INTRODUCTION TO

MEDICAL LABORATORY
SCIENCES

Anumein M.
04/26/2024 1
 CHAPTER ONE
THE LABORATORY

04/26/2024 2
 Objectives
 After completion of this chapter, the student will be
able to:
1. Define laboratory.

2. Identify the different kinds of medical laboratories.

3. Explain the role of medical laboratory services.

4. State the laboratory rules, ethics, professional code

of conduct and polices.

04/26/2024 3
Outlines

1.1: General overview

1.2: Classification of laboratories
1.3: Structure of laboratory services
1.4: Role of clinical laboratory services
1.5: Function & use of different medical laboratory
department/units
1.6: Role of medical laboratory personnel
1.7: Laboratory rules and policies

04/26/2024 4
1.1. General overview

Laboratory – is a place that is equipped with different

instruments, equipment, chemicals etc for performing
either experimental works or research activities
Medical laboratory is part of the laboratories that is
equipped with various biomedical instruments and
chemicals for performing different lab diagnostic
activities by using biological specimens. (Whole blood,
serum, plasma, urine, stool, sputum etc).
It is also called clinical laboratory science
04/26/2024 5
1.2. Classification of laboratories

WHO classify laboratory into 3- levels based on risk levels.

Risk group I
Low individual & low community risk.
(A pathogen is unlikely to cause disease.)
Risk group II
Cause moderate individual risk & limited community risk
(Agents that can cause human disease but unlikely to be a
serious hazard to the lab worker and the community.
 Lab exposure may cause serious infection, but effective
treatment & preventive measures are available & the risk
of spread is limited.)
e.g. L. monocytogens 04/26/2024 6
◦ Risk group III
 High individual & low community risk
(A pathogen that usually produces human disease
but does not ordinarily spread from one infected
individual to another.)
 E.g. Brucella, clostridium botulism
◦ Risk group IV
 High individual & community risk
(A pathogen that usually produces serious human
diseases & may be readily transmitted from an
individual to another directly or indirectly within the
community.) e.g. Ebola, Plague

 No effective prophylaxis or treatment

04/26/2024 7
Classification of laboratories cont’d

[Link] lab. (Level 1 and level 2 laboratories)

 It is the simplest kind.
 It is adequate for work at the PHC and hospital
diagnostic lab.
 It is adequate for work with organisms in risk group
1 and 2 i.e. Low risk.
2. Containment lab –( level 3)
 More advanced and it is used for work with
infections
organism E.g. TB, salmonella – risk group -3
 The principle is to remove from basic lab those
organisms which are particularly hazardous.
 The objective is to expose as few people as possible
to the risk of infection
04/26/2024 8
 [Link] is a separate room with controlled access by
authorized staff only
2. It should be fitted with a microbiological safety
cabinet.
3. Its ventilation should be arranged.
3. Maximum containment lab (level 4)
 intended for work with viruses.
 Risk group-4 for which the most strict safety
precautions are necessary.

 These labs are usually separate buildings with strictly

controlled access through decontaminant showers.

All air from rooms is filtered before discharge to the

atmosphere
04/26/2024 9
1.3: Structure of laboratory services

A medical Laboratory service must be integrated with the

health care system which exists in the country.
- They function as a network, which could be accessible
and provide a service that is needed by the community.
This Networking consists of:
A. community-based health center lab:-
I). comprehensive health centers lab.
◦ Investigation, controlling and preventing major
disease in a community
04/26/2024 10
◦ staffed by lab personnel
◦ Promote health by health education
◦ Able to perform basic tests.
ii). Maternity health units (MCH)
Staffed with nursing staff trained by MLT and
responsible in :
◦ Screening for anemia and proteinuria.
◦ Collecting blood for antibody screening or for
examination of parasites

04/26/2024 11
B. District Hospital laboratories (DHL)
 Supervising the work of community-based health center
lab.
 Testing referred specimens

 has facilities for clinical investigations and

epidemiological surveys
 Specimen collection and transportation system

 Patients attending health center to benefit from the

facilities of DHL
 Epidemics to be investigated rapidly
04/26/2024 12
C. Regional (hospital) laboratories

 It assists and supervise the DHL

 Analyses referred samples

 Perform a range of specialized testes

 Investigate epidemic and do more clinical and public

health facilities

 Trains lab technicians by organizing refresher courses

04/26/2024 13
 D. Central (hospital) and public health
laboratories
• It assists and supervise the DHL

• Analyses referred samples

• Perform a range of specialized testes

• Investigate epidemic and do more clinical and public

health facilities
• Trains lab technicians by organizing refresher
courses

04/26/2024 14
 Summary of laboratory service network

central or
National
laboratories

Reference
• N.B There

diagnostic

Laboratory
hospital,
are also

clinic&
private

regional regional
laboratori laborato
es ries

District District District District

or District or or District or or
or hospital
hospital hospital hospital hospital hospit
laborat laboratorie laborat laboratorie al
laborat s
ories ories s ories laborat
ories
Health Health health
center health health health
center center center center
laborat laborat laborato center
ries laborat laborat laborat
ories ories ories ories
ories

04/26/2024 15
1.4 Medical Laboratory and Its Function in a Health
Care System.
 Laboratory has an important role in improving the
◦ quality
◦ efficiency
◦ cost effectiveness
◦ planning and management of the health care
system .
 They are divided into three :
I. providing quality health care service
II. achieving efficiency and cost effectiveness
in health care system.
III. achieving good health planning and
management 04/26/2024 16
Medical Laboratory and Its Function in …………
A. The role of laboratory in providing quality health
care
[Link] investigation increase the accuracy of
disease diagnosis.
 Many infectious disease and serious illness can be
diagnosed by using the laboratory.

 E.g. error in diagnosis of malaria is high when

diagnosis is on clinical symptoms only.

04/26/2024 17
Medical Laboratory and Its Function ………..

2. Laboratory has essential role in screening for ill

health and assessing response to treatment.

◦ Assess a patients response to drug therapy

◦ Screen individuals with infectious disease. E.g. TB,

sexually transmitted diseases

◦ Screen whole blood and blood product for transfusion

transmitted pathogen
◦ Screen pregnant women for anemia, infections which
may transmitted to newborn and others
04/26/2024 18
3. The laboratory is needed to work with other in
reducing infection in the community and
investigating epidemics rapidly.
◦ Detecting source of infection, identifying carries contact
tracing
◦ Participating in epidemiological surveys
◦ On site testing and collection and dispatch of specimens
when an epidemic occurs
◦ Participating in health education
B. The role of laboratory in achieving efficiency and cost
effectiveness in health care system.
1. The laboratory reduce the expenditure of money on
drugs.
◦ Drugs can be used more selectively and only when
needed 04/26/2024 19

◦ Drug resistance can be identified more rapidly and

[Link] lowers health care costs by identifying
disease at an early stage.
 Reduce number of times a patient may need to seek
medical care for same illness.
 Prevent complications
 Avoid hospitalization and further costly investigation

[Link] can be made when laboratory participate in

local disease surveillance and control. this is because
source of infection and disease carriers can be
identified
the spread of infectious disease can be
controlled
disease control measures
04/26/2024
can be selected and
20

targeted more effectively

C. The role of laboratory in achieving good health
planning and management
[Link] laboratory test result with relevant patient
data, provide information on the health status of a
community, health pattern and disease trend. This
information is needed to establish health care priority
and plan:
◦ Health care program
◦ Training of health personnel and delivery of health service
◦ Treatment schedule and change in drug usage
2. public heath laboratories provide accurate
epidemiological information for health planning

◦ cause of the disease in the community

◦ prevalence and incidence rate of infectious disease

04/26/2024 21
With out reliable lab support:
I. Patients less likely to receive the best possible care
II. resistance to essential drugs will to continue to
spread
III. the source of disease may not be identified
correctly
IV. epidemics and spread of major communicable
diseases will not be checked reliably
V. Valuable financial and human resource may not
use properly.

04/26/2024 22
Medical Laboratory and Its Function ………
 Indications
(importance) of requesting lab
examinations are:
To make a diagnosis of pathogen.
Confirm a clinical impressions
To rule out (R/o)a disease and diagnosis
To provide prognostic information
To provide therapeutic guidance so that:
◦ Drugs can be used more selectively
◦ Patterns of emerging drug resistance can be identified
◦ Side effects and progress are monitored.
◦ To screen for disease.

04/26/2024 23
1.5: Function & use of different medical laboratory
department/units

 Hematology- deals with examination of the

constituent of blood.
 Clinical chemistry – deals with measurement of
various bio-chemicals changes in serum and body
fluids.
 Medical microbiology - deals with microorganisms of
medically important, performing different diagnostic
and research activities on micro organisms and
parasites . Microbiology includes the following sub
disciplines
◦ Bacteriology is a science dealing with bacteria
◦ Virology is the study of virus and viral disease
◦ Mycology is the study of fungi
◦ Parasitology: is the study of parasites.
04/26/2024 24

◦ Immunology: study about immune system

Function & use of different medical laboratory…….
 Immunohematology- deals with blood banking and
transfusion medicine.
 Urinalysis and body fluid analysis- deals with the
analysis of their constituent.
 Serology- is the study of antigen and antibody and
their interaction in vitro.
 Molecular biology :branch of biology that seeks to
understand the molecular basis of life. In particular, it
relates the structure of specific molecules of biological
importance—such as proteins, enzymes, and the
nucleic acids DNA and RNA—to their functional roles in
cells and organisms.

 04/26/2024 25
1.6: Role of medical laboratory personnel
Introduction:
 Medical laboratory is a health profession its goal is to resolve
patients’ problem presented to the physician by performing
laboratory analysis.
 Roles:
1. Diagnosing of diseases
 Errors occur when diagnosis of diseases depend on
clinical symptoms alone.
2. Treating of diseases
 Antibiotic sensitivity testing
 Monitoring of patients response to treatment
3. Screening of diseases
 Detection of in apparent infections
4. Control of epidemics
◦ Early detection of pathogens04/26/2024 26
Role of medical laboratory ……..
5. Surveillance & provision of health information
 Source identification
 Water supply testing
 Carrier identification
 Risk factor assessment
6. Controlling field trials
◦ New drug/vaccine testing
◦ Vaccine potency test

04/26/2024 27
Role of medical laboratory ……..
7. Management of finance, equipment and supplies
8. Ensuring a reliable and quality lab practice
Such a comprehensive commitment to quality is
essential to achieve –
 best possible service to patients
 user confidence
 effectiveness and efficiency
 accountability
 optimal use of recourses

04/26/2024 28
1.7: Laboratory rules, ethics and policies

 Ethics-moral principle or rules of behavior that govern

or influence a person’s behavior
 Rule-a statement of what, should or must be done in
particular circumstance.
 Code of conduct -a set of professional standards
agreed on by members of a particular profession
Code of conduct for medical laboratory personnel
 Should include those practices and attitudes which
characterize a professional and responsible lab officer.
 Adopting it helps to remind medial laboratory personnel
of their
◦ Responsibility to patients
◦ Duties to up holds professional04/26/2024
standards and 29

◦ Need to work with complete integrity.

 Laboratory rules……
1. Place the wellbeing & service of the patient above
your own interest.
2. Be loyal to your profession by maintaining high
standard of work & striving to improve professional
skill & knowledge
3. work scientifically & with complete honesty
4. don’t misuse your professional skill or knowledge
for personal gain
5. never take anything from your place of work that
does not belongs to you
6. don’t disclose to a patient or any other
unauthorized person the result of your investigation
7. treat your patient with strict confidentiality
04/26/2024 30
Laboratory rules…..
8. Respect & work in harmony with other members of
your staff or health center team.
9. Be any time courteous, patient, considerate to the
sick & their relatives.
[Link] safety procedures & know how to apply first
aid.
[Link]’t drink alcohol or unprescribed drugs that
would interfere to your work performance during
laboratory working hours.
[Link] laboratory equipments with care
[Link]’t waste reagents & other supplies.
[Link] the dignity & privacy of the patient.

04/26/2024 31
Laboratory policies
 Laboratory policies are those decisions which are taken
in consultation with other medical staff to enable a
laboratory to operate reliably and effectively in
harmony with other departments.
 These policies usually cover:
A. Laboratory hour and emergency work
B. Range of tests to be performed and those to be
referred to higher level.
◦ Range of tests to be performed depend on
 The number of material resources
 The availability of material resources
 The types of health institution
◦ Referral of specimen
04/26/2024 32
Laboratory rules….

C. Collection of Specimen
D. Work load capacity of the laboratory
E. Delivery of laboratory reports

04/26/2024 33