Post-Examination Process

storage and disposal of samples safely.

When all examinations are complete in a given primary sample

1. Put sample in racks.
   
2. Arrange samples in racks sample_id wise, to hasten its retrieval when needed again.
   
3. When a rack is completely filled , put it refrigerator as follows.
   
   1. Put a note of date of sample receipt in each rack, to hasten its retrieval when needed again as well as to determine time for disposal.
   2. Put rack in shelf of a dedicated primary sample storage refrigerator maintained at 2'-8' C.
      
   3. Preserve samples for 3 days
      
4. Every day at 8 am, discard samples of the day before yesterday, so that all samples are preserved more than 24 hours of time of receipt.
   
5. Use date-slip kept in the rack to determine weather it is due for disposal or not.
   
6. Secondary samples, i.e aliquots are not stored.
   
7. Request forms are stored for 1 days.
   

• For checking integrity of stored samples, temperature of that refrigerator being noted daily and maintained as record in LIS .
• Run any of two samples from stored samples and compare the result with previous day's result for its integrity. This will be done once in month. Records will be kept in LIS.
• Choose samples with those parameters which are stable for 48 hours or more. Parameters like elecrtrolytes and bilirubin are not being considered for integrity checking as they are unstable parameters.
• Set monthly reminder in LIS for this.

1. Autoclave samples which need to be disposed every alternate day.

How to operate fully autoclave vertical instrument

-Depending upon the availability of ependroff cups, we can either discard or re-use the cups

-For reusage, proper washing of cups is required.

1. Washing of cups for testing of patient' samples

Any waste generated at the biochemistry section is disposed as follows.
New Guidelines for Biomedical waste disposalbmw_rules.pdf

Guidelines for Biomedical waste disposal in Biochemistry Labwaste_disposal_for_biochem_lab.pdf

Prepare following containers

1. Black Containers:
   
   1. Black plastic containers of large size in main trolley
      
   2. Black plastic container small size
      
   3. Black plastic small size container is not available, take available plastic container and cover it with black bag
      
   4. Black plastic bags
      
2. Blue Containers:
   
   1. Blue plastic containers of large size in main trolley
      
   2. Cardboard boxes with blue colored sticker
      
   3. Take cardboard box and protect it with cello-tap and label it with blue color sticker
      
3. Red Containers:
   
   1. Red plastic containers of large size in main trolley
      
   2. Red plastic bags
      
4. Yellow Containers:
   
   1. Yellow plastic containers of small size
      
   2. yellow plastic bags
      
   3. keep this plastic container with yellow bag in sample collection disposal box
      
5. White (Translucent) container
   1. Puncture proof,Leak proof,tamper proof containers
      
   2. keep this white plastic container in sample collection disposal box
      

Mutilation/Shredding , Segregation, disinfection, transport and disposal of wastes:

1. Liquid waste without biological materials:
   
   1. Example: drinking water
      
   2. Disposal:General laboratory drain
      
2. Liquid waste with biological materials:
   
   1. Example: Serum, Blood, reaction mixtures, washing liquids of analyzers.
      
   2. Segregation: If required segregate in containers with colors other than Black,Red, Yellow and blue
      
   3. Disinfection: Add sufficient hypochloride to make 1% concentration of hypochloride in the liquid. (e.g. For 100 ml of such waste add 10 ml of 10% hypochloride)
      
   4. Disposal:General laboratory drain
      
3. Solid waste without biological material:
   
   1. Example:Paper, food,
   2. mutilation/shredding: Shred documents request forms and reports before disposal.
      
   3. Segregation: Black containers
      
   4. Transport: In black plastic bags/containers as per hospital waste transport system
      
   5. Disposal: Secured landfill as per hospital waste disposal system
      
4. Sharp waste with biological material:
   1. Example:glass, needle
      
   2. mutilation/shredding: mutilate needles with needle-cutter
      
   3. Segregation: Blue puncture-proof containers
      
   4. Disinfection:1% hypochlorite / autoclave
      
   5. Transport:In blue plastic puncture-proof containers as per hospital waste transport system. Do not transport as blue-bag waste without puncture-proof containers
      
   6. Disposal:secured landfill as per hospital waste disposal system
      
5. Disposable plastic items contaminated with biological material:
   
   1. Example:plastic vacuum tubes with primary samples , eppindorf tubes used for aliquot , Reagent bottles , analyzer tubings , gloves
      
   2. mutilation/shredding: shred gloves with scissor (disinfect scissor with autoclave/1% hypochlorite)
      
   3. Segregation: Red containers
      
   4. Disinfection:1% hypochlorite/autoclave
      
   5. Transport: Red plastic bags as per hospital waste transport system.
      
   6. Disposal:secured landfill as per hospital waste disposal system.
      
6. Cotton/Paper Items soiled with biological material:
   
   1. Example:tissue paper used for equipment cleaning cloth used for cleaning laboratory
      
   2. Segregation: yellow containers
      
   3. Disinfection:1% hypochlorite / autoclave
      
   4. Transport: yellow plastic bags as per hospital waste transport system.
      
   5. Disposal:incineration as per hospital waste disposal system.
      

General guidelines:

1. Segregation:If a Black-coded waste is mistakenly put in biological-waste containers(red, yellow, blue), segregate it as contaminated waste only. Do not keep it back to black container.
   
2. Disinfection:Autoclave is preferred method for all solid waste disinfection at biochemistry section.Autoclave for 20 minutes between 12-20 lb/in2 pressure.Hypochlorite concentration may be increased up to 10 % for heavily contaminated items like vacuum tubes.
   
3. Transport:Label all waste containers/bags for transport indicating site of generation, date and approximate weight.Get acknowledgement from hospital person receiving waste.
   

Procedure: How to operate fully autoclave vertical instrument COVID 19 sample handling and processing:
covid_19_sample_handling_and_process.odt covid_19_sample_handling_and_process.pdf

reference of Laboratory biosafety guidance related to coronavirus disease 2019 laboratory_biosafety_guidance_related_to_coronavirus_disease.pdf