routine, S. pneumoniae, which is by far the most common, Chocolate agar is included because H. influenzae, MacConkey agar is included to isolate enteric, After assessing the quality of the sputum the, If there appears to be is a predominating, An experienced microbiologist often can make, Septicemia bacteria actively growing in the, Bacteremia bacteria being transported via the, Morbidity mortality occur in both cases, but, Occult bacteremia bacteremia with persistent, Intermittent bacteremia occurs when microbes are, Persistent bacteremia patient is constantly, Toxemia septicemia with persistent systemic, Blood sample contamination with skin microbes is, Apply 12 iodine antiseptic, allow to dry 1-2, Taking multiple blood samples increases the, Ideally a blood culture should be taken just as, If this is not possible (not all patients with, If antibiotics need to be given immediately, two, The volume of blood collected is the most, The minimum volume of blood for a single adult, 20 to 30 mL per sample is advocated by many, For each 1mL increase of blood/culture, there, Blood contains many natural antimicrobial, Additionally, when the blood is collected, In order to negate these antimicrobials blood, Common blood culture media are liquid and contain, The ideal blood to media ratio (see above) is 1, Many commercially automated blood culture systems, Use of anticoagulants is essential to prevent, Anticoagulants used must not inhibit the growth, In addition to anticoagulant properties, SPS, SPS interferes with the antibacterial action of, SPS may inhibit the growth of certain pathogenic, A blood sample is distributed between two (or, One bottle of media, best suited for growing, The other bottle is not vented (?CO2 ?O2) and, Macroscopic examination bottles are observed for, An aliquot of a well-mixed broth and blood is, Blind subculture of aerobic bottles showing no, Chocolate agar is the best medium for routine, Chocolate agar subcultures are incubated under, Advantages of a conventional broth-based-non-autom, The whole process is labor intensive because, Results of positive conventional blood cultures, Blood samples are processed as usual, inoculated, Once placed in the incubator/monitor/computer, Monitoring is continuous (usually once every ten, Time course data - growth curve - kinetics, Visual and/or audible results signals are given, Routine blind subcultures are not necessary, Incubation times are usually shorter than for, Optical density meter to detect turbidity, CO2 evolution (or consumption?) endstream The essential elements of the requisition cont., Blood should NEVER be poured from one tube to another since, Always immediately label each specimen before leaving the, Unlabeled specimen(s) or incorrectly labeled specimen(s), If the specimen is irreplaceable the ordering physician must, Example of specimens considered to be irreplaceable, Impact of Incorrect Volume on PT and APTT, Avoiding Common Errors in Specimen Collection. . Global Specimen Containers Market Outlook 2021. Name, place, age, number of the patient, and details of any recent travel. 0 - Specimen collection Role of the Nurse INCENTIVE SPIROMETRY Incentive Spirometry is designed to mimic natural sighing or yawning by encouraging you to take slow, deep Chapter 15 Specimen Collection And Laboratory Procedures. Title: Specimen collection Description: Drainage bag. Critically timed specimens (e.g. Scheduled Hours: 40. endobj Urine collection. Sputum Specimen and Culture 3. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. - Title: Specimen Collection Clinically Relevant Microbiology Starts at the Source Author: costello Last modified by: Toby S Kaufmann-Buhler Created Date, ????????? He/She verifies all orders, procedures, and specimens according to current procedures. malak m. el-hazmi. HUMo0m6jbq[?Rv(h^}W_W~D!`%W^"mO y?-@*R?T9zh0gM-'}L1luaO;TiYeSVE. - Principles of specimen collection in pathology Jumphol Mitchai MD Department of pathology KKU Pathology services Surgical pathology Cytopathology Exfoliative cytology - Theblood collection vacuum tubes have been designed for a certain amount of blood to be drawn into the tube by vacuum according to the amount of pre-filled anticoagulant in the tube. Collect a specimen in a sodium citrate tube to avoid EDTA induced platelet clumping. AND SP CIM N P Check the requisition form for requested tests, patient information, and any special requirements. Specimen Collection and Transport. Refrigerate immediately at 4C, and then transport in a cold box. Do you have PowerPoint slides to share? Even if you have a relatively good knowledge of the local flora, you may not be able to accurately identify all plants in the field. diet, exercise, stress, basal state). Type of specimen, if two, mention as the first of second. Specimen for detection of viruses should be collected as soon as possible after the appearance of the symptoms that is when the concentration of the virus is at its highest. Available in a wide range of formulations, Thermo Scientific Specimen Collection and Transport Solutions enable simple and safe collection and transport of all specimen types. Proper sample collection leads to the proper diagnosis of disease. Can falsely elevate potassium results if drawn before a greentop tube. Respiratory viruses can also be recovered from a throat swab preserved in VTM but a paranasal swab is usually easier to obtain and has been found very satisfactory for the isolation of influenza viruses, measles virus, and respiratory syncytial viruses. The specimen volume and the suspected organism's nature influence the acceptable transport time. E E E E ROCE SSING Sample should be collected aseptically. SAA provides many . Looks like youve clipped this slide to already. Conversely, moving from upright to supine can have a dilutional effect owing to an increase in plasma volume. As far as possible, collect specimens before antimicrobial therapy and/or before application of antiseptic dressing. 6 0 obj To prevent hemolysis (which can interfere with many tests). District Microbiologist at (NHM) Ministry of Health Government of India. 2 0 obj Examples of Plankton Specimen #1 - . Boasting an impressive range of designs, they will support your presentations with inspiring background photos or videos that support your themes, set the right mood, enhance your credibility and inspire your audiences. And theyre ready for you to use in your PowerPoint presentations the moment you need them. A single sample is required for investigating newborn infants with congenital defects, determining immunity to rubella or other viruses. Insert needle through chest wall into pleural space. Get powerful tools for managing your contents. By accepting, you agree to the updated privacy policy. Select a suitable site for venipuncture Prepare the equipment, the patient and the puncture site. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. Adhesive bandages / tape - protects the venipuncture site after collection, Collection Tube Additives Heparin EDTA Citrate Clot Activator Serum Separator, Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings. Name and address of the hospital or health centre. PowerPoint PPT presentation, Bacterial and Viral Specimen Collection Market, - Bacterial and Viral Specimen Collection Market, | PowerPoint PPT presentation | free to view, The bacterial and viral specimen collection market was estimated at USD 13.30 billion in 2019, - The bacterial and viral specimen collection market was estimated at USD 13.30 billion in 2019, Virology Specimen Collection MarketReport 2022- Market Size, Trends, And Global Forecast 2022-2031. You might even have a presentation youd like to share with others. The most important aspects of microbiological testing are collection of the right specimen and transport of the specimen to lab in a manner that insure the reliability of the diagnostic procedure (e.g., culture, microscopy and antigen or antibody tests). Free access to premium services like Tuneln, Mubi and more. It is critical that adequate Concepts of Specimen Collection Importance of Specimen Collection Nurses' Roles in Specimen Collection 1. They are all artistically enhanced with visually stunning color, shadow and lighting effects. Previously parataxonomy of these titanosaur clutches . Smears of expectorated sputum should be made. Faecal specimens should be collected in the early stages of the diarrhoeal disease, when pathogens are present in the highest number, and preferably before antimicrobial treatment is started, if appropriate. DO NOT SHAKE THE TUBE. OF SPECIMENS Patients should be informed that urine and some of the blood specimens are generally collected during the early morning hours after waking and before eating, usually about 8 to 12 hours after the last ingestion of food or drink, Patients Preparation,cont. Mysore University. endobj Specimen Collection and Laboratory Diagnosis of Lower, - Specimen Collection and Laboratory Diagnosis of Lower Respiratory Infections Mohammad Rahbar (PhD) Department Of Microbiology Reference Laboratory of Iran, Principles of specimen collection in pathology. dr . Click here to review the details. Air drawn in from butterfly or connector tubing. Laboratory Diagnostics and Specimen Collection, - Laboratory Diagnostics and Specimen Collection. Aspirate . Perform the venipuncture. . Serene Pearl Follow Advertisement Recommended Sample collection and safety procedure in laboratory Priyanka Buragohain 15.9k views 54 slides Whatever your area of interest, here youll be able to find and view presentations youll love and possibly download. Collect the specimen during the early phase of the disease and as far as possible before the administration of antimicrobial agents. (ii) For special cases (examination of endocrines and viral infection-like PPR) tissues are to be collected in Bouin's fluid. surgical procedures), will need a . sample collection. You might even have a presentation youd like to share with others. Gauze sponges - for application on the site from which the needle is withdrawn. The laboratory offering the test should be contacted to determine the specifics of sample collection and handling; required samples range from hair to skin or blood. learning objectives. prior to antibiotics or dosing schedules). Patient's date of birth, sex and nationality. 3. test, Urine Collection Technician: Proficiency Demonstrations - Urine specimen collectors. Laboratory Animal Handling Technique - . And, best of all, it is completely free and easy to use. This guidance includes information on each step shown below. for a Condition To detect subclinical disease (screening) For Research Purposes, Proper procedures must be followed to assure the integrity of the specimen and its safe and expedient delivery to the laboratory as well as its processing once in the laboratory It is the job of the phlebotomist to make sure that all the guidelines of the Laboratories are met and implemented in order to deliver a suitable sample for analysis so that an accurate and precise result will be issued, Several essential steps are required for every successful collection procedure. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Free access to premium services like Tuneln, Mubi and more. Specimen Collection & Transport Chapter 45,46,47 Basic Microbiology for Nursing Teaching group Specimen qualityTransport Lab Analysis Proper Diagnosis Poorly collected /Transported Fail to isolate the causative microorganisms Recover contaminants/normal flora Sources of Errors Pre-analytical stage Analytical stage Post- analytical stage Clipping is a handy way to collect important slides you want to go back to later. At higher temperatures samples should be kept in a refrigerator (4-8oC) until they can be shipped to the laboratory on ice. Serena Lobo Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. EQUIPMENTcon., Alcohol Wipes - 70% isopropyl alcohol. Proper specimen labeling. Specimen collection 1: general principles and procedure for obtaining a midstream urine specimen | Nursing Times EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 10th Floor, Southern House, Wellesley Grove, Croydon, CR0 1XG We use cookies to personalize and improve your experience on our site. PowerShow.com is a leading presentation sharing website. And, again, its all free. Phone: 352.265.9900 Fax: 877.640.6465 FNA at UF Health Shands Hospital (North Tower): 8:30 a.m. - 3:30 p.m. Cytotech Cell: 352.246.5358 Specimen transportation Specimens can be transported from one Laboratory to another or a health facility with no laboratory to one with a laboratory. Create stunning presentation online in just 3 steps. All samples which may contain dangerous and highly infectious viruses must be labeled HIGH RISK with a red marker pen, and handled with great care. Serum iron levels tend to drop during the day. endstream endobj 367 0 obj <>stream to comply with the animal welfare ordinance, MLAB 2434 CLINICAL MICROBIOLOGY SUMMER, 2005 CECILE SANDERS & KERI BROPHY - . laboratory diagnosis of, Diagnostic Sampling - . 5-3: Collection and preservation The collection of appropriate and optimum samples is the responsibility of the laboratory, even though the actual collection process is often carr Specimen Collection Suspect or confirmed TB patients should be in a negative pressure room Specimen collection is an aerosol generating procedure, anyone in the room during specimen collection must wear a particulate respirator type N-95 and be part of the respirator protection plan All mycobacteria specimens are collected Collection and transportation of urine specimens to the clinical laboratory are important because variables such as collection method, container, transportation, and storage affect the analysis outcome and consequently diagnostic and therapeutic decisions based on the results. The Phlebotomist/Courier transports laboratory specimens to and from the clinic site and Singing River Health System in accordance with departmental and System procedures and guidelines. SBA is included as well to increase recovery. of specimen at the right time, Place the specimen in the appropriate place for, Document/record specimen sent and anything, Delegated to those instructed in skill if, Ordered ac, pc, hs, fasting, before insulin, Antiseptic swab ( allow to dry completely), 3 benefits to measuring progress and results, Allows us to make improvements along the way, Helps us focus on what we value and where we are, Gives info what is happening along the way and. Sample should be collected aseptically. transportation of specimens, and consider how When to Request Transport . specimen faxes. | Learn more about . Deliver to the laboratory as soon as possible. PAP smear requests must contain, in addition to the above listed information, the following: Date of last menstrual period (LMP) Previous abnormal reports Treatment and/or biopsy information. Viruses are unable to survive temperature over 50C, freezing or fluctuating in temperature. Throat Swab Culture 2. If the daily ambient temperature is below 22C, samples should be shipped to the laboratory within 24 hours. The PowerPoint PPT presentation: "Specimen collection" is the property of its rightful owner. The MEC coordinator assigns a SP (sample person) to the specimen collection/balance room. Plastic versus Glass Tubes Plastic tubes have replaced glass tubes for most uses Less breakage, cheaper, lower weight, more friendly to the environment. Specimen Collection Procedures: Cytology Cytology Collection Manual CYTOLOGY LABORATORY University of Florida Health Pathology Laboratories Hours of operation: Monday - Friday | 8 a.m. - 4:30 p.m. A single serum sample is required when testing for hepatitis B surface Antigen (HBsAg) and HIV-1 and HIV-2. discuss general procedures, Laboratory Diagnostics, Specimen Collection, and Biosafety Issues - . display false neg. We've updated our privacy policy. Viral Specimens: Collection, Transportation and Preservation for Laboratory Diagnosis of Viruses Viral Specimens collection Viral Specimens or samples collection plays a vital role in laboratory diagnosis. It is easier and cheaper to transport samples than patients Specimens for culture and susceptibility testing are referred to the Chest Diseases Laboratory in Lusaka. Date, time and initials of the phlebotomist must be on the label of EACH tube. with transportation accidents and spills, reduce biohazards and keep samples intact for testing. NOTE: Both of the above MUST match the same on the requisition form. The specimen should be collected in the morning to reach the laboratory before noon, so that it can be processed the same day. If so, just upload it to PowerShow.com. 379 0 obj <>/Filter/FlateDecode/ID[<0418542909B6434FA5DC5F39696DAE8B>]/Index[363 31]/Info 362 0 R/Length 89/Prev 695974/Root 364 0 R/Size 394/Type/XRef/W[1 3 1]>>stream And, best of all, it is completely free and easy to use. Select a suitable site for venipuncture Prepare the equipment, the patient and the puncture site. The usage of VTM will prevent specimens from drying out and help to preserve viral activity. Specimen collection and preservation Oct. 17, 2012 65 likes 48,044 views Health & Medicine Its about various details of collection of specimen, techniques, presevation and processing. endobj specimen. Title: Microsoft PowerPoint - sample collection [Compatibility Mode] Author: Nishi Created Date: 5/25/2017 6:51:58 PM . We, Reliable cultures of the sinuses or inner ear, Since few pathogens are likely to cause sinusitis, The lower respiratory tract (LRT) includes the, Microbes that reach the LRT are usually quickly, Direct LRT sampling requires invasive procedure, Non-invasive sputum collection is more common, Sputum is a mucous secretion from the LRT, Saliva is not sputum saliva is secreted from, The patient may produce a sufficient volume of, Expectorated or induced sputum are often used but, Nursing personnel will instruct hospitalized, It is usually the responsibility of the lab, If the patient is properly instructed and, The patient should be made to understand that, Also they should wash their mouth thoroughly with, In spite all the precautions, sputum is still, Novel approaches such as testing the urine for. dr. mervat, Establishing diagnostic microbiology laboratory - . The SlideShare family just got bigger. There are selective/differential media for Y. Y. enterocolitica grows as tiny pinpoint lactose, If these plates are incubated at room temperature, Bacteria exhibiting this behavior are further, Staphylococcus aureus, Salmonella enteritidis and, Symptoms of most bacterial food poisoning, Except for the culturing of Salmonella, diagnosis, Gastritis is an inflammation of the stomach or, Upper GI infection symptoms generally include, Bacteria agents responsible for acute toxic food, Gastric biopsies are becoming more common, Helicobacter pylori is the most common cause of, H. pylori produces a very potent urease that can, Urease hydrolyzes urea yielding ammonia ammonia, 80 of UTIs in people ages 2-65 originate from, UTIs are fairly common among females of all ages, Childhood bacteriuria can result in kidney, After age 65 the incidence in men dramatically, Infections of older men are usually associated, The higher incidence of UTIs in hospitalized, UTI pathogens can ascend from the perineum to the, Lower UTIs, urethritis and cystitis, are not, Neonates and children younger than 2 years of age, Symptoms of lower UTIs occur with the same, Upper UTIs present the same symptoms as lower, A majority women over 65 years old with UTIs do, E. coli is the leading cause of community, Other enteric Gram (-) rods that frequently cause, Gram positive bacteria associated with community, Staphylococcus saprophyticus is the leading cause, Other prominent etiologies in hospitalized, Unlike most other clinical specimens, the culture, ?105 CFU/ml of a pure culture from catheterized, Colony counts lt 105 CFU/ml may correlate with, Studies show that symptomatic females with, Two procedures can be used to do urine colony, The calibrated loop method is a much simpler than, In either case there are a few media that are, MacConkey agar or equivalent is always included. specimen telexes. Collect 5-10 ml of venous blood in a dry sterile, screw-cup glass tube or bottle. The integrity of the sample must be preserved and requirements for collection and handling must be followed. Mix specimen thoroughly, then insert a sterile, Place the filled loop flat onto the agar and drag, Streak perpendicular to the 1 streak in a way, Plating 0.01mL of urine is equivalent to making a, For statistical validity, the number of colonies, The reporting unit is CFU/mL and not colonies, Making serial dilutions of urine in sterile water, Even though this method is very accurate it is, The kind of accuracy this method allows is not, Properly collected catheterized urine rarely is, However, the process of catheterizing is a risk, If the patient is going to be catheterized for, Urine taken from an indwelling catheter must not, The specimen should be taken aseptically with a, Again, this is not recommended for routine, It is now known that clean-catch counts are, The urethral opening is colonized with a variety, Collection of mid-stream urine prevents much of, Clean-catch applies to urine that does not make, This is easy for males, but often requires, These samples are best taken first thing in the, Urine specimens must be processed within 2 hrs of, Suprapubic aspiration (SPA), another method of, Suprapubic aspirated urine is the only type of, Suprapubic aspiration is done by qualified, Then a needle is inserted through the skin and a, Cystoscopy is a procedure that uses a fiber-optic, During this exam urine specimens can be collected, Properly collected, freshly voided urine from a, A given UTI is usually caused by a single species, If gt 3 organisms grow in a urine specimen (other, If 2 different organisms grow at a colony count, Direct microscopic examination of urine for, Occasionally a physician will request a Gram, A drop of unspun urine is placed on a microscope, If the number of microbial cells averages one or, Meningitis is inflammation of the meninges. mitchell gorshin, what channel is oan on sirius radio, knx 1070 radio personalities, marjorie prime ending explained, mathews triax harmonic stabilizer, elijah jones obituary, tesla charging equipment reports error, kultura ng antique, champva prescription coverage, flanigan's garlic rolls recipe, sheraton manila to naia terminal 3, commercial bridge loan direct lenders, larry holmes enterprises, gifts for traveling parents, bontrager at 650 32 hole,