Laboratory

Laboratory services are essential to support disease surveillance, diagnosis and efficient patient management.

Laboratory capability should be appropriate to EMT type and to the context in which the team deploys. EMTs should consider endemic infectious diseases and regional outbreaks when considering tests to carry.

1. Establish clear guidance and step by step procedures on how tests are requested, patients and samples identified, samples collected, and results delivered to the requesting physician.
2. Provide the right medium/packaging for any sample that is sent for further investigation, for example, meningitis and tuberculosis (TB).
3. Document results in the patient’s notes, (acknowledged by the responsible physician) and relevant pathological tests conveyed to the patient.
4. Train staff on laboratory testing when there is no laboratory technician in the team.
5. Understand the false positive/false negative rates for the tests in use, in particular the limitations of some point-of-care tests.

Testing capacity

1. Endemic disease rapid diagnostic testing (RDT) appropriate to the context of the deployment, if available.
2. Basic diagnostic tools (urine pregnancy test, urine dipstick, blood glucose, haemoglobin testing).

Type 2

AB0, Rhesus D grouping, HIV 1 and 2, hepatitis B and C and syphilis.

Type 3

Accept samples from smaller teams for processing:

• • blood gas
  • basic electrolytes
  • renal function (urea and creatinine)
  • full blood count
  • basic culture and sensitivity
  • basic gram staining and microscopy

1. Consider transport and storage of temperature sensitive tests and reagents.
2. Establish sufficient climate control and appropriate ventilation in laboratory areas.
3. Maintain IPC precautions and appropriate waste management of samples and any associated chemicals/reagents.