I love to ride roller coasters. I enjoy the twists and turns, the steep hills, the loops, and even the sudden stops. I even prefer launched coasters that take off right from the start at high speeds. Wooden roller coasters are good too, because they add the elements of shaking and feeling like you might fly out of your seat.
If you’ve ever ridden a roller coaster, you have some idea about what specimens go through when being transported via a pneumatic tube system (PTS). They, too, experience twists and turns on the journey, shaking, vibrations, there may be breakdowns, stuck tube carriers, and sample spills or leaks. It is important, both from a safety and a quality standpoint, to make sure specimens are packaged carefully and correctly before using a PTS for transport. It is also important to know which specimens should never be transported in that fashion.
Laboratory specimens should never be sent via the PTS without foam inserts. PTS travel is a rough ride for specimens, and it is known to shake and vibrate specimens quite a bit. Not using foam allows specimens to be tossed about and shaken even more than usual leading to hemolysis, container leaks and breakage. PTS carriers should not be shared among facility departments. Lab specimen carriers should be designated for lab use only. These carriers may become contaminated while transporting specimens, and medications or other patient care items should not be sent using the same carriers.
In many hospitals with shared carrier tubes, other departments will remove the foam inserts so that larger items can be transported. The laboratory should keep extra inserts or have a source for extra foam in the event a carrier is received without it.
The laboratory should perform risk assessments when determining the types of specimens that can be safely transported using the PTS. PTS transport is a known aerosol-generating procedure, so respiratory specimens should never be transported using this method. While that may seem inconvenient, the risk to the employee opening a carrier tube is high for airborne or aerosolized pathogens, and it should be avoided. Non-recollectable specimens (like surgical specimens) should never be sent via the PTS in case the system breaks down or a carrier is lost. Body fluids should be carried to the lab for analysis since the cells in them tend to be more fragile. Hazardous chemicals should never be in the PTS, and that includes pathology specimens with formalin or other chemicals. A chemical spill in the PTS cannot be easily dealt with, and there would be chemical exposure to those opening carriers if there were a spill.
When spills do occur, the laboratory should have a procedure for addressing the issue right away. Remove the foam insert and dispose of it properly. It cannot be adequately disinfected. Disinfect the carrier with a 10% bleach solution and replace the foam. Some PTS systems have cleaning carriers which can be filled with a disinfecting product and run through the system. Make sure the facility has the procedures and supplies in place to deal with a specimen spill scenario.
I enjoy roller coasters, but I realize there are people who do not- they feel the effects of the sudden turns, the jerky movements, and the sudden stops. Whether or not the ride is enjoyed, it is a rough experience. That’s true for specimens riding the pneumatic tube system as well. For the safety of patients and laboratorians, we need to make sure we use the PTS properly, package our specimens well, and ensure they arrive safely at the end of the journey.