Medical Laboratories Departments and Overview

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Clinical or Medical laboratory are made up of different departments. These departments are sometimes referred to as benches. The number of departments usually varies based on the standard of the medical facility, countries and many other factors. In well-organized medical laboratories, each department or benches operates under the supervision of its own head of department general supervisor. Some of the most common department in clinical laboratories are listed below:

Immunology

Immunology was formerly called Serology because of the type of specimen often used. That is Serum. Immunology can be a separate bench or part of another department in smaller laboratories. It is commonly associated with department such as microbiology or blood bank.

The most common principle of tests performed in this department are based on antigen-antibody agglutination. Some of these common tests are pregnancy test, Hepatitis, HIV infection, arthritis, antistreptolysin- O and other sexually transmitted diseases such as Syphilis, Chlamydia etc.

Specialists of this department are referred to as Immunologist.

Hematology

Most of the tests performed in the hematology department aimed at studying the cellular components of blood. These tests could be quantitative or qualitative.

The quantitative procedures include counts of the various blood components, such as the number of leukocytes (white blood cells), erythrocytes (red blood cells), or platelets. Red blood cells indices are commonly performed for the diagnosis of anemia. Hematological tests can be manually performed although time consuming. Electronic devices such as cell counter or hematology analyzer, haemoglobinometer are most often used for automatic and rapid diagnosis. These devices are capable of performing several hematological procedures simultaneously.

Quantitative hematological procedures involves the observation of blood components for qualities such as cell size, shape, and maturity. This is commonly done using a microscope, a laboratory worker can view a blood smear to determine the types of leukocytes present; estimate the size, shape, and hemoglobin content of erythrocytes; or estimate the number of platelets. Cell abnormalities, including immature leukocytes or erythrocytes, are noted during microscopic examination of the blood smear. In large laboratories, complicated tests such as special stains to classify leukemic cells might be performed in a hematology section called special hematology. Some tests in special hematology are performed manually.

Specialists of this department are known as Hematologist.

Blood Bank/Transfusion Services

This department is often referred to as transfusion services or immunohematology. This department is critical to patient wellbeing as it deals with transfusion of blood or blood component. If a transfusion is required, the patient’s ABO group and Rh type are determined by blood bank technologists. Before blood is transfused, stored components of donor blood are tested for compatibility with patient blood. The blood bank department might also have the capability to collect special blood donations or process donated blood into specialized components. The blood bank is the only area of the clinical laboratory for which there are no waived tests.               

Coagulation

Coagulation tests are used to diagnose and monitor patients who have defects in their blood-clotting mechanism or are being treated with anticoagulants, drugs that prevent blood coagulation. Coagulation tests can be performed in the hematology department or, in large laboratories, in a separate department. Automated coagulation testing systems, which were once used primarily in larger laboratories, are now available in small, easy-to-use models that allow even small POLs to have the capability of performing some coagulation procedures. Plasma, the liquid portion of anticoagulated blood, is the specimen used for most coagulation studies.

Clinical Chemistry

The specimen used in clinical chemistry are plasma, serum, urine, and other body fluids such as cerebrospinal fluid and joint fluid. Serum is the liquid part of blood remaining after a clot has formed. Serum is obtained by collecting blood without anticoagulant, allowing it to clot, and centrifuging it to separate blood cells from the serum. Many chemistry analyzers can perform assays using plasma; this eliminates the time delay required for blood to clot if serum is used.

Clinical chemistry is the largest department in most laboratories. Procedures performed in the clinical chemistry department include Liver profile, Kidney function test, blood glucose, cholesterol, assays of heart and electrolytes (chloride, bicarbonate, potassium, and sodium).

In some laboratories, Clinical chemistry department is subdivided into sub departments such as special chemistry and toxicology. Procedures such as electrophoresis and measurement of hormone levels are performed in special chemistry. In toxicology, blood or urine can be analyzed to determine the drug involved in an overdose or blood levels of prescribed drugs.

Microbiology

This department is involved with the culturing, isolation and identification of microorganisms. It is subdivided into many sub benches or sub departments such as Virology, Parasitology, Mycology and bacteriology.

Parasitology is the study of parasites. Patient specimens are examined for parasites in parasitology, which is normally part of the microbiology department. Intestinal parasites such as intestinal ameba, tapeworms, and hookworms are studied microscopically in feces samples. In order to detect parasite antigens in feces samples, immunological tests are used. Blood parasite tests, such as those for the malarial parasite, are normally done in the hematology department.

Bacteriology is the study of bacteria. Bacteriology procedures account for the vast majority of microbiology practice. Bacteria may be isolated from a variety of specimens, including sputum, wounds, blood, urine, and other body fluid, by inoculating them to culture media. Susceptibility tests are used to assess the most suitable antibiotic therapy for the organisms that develop in the culture. This is accomplished by subjecting a bacterial culture to various antibiotics and observing how they affect the organism’s growth. In bacteriology, automated systems that can detect an organism’s growth, classify it, and evaluate its antibiotic susceptibility are commonly used.

Virology and mycology are two fields of research. In the microbiology department, procedures involving virology (the study of viruses) and mycology (the study of fungi) are normally performed. Virology and mycology specimens are often sent to a reference laboratory for culture and identification. Since pathogenic fungi and mycobacteria cultures need special handling, specimens suspected of possessing these species are usually inoculated to media and sent to a reference laboratory for identification.

About the Author: Labweeks

KEUMENI DEFFE Arthur luciano is a medical laboratory technologist, community health advocate and currently a master student in tropical medicine and infectious disease.

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