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Test Code M72 Sputum Algorithm

Additional Codes

ALAB: SPUTALG

PowerChart: Sputum Algorithm

Test Method

Manual; Agar Growth and Biochemical Identification

Specimen Requirement

Sputum collected as outlined below in a sterile container or Luki tube. If physician orders Sputum Culture "x 3", collect three separate specimens at three different times during the day or on three consecutive days.

Additional Specimen Collection Information

Collect specimen by one of the following methods:

  • Deep Breathing And Coughing:
  1. Obtain in early morning.
  2. Have patient rinse out mouth with water, if allowed.
  3. Instruct the patient to take a deep breath and blow it out; take another deep breath, hold it, and cough deeply.
  4. Expectorate mucous into a sterile container or Luki tube.
  5. Label the specimen appropriately with two identifiers, patient name and another identifier, (patient ID number, DOB, etc.) include specimen source, date and time of collection.
  • Ultrasonic Or Heated Hypertonic Saline Nebulization:

Respiratory therapist will assist the patient with deep breathing treatment for 10 to 15 minutes to aid in loosening secretions. Follow collection procedure for deep breathing and coughing.

  • Suctioning With Use Of Sputum Trap:
  1. Prepare the suction equipment.
  2. Attach the sputum trap between catheter and suction tubing.
  3. Provide intermittent suction by placing thumb on and off sputum trap until adequate specimen is collected.
  4. When specimen reaches the trap, keep thumb over opening until suction is turned off.
  5. Disconnect suction tubing and close opening with small rubber tubing connected to luki tube.
  6. Label the specimen appropriately with two identifiers, patient name and another identifier, (patient ID number, DOB, etc.) include specimen source, date and time of collection.

Transport the labeled specimen to the laboratory within one hour of collection in sterile specimen container or Luki tube.

Performance

Testing is performed Monday through Sunday

A Gram Stain is performed in the laboratory at the collection site to determine if an adequate specimen was collected. If specimen is adequate it is transported to the Microbiology Department for culturing. If it is not adequate for culturing the Sputum Algorithm is cancelled and a Gram Stain is ordered and reported as "Greater than 25 epithelial cells/lpf on the gram stain of a deep breathing and cough sputum indicates excessive oropharyngeal contamination. A repeat specimen will be requested."

Typically completed 24 to 48 hours after specimen arrives at the testing site.

Reference Values

Normal respiratory flora.

 

The report will indicate presence or absence of normal flora. Any potential pathogens will be identified and sensitivities performed when appropriate.

CPT Code Information

87205 Identification of Organism form Primary Source and Sensitivity Studies: Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types.

87071 Quantitative, aerobic, with isolation and presumptive identification of isolates; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates

Useful For

Gram Stain:  Used to screen sputum specimens to establish acceptability for bacterial culture (<25 squamous epithelial cells per field is considered an acceptable specimen for culture) and may reveal the causative organism in bacterial pneumonia.

Culture: Detection of aerobic bacteria in clinical specimens.

LOINC Code Information

622-1 Bacteria Identified In Sputum By Aerobe Culture

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