Collecting a Sputum Specimen

Preparation

• Privacy and Identification: Ensure privacy for the patient and correctly identify them.
• Positioning: Position the patient in a semi-Fowler's position.
• Assessment: Evaluate the patient's respiratory status and anxiety level both before and during the procedure.

Collecting Specimen by Coughing and Expectoration

1. Preparation:
   • Wear clean gloves.
   • Hand the specimen container to the patient without touching its interior.
2. Breathing Technique:
   • Instruct the patient to take 3-4 slow, deep breaths.
   • Exhale slowly and completely to clear pulmonary secretions into the larger airways.
   • Position yourself sideways to the patient, possibly wearing a mask for protection.
3. Coughing:
   • After deep breaths, ask the patient to cough after a full inhalation.
   • Ensure the patient coughs productively and expectorates sputum into the container.
   • Avoid letting the patient clear throat and spit saliva.
4. Repetition:
   • Repeat deep breathing and coughing until 2-10 mL of sputum (not saliva) is collected.

Collecting Specimen by Suctioning

1. Equipment Preparation:
   • Prepare the suction machine and connect the suction tube to the sputum trap.
   • Have sterile saline ready to rinse the catheter or push sputum into the trap.
2. Procedure:
   • Wear sterile gloves, keeping dominant hand sterile and non-dominant hand clean.
   • Connect the sterile suction catheter to the sputum trap, keeping it upright.
   • If needed, pre-oxygenate the patient with 100% oxygen for 1 minute.
   • Lubricate catheter, and without applying suction, insert into nasopharynx, endotracheal tube, or tracheostomy.
   • As the patient coughs, apply suction for 5-10 seconds, collecting 2-10 mL of sputum.
   • If sputum remains in the catheter, flush with sterile saline into the trap.

Post-Procedure

• Sealing and Disposal:
  • Securely close the specimen container or sputum trap.
  • Properly dispose of the catheter.
• Sputum Characteristics: Note color, consistency, odor, volume, viscosity, and blood presence.
• Clean Up:
  • Offer tissues to the patient and dispose of them properly.
  • Clean any sputum on the container with disinfectant.
• Labeling and Transport:
  • Attach completed identification label to the container.
  • Place in a biohazard bag, then in a second bag with lab requisitions.
  • Ensure immediate transport to the lab or refrigeration.

Follow-up Care

• Offer oral hygiene to the patient.
• Plan to review the test results when available.