Specimen handling and transport is a vital training topic in the realm of Laboratory Safety. There is much to consider that affects specimen quality and integrity, and ultimately affects patient results. There are also considerations involving employee safety at each step of these processes. One group of employees that is often overlooked when it comes to proper safety training is specimen couriers. They perform the important role of properly and safely transporting specimens for testing, but without the proper education and tools, these team members can quickly fall into situations of harm.
The courier was running late, and she had one last stop on her route at a medical office building with multiple physician offices and drop boxes. It was cold, and she decided to leave the vehicle running while she went inside to pick up more specimens and deliver lab reports. The car was also left unlocked. When she came back outside, the car was gone. It was found hours later in am empty field, but it had been set on fire. There were lab specimens and reports strewn all over the field and into the nearby woods.
Couriers need to be trained about the importance of their role, and that training should include information about security and protected health information (PHI). Be sure to include HIPAA training for all courier staff. Enforce specific processes such as always turning off vehicles before exiting and properly securing all patient specimens and any paperwork being transported. Whether couriers use company vehicles or their own personal transportation for the job, making sure harm does not come to the vehicle nor any contents being transported is key.
The courier knew he had a long drive ahead of him because of the toll bridge, and he had several specimens that needed to be delivered frozen. He scooped a large pile of the dry ice from the lab into a big box using his hands. It was cold, but it helped to wake him up a bit. He placed the specimens in the box and placed it in the back seat of his vehicle. It was cold, so as he began his drive, the courier made sure the heat was on high and that all windows were closed. After a few miles, the courier began to feel very tired. He struggled to stay awake. After sitting in traffic on the bridge for a time, he pulled off the road and called the dispatcher to let them know he could not continue. When he got out of his vehicle, he began to feel better.
The College of American Pathologists (CAP) requires that laboratory staff have dry ice safety training, but that education should extend to anyone who may acquire the dangerous substance in the lab. Make sure staff are aware of the need for proper PPE use when handling dry ice. Insulated gloves, the use of a scoop or tongs, and face protection are necessary when scooping ice into a container. Couriers should carry no more than three pounds of dry ice in a vehicle, and there should always be adequate ventilation, including open windows in the vehicle when transporting dry ice. Dry ice converts rapidly from a solid state to a gas, and that gas rapidly displaces oxygen in the air making it difficult to breathe or stay conscious. High volumes of dry ice in a car can create a very deadly road situation very quickly.
The courier was transporting pathology specimens in a cooler, but was unaware that the lid had popped off of one of the specimens and formalin was splashing out inside of the cooler. As time went by, the courier began to feel queasy. After realizing that something did not smell right in the vehicle, she stopped the van and pulled to the side of the road to investigate. She opened the cooler and quickly pulled out dripping specimens and set them on the carpet before feeling too sick to clean up the mess. She had to be taken to the Emergency Room for formalin exposure symptoms while the Lab safety Officer had to bring spill clean-up supplies to the van to neutralize the spilled chemical. The carpet had to be removed and disposed of properly.
Courier vehicles need to be equipped with spill clean up supplies that can handle whatever types of spills could occur during transport. If formalin is transported, couriers need training in the proper transport and clean up of that chemical. Biological spill kits should be available as well, and spill training should be a regular part of overall courier safety training.
I wish these were imaginary specimen transport stories, but sadly, that is not the case. They illustrate clearly what can happen when proper safety management and training are lacking. Every part of the laboratory pre-analytical process is important, and every lab team member involved in the process needs proper safety training. By providing the proper tools and safety training to couriers, you can ensure the quality of lab results, and you can prevent incidents like these with your employees.