II. Technique: Obtaining a Sputum sample
- Mouth should be free of foreign objects
- Remove food, gum, or Tobacco
- Remove dentures
- Early morning specimen is best
- Induce Sputum if necessary
- Nebulized Hypertonic Saline or distilled water
- Chest percussion
- Postural drainage
- Cough into sterile specimen cup
III. Approach: Special Circumstances
-
Tuberculosis suspected
- Sputum collected in negative pressure room
- Early morning gastric aspirate
- Bronchoscopy with Bronchial lavage
- Anaerobic culture specimen
- Transtracheal aspiration
- Thoracentesis
- Direct lung puncture
- Viral Culture Specimens
- Patient gargles and expectorates with nutrient broth
- Nasopharyngeal swab transported in viral medium
IV. Preparation: Sputum for Lab
- Fixation of Sputum for cytology (prevents air drying)
- Patient expectorates into jar of 70% Ethanol
- Spread fresh Sputum on slide and spray pap fixative
- Culture specimen transport to lab
- Sputum Gram Stain assesses sample for adequacy
- Anaerobic cultures transported in air tight container
- Transport to lab for immediate plating
- Aerobic culture specimen
- Bring to lab as quickly as possible
- Refrigerate specimen if transport delayed
- Consider washing specimen of oral flora
- Rinse several times with saline
- Discard supernatant (non-viscous Saliva)
- Tuberculosis culture
- May be stored at room Temperature for up to 48 hour