This video focuses on:
- Preparation and equipment
- Handling the specimen
- Removing Personal Protective Equipment
- Collection of specimens from the surface of the respiratory mucosa with nasopharyngeal swabs is a procedure used for the diagnosis of Covid-19 in adults and children.
- The procedure is commonly used to evaluate patients with suspected respiratory infection caused by other viruses and some bacteria.
- This video describes the collection of nasopharyngeal specimens for detection of Covid-19, the illness caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
- There are no specific contraindications for collecting specimens with nasopharyngeal swabs.
- However, clinicians should be cautious if the patient has had recent nasal trauma or surgery, has a markedly deviated nasal septum, or has a history of chronically blocked nasal passages or severe coagulopathy.
Preparation and equipment :
- Nasopharyngeal swabs have long, flexible shafts made of plastic or metal and tips made of polyester, rayon, or flocked nylon.
- Personal protective equipment (PPE), including a gown, nonsterile gloves, a protective mask, and a face shield is needed.
- All sample tubes should be labeled and that the appropriate requisition forms should be filled out before starting the procedure.
- It is essential to follow the pertinent respiratory and contact precautions specified by the Centers for Disease Control and Prevention (CDC) to put on the PPE correctly.
- If possible, you should put on and take off the PPE in the presence of an observer to make sure there are no breaks in technique that may pose a risk of contamination.
- First, put on a protective gown, wash your hands with soap and water (or use an alcohol-based solution), and put on a pair of nonsterile gloves.
- Then put on a protective mask with a rating of N95 or higher, as recommended by the CDC.
- Finally, put on a face shield for face and eye protection.
- Masks are recommended for all patients suspected of having Covid-19
- Ask the patient to take off her mask and blow her nose into a tissue to clear excess secretions from the nasal passages.
- Remove the swab from the packaging.
- Tilt the patient’s head back slightly, so that the nasal passages become more accessible.
- Ask the patient to close her eyes to lessen the mild discomfort of the procedure.
- Gently insert the swab along the nasal septum, just above the floor of the nasal passage, to the nasopharynx, until resistance is felt .
- Insert the swab into the nostril, parallel to the palate. If resistance to the passage of the swab is felt, back off and try reinserting it at a different angle, closer to the floor of the nasal canal.
- The swab should reach a depth equal to the distance from the nostrils to the outer opening of the ear.
- The CDC recommends leaving the swab in place for several seconds to absorb secretions and then slowly removing the swab while rotating it.
Handling the specimen
- Open the collection tube and insert the swab into the tube.
- Break the swab at the groove and discard what remains of the swab.
- Close the labeled collection tube, wipe the tube with a surface-disinfectant wipe, and insert the tube into an open biohazard bag held by an assistant
- Follow the CDC directions for direct processing of the swab specimen or placement of the swab in media with or without refrigeration.
Removing Personal Protective Equipment
- First, remove your gown and gloves.
- Clean your hands with an alcohol-based solution or soap and water.
- Put on a new pair of gloves, and then remove your face shield and either dispose of it or clean and store it in accordance with the guidelines.
- Remove your gloves, rewash your hands, and put on another pair of gloves; then remove your mask and follow guidelines for disposal or reuse.
- Finally, remove the last pair of gloves and wash your hands.
- This video demonstrates the collection of specimens from the surface of the respiratory mucosa with nasopharyngeal swabs for the diagnosis of Covid-19 in adults and in children.
- It is important to use approved PPE and the appropriate technique to minimize the possibility of spreading the virus.