II. Technique: Obtaining a Sputum sample

  1. Mouth should be free of foreign objects
    1. Remove food, gum, or Tobacco
    2. Remove dentures
  2. Early morning specimen is best
  3. Induce Sputum if necessary
    1. Nebulized Hypertonic Saline or distilled water
    2. Chest percussion
    3. Postural drainage
  4. Cough into sterile specimen cup

III. Approach: Special Circumstances

  1. Tuberculosis suspected
    1. Sputum collected in negative pressure room
    2. Early morning gastric aspirate
    3. Bronchoscopy with Bronchial lavage
  2. Anaerobic culture specimen
    1. Transtracheal aspiration
    2. Thoracentesis
    3. Direct lung puncture
  3. Viral Culture Specimens
    1. Patient gargles and expectorates with nutrient broth
    2. Nasopharyngeal swab transported in viral medium

IV. Preparation: Sputum for Lab

  1. Fixation of Sputum for cytology (prevents air drying)
    1. Patient expectorates into jar of 70% Ethanol
    2. Spread fresh Sputum on slide and spray pap fixative
  2. Culture specimen transport to lab
    1. Sputum Gram Stain assesses sample for adequacy
    2. Anaerobic cultures transported in air tight container
      1. Transport to lab for immediate plating
    3. Aerobic culture specimen
      1. Bring to lab as quickly as possible
      2. Refrigerate specimen if transport delayed
      3. Consider washing specimen of oral flora
        1. Rinse several times with saline
        2. Discard supernatant (non-viscous Saliva)
    4. Tuberculosis culture
      1. May be stored at room Temperature for up to 48 hour

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