Matters requiring attention are as follows.
1. The patient should blow his nose first
(This stage is very important!) .
This will reduce contamination and interference from nasal secretions and ensure the quality of the specimen.
In previous clinical trials, but no nasal blowing to collect samples, the nasopharyngeal swabs were inoculated within a few days, and the culture dish was full of debris and affected by the debris.
2. The direction of swab entry must be parallel to the upper and lower jaw
When operating, the upper part of the swab should face the direction of the earlobe, not the top of the head.
When actually collecting specimens in the clinic, many beginners swallow swabs with the tip facing the top of the head. Since bacteria and viruses are mostly parasitized at the bottom of the nasopharynx, if the nasopharyngeal swab enters in the wrong direction, it is difficult to reach the bottom of the nasopharynx, and the positive rate will be significantly reduced.
3. The swabber must reach the bottom of the nasopharynx after entering the depth
The depth of swallowed swab is equivalent to the distance between the tip of the nose and the earlobe. In practice, if the top of the swab swallowed faces the top of the head, the depth of the swab swallowed may be significantly insufficient.
4. No insertion of forced violence is allowed.
When the swallowed swab enters the direction of the earlobe, if it encounters resistance, it should be entered by slightly rotating the direction, and should not be inserted with forced violence to avoid injury. Before reaching the bottom of the nasopharynx, it is enough to have the resistance of hitting the wall.
5. If you hit the wall, the swabber will stay for a few seconds and rotate to pull out
If you find the feeling of hitting the wall the nasopharyngeal swabber has reached the bottom of the nasopharynx, you should let the nasopharyngeal swabber stay at the bottom of the nasopharynx for 10~15 seconds, so that the swabber can fully contact the secretion at the bottom of the nasopharynx and adsorb more pathogens.
Operation specification: during the stay can be rotated a few turns better, but the operation of children, children are not very suitable, so generally stay at the bottom of the nasopharynx for a few seconds is not rotated necessary (in theory, the longer the stay, the better to rotate a few turns). Then the swab should be rotated to remove. This will not only reduce the irritation of the child, but also to meet the sampling effect at the same time.
Removal of sub-materials and example section selection.
(1) Special attention should be paid to the choice of material of the nasopharyngeal swab and the influence of the sample part of the specimen on the examination results.
(2) The choice of material for swabbers depends on the detection method and pathogen characteristics.
(3) For simultaneous culture and PCR examination, swabs of dark ketone or nylon material should be used; calcium swabs should only be used for culture, which may affect the results of nucleic acid detection
(4) The impact of specimen collection site on the test results is very important. General influenza is best to choose the anterior nostril area to collect nasal swabs and give some force to scrape the epithelial cells of the anterior nostril.
(5) Avian influenza virus receptors are mainly distributed in the lower respiratory tract, so nasopharyngeal swabs are often negative, and specimens from the lower respiratory tract should be collected whenever possible.
(6) Bacteria are mainly parasitized at the base of the nasopharynx, so nasopharyngeal swabs are most suitable for collection, and oropharyngeal swabs should have a lower positive rate than nasopharyngeal swabs.
Task summary.
(1) Nasopharyngeal swab samples should be preceded by nasal blowing to remove nasal secretions.
(2) The swab should enter the earlobe direction vertically and the depth should be from the tip of the nose to the earlobe distance
(3) To reach the bottom of the nasopharynx (the feeling of hitting the wall), it needs to stay for a few seconds, and then rotate and pull off
(4) Other pathogens should be examined with attention to the selection of sub-materials and specimen collection sites.
