Specimen Collection

The information your doctor receives from your test(s) is only as accurate as the collection procedure you follow. Therefore, it is important that you collect the urine in the following manner:

1. You must begin all 24 - hour urine collections with an empty bladder. When you wake up the morning of the day the collection is to begin, empty your bladder, discard the urine and note the time.
2. Collect all urine throughout the day and night. Keep samples refrigerated at all times unless otherwise specified.
3. The next morning wake up at the same time you did the day you began the collection, empty your bladder and add this to the urine you collected the day before. This completes the 24 - hour urine collection.
4. Return specimen to a Weland Clinical Laboratories site as soon as possible after collection.

IMPORTANT: Before you stop taking any medications you must check with your physician!

The following is a list of preparation requirements for tests requiring 24 hour urine collection:

5 - HIAA – Patients should avoid for a 72 - hour period prior to and during collection the following foods and drugs or any compound containing these drugs; avocados, bananas, eggplant, plantain, plums, tomatoes, pineapples, walnuts, taking cough syrup containing guaifenesin, Tylenol, Empirin, Acetanilid, Glyceryl Guaiacolate, Mephenesin, Methocarbamol, Reserpine, Chlorpromazine, Promazine, Imipramine, Isoniazid, MAO Inhibitors, Methenamine, Methyldopa and Phenothiazines.

17 Hydroxycorticosteriods – No special preparation required.

17 Ketosteriods - No special preparation required.

17 Ketogenic Steroids - No special preparation required.

Catecholamines – Avoid patient stress. Many drugs (reserpine and alpha methyldopam, levadopa, monoamine oxidase inhibitors and sympathomimetic amines) may interfere and should be discontinued two weeks prior to specimen collection. Nose drops, sinus and cough medicines, bronchodilators and appetite suppressant – agonists, calcium channel blockers, converting enzyme inhibitors, bromcriptine, phenothiazine, tricyclic antidepressants, - and β - blockers, and laetalol may interfere. Mandelamine® interferes, but thiazides do not. Caffeine products should be avoided before and during collection. The patient should not be subjected to hypoglycemia or exertion. Increased intracranial pressure and clonidine withdrawal can cause false - positive results.

Citric Acid - No special preparation required.

Creatinine – No special preparation required.

Heavy Metals – Patients should avoid seafood and red wine 72 hours prior to collection.

Oxalate – No special preparation required.

Metanephrines – No caffeine before or during collection. Monamine oxidase inhibitors (Marplan, Nardil, Parnate) should be discontinued at least one (1) week prior to beginning collection.

Vanillylmandelic Acid VMA – Patients should avoid for 72 hours prior to collection salicylates, caffeine, phenothiazine and antihypertens ion agents. Also coffee, tea, chocolate, fruit (especially bananas and any vanilla containing substances).

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1. Use the sterile container provided by your healthcare provider or We land Clinical Laboratories.
2. While holding the labia apart or foreskin retracted, begin voiding.
3. After several milliliters have passed, collect a midstream portion without stopping the flow of urine into a sterile container.
4. Close the container tightly.

If the specimen cannot be brought to a Weland Clinical Laboratories site within 1 hour, REFRIGERATE for a maximum of 24 hours.

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Collection Notes:

• Specimens are best obtained a few hours after the person has retired, between the hours of 9 p.m. and midnight, or in the morning immediately upon rising before bathing or bowel movement.
• Collection of three to six consecutive daily specimens is recommended.
• Specimens should be obtained before therapy has begun.

Specimen Collection:

1. Hold the paddle by the cap and remove it from the tube.
2. Separate the buttocks and press the tacky surface against several areas of the perianal region.
3. Replace the paddle in the tube for transport to a Weland Clinical Laboratories site.
4. Specimens should be refrigerated if examination is to be delayed for more than one day.

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1. Collect the sample in a sterile container provided by the doctor’s office or Weland Clinical Laboratories. Collection should follow 2 - 7 days of sexual abstinence.

   • Collection should follow 2 - 7 days of sexual abstinence.
   • Condoms cannot be used because of sperm-killing properties of the latex.
   • The entire specimen must be provided for testing.
2. After collection, keep the specimen warm (keep next to body) until it is taken to the main Weland Laboratory at 1911 First Ave SE, Cedar Rapids, IA 52402.

Specimen must be brought to the laboratory as soon as possible, but no longer than one hour after collection.

Collection of specimens may be done at the 1911 First Ave Weland Laboratory location. Specimens older than one hour will be rejected.

Label the container with the patient's name and time of collection. It will be necessary to complete a collection information form when the specimen is delivered to the laboratory.

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Specimen Collection - Enteric Transport Container (Green Cap / Red Fluid):

The patient must not be taking any form of medication unless specifically permitted by the physician. The use of barium and bismuth with certain radiological examinations is particularly damaging to the specimen. Collection should be at least one week after usage.

Samples from multiple stool specimens are recommended to assure optimum recovery of enteric pathogens. Three consecutive specimens should be obtained during the acute stage. To identify chronic, subclinical, and carrier states, collection of stool specimens on three consecutive days is recommended.

1. The bowel movement should be passed in to a clean, dry, wide- mouthed container. Urine or water must not contaminate the stool.
2. Select watery, bloody, or mucoid portions of the stool using the attached collection spoon. To insure adequate sampling of formed stool, sample portions of the side, middle, and end of the bolus.
3. Fill two enteric transport vials. Place enough specimen into the vial to raise the level of the medium to the FILL line on the vial.
4. Mash and mix the stool against the side of the vial with the spoon. Tighten the cap and shake the vial until the mixture appears homogeneous.
5. Two enteric transport vials are needed for the stool culture.
   • a. Label the vials with pertinent patient information. Include the time and date of collection. Label one green top with "EHEC" and refrigerate.
   • b. Label the second green top with "Stool Culture" and keep at room temperature.
6. Return Specimens to a Weland Clinical Laboratories site within 48 hours of collection.

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1. Collect approximately one ml of liquid stool or approximately a pea-sized portion of formed stool into a clean container with no preservative.
2. Tighten the cap on the container and REFRIGERATE.
3. Write the patient's name, date and time the stool was collected on the label.
4. Return to a Weland Clinical Laboratories site within 5 DAYS of collection.

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Specimen Collection - SAF vial (Yellow Cap / Clear Fluid)

The patient should be cautioned against the use of antacids, barium, bismuth, antidiarrheal medication, or oily laxatives prior to collection of the specimen. Specimens should be delayed five to ten days after barium and at least two weeks after antibiotics are administered.

To assure recovery of parasitic elements, which are passed intermittently and in fluctuating numbers, three specimens spaced a few days apart must be examined.

1. The specimen is ideally passed into a bedpan, or a clean and dry container without being contaminated with urine. Alternatively, a large plastic bag or "saran wrap" may be placed over the toilet seat opening and the specimen passed into the bag.
2. An appropriate (i.e. bloody, mucoid, watery) area of stool should be selected and sampled with the collection spoons provided in the caps of the containers.
3. Sufficient stool is added to each container to bring the liquid level up to the "Fill to Here" line. This will result in approximately 5 ml of sample. To insure adequate sampling of a formed stool, material should be removed from the sides, ends, and middle of the bolus.
4. Agitate each specimen with the spoon along the sides of the container, tighten the cap and shake firmly to insure that the specimen is adequately mixed. When mixing is completed the specimen should appear homogenous.
5. Label the vial with pertinent patient information. Include the time and date of collection.

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1. Collect approximately one ml of liquid stool or approximately a pea sized portion of formed stool into a clean, dry container with no preservatives.
2. Tighten the cap on the container and REFRIGERATE.
3. Write the patient's name, date and time the stool was collected on the label.
4. Return to a Weland Clinical Laboratories site within 72 HOURS of collection.

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1. To collect a stool sample, place plastic wrap over the toilet (for infants line the diaper with plastic wrap). Do NOT contaminate the stool sample with water or urine. After collecting the stool sample into the plastic wrap, place sample in sterile container (Orange Cap) as follows:
   • a. If the stool is formed: Add a walnut size piece of stool to the bottle.
   • b. If the stool is liquid: Add enough stool to the bottle to cover the bottom of the bottle with a ¼ inch of stool.
2. Tighten the cap on the bottle and leave at room temperature.
3. Write the patient's name and the date and time the stool was collected on the bottle label.
4. Return to a Weland Clinical Laboratories site within 1 HOUR of collection.

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