Key Points
- Gold standard for upper respiratory tract sampling
- High sensitivity for respiratory pathogens
- Requires specific technique for optimal results
- Age-appropriate approaches needed
- Essential for respiratory infection diagnosis
Clinical Indications
- Respiratory viral infections
- COVID-19 testing
- Influenza testing
- RSV detection
- Pertussis diagnosis
- Surveillance studies
- Research protocols
Technical Considerations
Anatomical Guidelines
- Distance measurements
- Nares to external ear canal
- Age-specific depth calculations
- Anatomical landmarks
- Important structures
- Nasal turbinates
- Nasopharyngeal wall
- Septum orientation
Equipment Selection
- Swab types:
- Flocked swabs (preferred)
- Flexible shaft design
- Age-appropriate sizes
- Pediatric-specific swabs
- Transport media options
- Personal protective equipment
Sample Collection Protocol
Pre-procedure Preparation
- Patient positioning
- Head tilt: 70 degrees
- Neck in neutral position
- Proper immobilization
- Equipment setup
- Parent/guardian positioning
- Age-appropriate explanation
Step-by-Step Procedure
- Hand hygiene and PPE application
- Patient identification verification
- Measure insertion distance
- Gentle insertion along septum floor
- Reach posterior nasopharynx
- Rotate swab gently
- Hold in place 5-10 seconds
- Remove smoothly
- Place in transport medium
Age-Specific Considerations
- Neonates and Infants
- Smaller swab size
- Gentler technique
- Careful depth control
- Toddlers and Preschoolers
- Behavioral management
- Distraction techniques
- Parent involvement
- School-age Children
- Clear explanation
- Cooperative techniques
- Positive reinforcement
Safety Considerations
Risk Management
- Common complications
- Epistaxis
- Discomfort
- Sneezing/coughing
- Gagging
- Contraindications
- Recent nasal surgery
- Nasal obstruction
- Severe coagulopathy
- Facial trauma
Infection Control
- Personal protective equipment
- N95 respirator/surgical mask
- Eye protection
- Gloves
- Gown
- Environmental considerations
- Proper ventilation
- Surface decontamination
- Waste management
Quality Assurance
Specimen Adequacy
- Visual inspection criteria
- Cellular material presence
- Mucoid content
- Sample volume
- Documentation requirements
- Collection time
- Specimen type
- Collection method
- Transport conditions
Transport and Storage
- Temperature requirements
- Time limitations
- Transport media specifications
- Labeling protocols
Common Errors
- Insufficient depth
- Improper angle
- Inadequate rotation
- Wrong transport medium
- Delayed processing
Further Reading
