# Presentation: 432241

## Module 14:  Blood Collection and Handling Dried Blood Spot

## What Is a Dried Blood Spot (DBS)?

- Whole blood collected on filter paper and dried
- Made directly from the client’s whole blood
- Used for re-testing at a reference laboratory
- Testing site results are compared to reference laboratory results.
- This is part of External Quality Assurance.

## EQA Re-testing 

- EQA is a process by which specimens:
- Are randomly selected from the routine workload at a test site
- Are sent to the reference laboratory for validation of results

- Specimens collected for EQA could be dried blood spots (DBS) or serum/plasma

## Learning Objectives

- At the end of this module, you will be able to:
- Collect dried blood spots (DBS)
- Package and store DBS in a way to maintain specimen integrity
- Maintain DBS records
- Distinguish between valid and invalid DBS

## Content Overview

- Required supplies
- How to collect and dry DBS
- How to package and store DBS
- Valid and invalid DBS
- Hands-on practice

## What Are Your Responsibilities?

- Collect valid specimens
- Label and store appropriately until transported for re-testing
- Ensure records are properly maintained
- Avoid transcription errors

**A test result is only as good as the specimen collected**

## EQA Specimen Transfer Log

## Required Supplies for DBS

- Blood collection card (filter paper)
- Glycine weighing paper
- Sealable plastic  bags
- Humidity cards
- Desiccant packs

## How to Collect DBS

- Use Universal Safety Precautions
- Clearly label card with appropriate identification number
- Follow finger prick procedure
- Uniformly saturate entire circle

- Two complete circles
- are better than five
- incomplete ones!!

## How to Dry DBS

- Avoid touching or smearing the blood spots
- Allow the specimen to fully air dry horizontally (at least 3 hours) at room temperature
- Keep away from direct sunlight
- Do not heat, stack or allow  DBS to touch other surfaces during the drying process

## Dry Completely Before Packaging

## How to Package DBS for Storage

- Appropriately stack DBS
- Insert into sealable plastic bag
- Add desiccant packets
- Add humidity cards
- Label contents of bag and seal

## Place filter paper between sheets of weighing paper 

- Fold weigh ends of weighing paper** **

**1. Stacking DBS **

## 2. Insert Into Sealable Plastic Bag

## 3. Add Desiccant Packets

## 4. Add Humidity Cards and Seal Bag

## 5. Label Outside of Plastic Bag with Contents 

## How to Store DBS  

- Keep packaged DBS (in sealable plastic bags) cool and dry until transported to reference laboratory

**Avoid leaving in vehicle, as sun and heat will deteriorate DBS**

## How to Package DBS for Shipping

- Insert bundled DBS into rip-resistant envelope
- Include appropriate documentation
- Insert both into brown envelop and seal for shipment

## EQA Specimen Transfer Log

## Valid DBS Specimen

## Valid DBS Specimen

## Invalid DBS Specimen

**Specimen quantity insufficient for testing**

## Invalid DBS Specimen

**Specimen appears scratched or abraded**

## Invalid DBS Specimen

**Specimen not dried sufficiently**

## Invalid DBS Specimen

**Specimen appears clotted or layered**

## Invalid DBS Specimen 

**Specimen appears hemolyzed, discolored, or contaminated**** **

## Invalid DBS Specimen

**Specimen exhibits serum rings**

## Invalid DBS Specimen

**No Blood**

## DBS Collection: Demonstration

_**Procedures**_
- Fingerprick steps 1-7
- Apply pressure
- Allow a large drop of free-flowing blood to collect
- Quickly and gently touch the card with blood
- Let blood soak through
- Repeat until at least 2 circles are filled
- Fingerprick steps 9-10

_**Tips**_
- Do not press the filter paper against the puncture site.
- Apply blood to only one side of the filter paper.
- Do not apply blood more than once in the same collection circle.
- Do not “milk” the finger.

## DBS Collection: Hands-on Practice

_**Purpose**_
- To practice collecting DBS from another person
_**Total Time**_
- 30 Minutes

_**Process**_
- Work in groups of 2
- Take turns practicing collecting DBS from your partner’s finger

## Exercise: Valid vs. Invalid DBS

**Objective**: To distinguish between valid and invalid DBS specimens
**Process**: Examine the specimens collected from hands-on practice and determine whether each is valid or not.
**Total time**: 3 minutes

## Summary

- Describe the procedures for:
- Collecting DBS
- Drying DBS
- Packaging DBS for storage
- Storing DBS
- Packaging DBS for shipping
- Describe the criteria for valid DBS samples.
- What may have caused a DBS sample to be invalid?