PMTP 1 – 2nd Shifting Reviewers C.

MEDICAL TECHNOLOGIST/MEDICAL LAB

SCIENTIST/CLINCAL LAB SCIENTIST
UNIT 3 – REGULATIONS GOVERNING LABORATORY
PERSONNEL - Performing routine as well as highly
specialized tests
Medical Laboratory Professionals - Perform quality control checks
- skilled and educated laboratory - May assume managerial roles
professionals - Have a Bachelor’s degree in
- play a very important role in health clinical/medical lab science
care - 3 to 4 years of academic course
- responsible for conducting tests that work and one year of clinical
provide crucial information for experience
detecting, diagnosing, treating, and - Certified by PRC. AMT, or ASCP
monitoring diseases

Clinical Laboratory team consists of:

d. medical laboratory technician/clinical
a. Laboratory Director lab technician
b. Technical and General Supervisors
c. Medical Technologist/Medical - Perform routine tests in all areas of
Laboratory Scientist/Clinical the clinical laboratory
Laboratory Scientist - Have an associate degree and have
d. Medical Laboratory completed an accredited Clinical
Technician/Clinical Laboratory Laboratory Technician or certificate
Technician program
e. Phlebotomist
E. PHLEBOTOMIST (PBT)
A. Laboratory director
- Phlebotomists work directly with
- Responsible for managing overall the patient to draw blood for
operations within the laboratory laboratory tests using venipuncture
1. Pathologist or skin puncture.
- Board certified physicians who have
specialized training in disease and
laboratory interpretation Professional organizations
- Perform all levels of laboratory
- Philippines Association of Medical
testing
Technology (PAMET)
- Affiliated with hospitals and
- Philippines Association of Schools of
reference lab
Medical Technology and Public
2. Physician Health (PASMETH), inc.
- A physician without any laboratory
specialty training Pamet
- With additional credentials
specifically qualifying for the - Non-stock and non-profit
laboratory setting organization
- Only accredited professional
B. TECHNICAL AND GENERAL SUPERVISORS organizations for RMT in the Phil.
based on PD 223
- A general supervisor is responsible - Organized by Mr. Crisanto Almario
for oversight of the day-to-day (Father of PAMET) on September 15,
laboratory operations as well as
1963
the personnel conducting the tests
- September 20, 1964: first national
and reporting results
convention of PAMET held at FEU

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 - Registered at SEC on October 14, - Green – health
1969 with regs no. 39570 - Microscope & Snake – Medical
- Regs during the term of Mr. Nardito technology profession
Moraleta as president - 1964 – first PAMET election
- With 47 provincial chapters
PAMET LOCAL & INTERNATIONAL AFFILIATIONS
Presidents of pamet
LOCAL:
1. Charlemagne T. Tamondong (1963-
67): Emergence of the Profession 1. Council of Professional Health
2. Nardito M. Moraleta (1967-70): Association (COPHA)
Professional Recognition 2. Philippine Federation of Professional
3. Felix E. Asprer (1970-71, 73-76): Association (PFPA)
Legislative Agenda 3. Council of Health Agencies of the
4. Bernardo T. Tabaosares (1971-73): Philippines (CHAP)
Celebration of the Practice 4. Philippine Council for Quality
5. Angelina R. Jose (Jan-Sept. 1973): Assurance in Clinical Laboratories
Career Advocacy (PCQACL)
6. Venerable C.V. Oca (1977- 5. Alliance of Allied Health
Sept.1973): Educational Organizations of the Nation
Advancement (AAHON)
7. Carmencita P. Acedera (1982-92):
International:
Image Building
8. Marilyn R. Atienza (1992-96): 1. ASEAN Association of Clinical
Proactivism Laboratory Scientists (AACLS)
9. Norma N. Chang (1996-00): 2. ASIA Association of Medical
International Leadership Laboratory Scientists (AAMLS)
10. Agnes B. Mendenilla (2000-02, 05- 3. International Federation of
06): Organizational Dynamism Biochemical Laboratory Scientists
11. Shirley F. Cruzada (2003-04): (IFBLS)
Interdisciplinary Networking 4. Asia Pacific Federation of Clinical
12. Leila M. Florento (2006-13): Global Biochemistry (APFCB)
Perspectives 5. International Federation in Clinical
13. Romeo Joseph Ignacio (2013-15): Chemistry (IFCC)
Golden Celebration
14. Rolando E. Puno (2015-present):
Empowerment Pasmeth

PAMET INSIGNIA - National organization of about 50

recognized schools of medical
technology in the Philippines
- Formed in 1970
- To maintain the highest standard of
Medical Technology/Public Health
education
- To foster closer relations among
schools
- Director Narciso Albarracin
- The Circle – continuous involvement appointed Dr. Serafin Juliano to lay
where practice and education are the foundation of the association on
always integrated May 13, 1970
- The Triangle – trilogy of love, - First organizational meeting held at
respect, and integrity UST on June 22, 1970

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 - First annual meeting was held at Pasmeth accomplishments
UST on May 7, 1971
- Formally registered with SEC on 1. Continuing professional education
program for medical technology
October 6, 1989 by Mr. Cirilo S.
faculty
Cajucom and Atty. Dexter Bihis 2. Preparation of a standard curriculum
(PASMETH legal counsel) for BSMT schools
3. Preparation of a standard course
syllabi for professional subjects in
Pasmeth president
Medical Technology
1. Gustavo Reyes (1970-73) 4. Scholarship grants for MedTech
2. Ibarra Panopio (1973-74): Velez students
College 5. Community outreach projects
3. Angelita G. Adeva (1974-75): UST 6. Recognition to graduates of BS
4. Elizabeth M. del Rio (1977-81) – Medical Technology Course
Martinez Memorial Colleges (PASMETH Gold Medal for
5. Norma V. Lerma (1983-84): UST Excellence Award)
6. Vivencio T. Torres (1984-85): 7. Accreditation as CPE Provider for
University of Luzon Medical Technologist
7. Nardito Moraleta (1985-88): FEU
PROFESSIONAL CODE OF CONDUCT
8. Norma N. Chang (1988-96): San
Juan de Dios Educational
- Ethics – principles of conduct
Foundation Inc.
governing an individual or a group
9. Rodolfo R. Rabor (1996-99): UST
10. Nini Festin-Lim (1992-2002): PWU Objectives
11. Zenaida Cajucom (2002-10): World
Citi Colleges 1. Define professional privileges,
12. Magdalena F. Natividad (2010-12): behaviors, and responsibilities
FEU towards the members of the
13. Bernard U. Ebuen (2012-present): community in general.
Arellano University 2. Promote professional quality,
professional conduct, and a moral
Pasmeth insignia method of procedures.
3. Defend private professions from
undue interference by the
government or by other private
agencies.
4. Preserve the dignity of the
profession and the confidence of the
public.
5. Defend clients from unscrupulous
individuals
6. Certain standards of the
- Circle – represents the continuity of compensations for services or work
learning and the never ending quest
for excellence in the academic field Principles of professional conduct
- Diamond – the four corners represent
1. Service to Others
the four objectives of the association
2. Integrity and Objectivity
- Microscope – represents the field of
3. Professional Competence
Medical Technology and Public 4. Solidarity and Teamwork
Health 5. Social and Civic Responsibility
- 1970 – the year the Association was 6. Global Competitiveness
founded 7. Equality of All Professions

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Ethical practice – good technical practice BIOLOGICAL HAZARDS
accompanied by proper attitude and
behavior. - Potentially harmful microogranisms
o Frequently present in the
Fundamental principles of ethics specimens
- Chain of infection
1. Autonomy – the right of the patients - Infection control
to make decisions on their behalf.
2. Beneficence – the duty or obligation
to act in the best interest of the
patient
3. Non-maleficence – the duty or
obligation to avoid harm to the
patient.
4. Justice – this embodies concepts of
fairness and giving what is rightfully
due.

General application of ethics

1. Medical laboratories have

responsibilities to others.
a. Patients
b. Colleagues and the
Profession Biological safety cabinets
c. Society
2. Collection of Information Class i
3. Collection of Specimen - Open front. Unsterilized room air
4. Performance of Test enters. Air passes through high
5. Reporting of Results efficiency particulate air (HEPA) filter
6. Storage and Retention of Medical before being exhausted.
Records - USE: Provides minimal personnel
7. Access to Medical Records protection. Doesn’t protect work
8. Financial Arrangements and surface.
organizational matters
CLASS II

Unit 4 – laboratory accidents & safety - Laminar flow cabinets with variable
sash opening. Air passes through 1
HEPA filter before reaching work
surface and 2nd one before being
exhausted.
- USE: Type most commonly used in
hospital micro labs. Provides
protection for worker and work.

Class iii

- Completely enclosed, negative

pressure. Air is filter-sterilized
coming and going out. Gloves are
attached to the front.
- USE: Provides maximum protection.
Used in lab that work with extremely
hazardous organisms.

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BIOSAFETY LEVELS - High mortality, potential for major
public health impact.
LEVEL I – MINIMAL RISK - Ex. Bacillus anthrasis, Yersinia
pestis, Francisella tularensis,
- Those not known to cause disease Clastridium batulinum toxin, small
in healthy adults. pox, hemorrhagic fever viruses
- Ex. Bacillus subtilis, Mycobacterium (Ebola, Marburg, Lassa, Machupo)
gordonae, soil microbes
- Standard microbiological practices. Category b – 2nd highest
No special equipment.
- Moderately easy to disseminate
LEVEL II – MODERATE RISK - Moderate illness, low death rate
- Ex. Brucella, Salmonella, Shigella,
- Common human pathogens E. coli, Burkholderia mallei,
- Ex. E. coli, Salmonella, HIV, HBV, Burkholderia pseuomallei,
influenza Chlamydia psittaci, Coxiella burnetii,
- BSC I or II. Personal protective Clastridium perfringens toxins, ricin
equipment (PPE). Autoclave must toxins, staphylococcal enterotoxin B,
be available. Limited access. Most Rickettsia prowazekii, viral
micro labs fall in this category. encephalitis viruses, Vibrio cholera,
Cryptosporidium parvum
Level iii – high risk
Category c – 3rd highest
- Those that may cause serious or
lethal disease via inhalation. - Could be engineered for mass
Effective treatment available. dissemination
- Ex. Bacillus anthracis, Francisella, - High morbidity/mortality, major
Brucella, Mycobacterium public health impact
tuberculosis, Rickettsia rickettsia, - Nipah virus, hantavirus
Coxiella burnetii, mold stages of
systemic fungi Sharp hazards
- Same as above plus negative air
flow, sealed windows. - Needles, lancets, and broken
glassware
Level iv – extreme risk - All sharp objects must be disposed
in puncture-resistant, leak-proof
- Those that pose high risk of life-
container with biohazard symbol.
threatening disease. May be
transmitted by aerosols. No vaccine
Chemical hazards
or theraphy.
- Ex. Ebola virus, Lassa virus, others - Chemical spills and exposure
that cause hemorrhagic fevers. - When skin contact occurs, the best
- Requires use of class III BSC; full- first aid is to flush the area with
body, air-supplied positive pressure
large amounts of water for at least
suit; independent unit with
specialized ventilation & waste 15 minutes, then seek medical
management to prevent release into attention.
environment. - Acid should always be added to
water to avoid the possibility of
Classification of biological agents sudden splashing caused by rapid
generation of heat in some chemical
Category a – highest priority
reactions.
- Easily disseminated or transmitted - Wearing goggles and preparing
from person to person reagents under a fume hood are
recommended safety precautions.

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 - Pipetting by mouth is unacceptable ELECTRICAL HAZARDS
in the laboratory
- Hazardous chemicals should be - Equipment should not be operated
labeled with a description of their with wet hands.
particular hazard such as poisonous, - Designated hospital personnel
corrosive, flammable, explosive, monitor electrical equipment closely;

teratogenic, or carcinogenic. however, laboratory personnel

should continually observe for any
Material safety data sheets (msds) dangerous conditions, such as
frayed cords and overloaded
Information contained in an MSDS includes
circuits, and report them to the
the following:
supervisor.
1. Physical and chemical - Equipment that has become wet
characteristics should be unplugged and allowed to
2. Fire and explosion potential dry completely before reusing.
3. Reactivity potential - Equipment also should be
4. Health hazards and emergency first unplugged before cleaning.
aid procedures - All electrical equipment must be
5. Methods for safe handling and grounded with three-pronged plugs.
disposal - When an accident involving
6. Primary routes of entry electrical shock occurs, the
7. Exposure limits and carcinogenic electrical shock source must be
potential removed immediately.
- This must be done without touching
Radiation hazards
the person or the equipment
- Radioactivity may be encountered in involved to avoid transferring the
the clinical laboratory when current.
procedures using radioisotopes are - Turning off the circuit breaker,
performed. unplugging the equipment, or moving
- The amount of radioactivity present the equipment using a nonconductive
in the clinical lab is very small and object are safe procedures to follow.
represents little danger; however,
- The victim should receive immediate
the effects of radiation are
medical assistance following
cumulative related to the amount of discontinuation of the current.
exposure.
- The amount of radiation exposure is Fire/explosive hazard
related to a combination of time,
- Flammable chemicals should be
distance, and shielding.
stored in safety cabinets and
- This symbol must be displayed on the
explosion-proof refrigerator, and
doors of all areas where radioactive
cylinders of compressed gas should
material is present.
be located away from heat and
securely fastened to a stationary
device to prevent accidental
capsizing.
- Fire blankets may be present inside
- Exposure to radiation during the lab.
pregnancy presents a danger to the - Persons with burning clothes should
fetus; personnel who are pregnant or
be wrapped in the blanket to smother
think they are should avoid areas
the flames.
with the symbol.

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r.a.c.e. jewelry, and maintain a clean,
organized work area.
- Rescue – rescue anyone in - Closed-toed shoes that provide
immediate danger maximum support are essential for
- Alarm – activate the institutional fire safety and comfort.
alarm system
- Contain – close all the doors to Factors contributing to lab accidents
potentially affected areas
- Extinguish/Evacuate – attempt to A poorly designed laboratory and
extinguish the fire, if possible or overcrowding can increase the risk of
evacuate closing the door. accident occurrence. Accidents are the
result of bad laboratory practices like:

 Poor training
 Lack of concentration
 Noisy environment
 Untidy working and not using racks
to hold sample containers
 Hurrying to finish work
 Allow the working bench to become
cluttered
 Carelessness and negligence
 Overwork and fatigue
 Hot and humid climatic conditions

Safe use and storage of chemicals

Flammable chemicals: ether, xylene,

toluene, methanol, ethanol, other alcohol,
glacial acetic acid, acetone, acetic
anhydride, Alcoholic Romanovsky stains,
and acid alcohol solutions.

- In a fire proof metal box at ground

level, preferably in and out side cool
and locked store
- Before opening a bottle containing
flammable solvent, check that there
is no open flame such as that from a
Bunsen burner
- Do not light fires near flammable
chemicals.

Corrosive chemicals: strong acids such as

concentrated sulfuric acid, nitric acid, glacial
acetic acid, trichloroacetic acid,
orthophosphoric acid, and caustic alkalis
such as sodium hydroxide, and potassium
Physical hazards hydroxide.

- General precautions to consider are - Stored at low level to avoid any

to avoid running in rooms and serious injury, which could be
hallways, watch for wet floors, bend caused if they are accidentally
the knees when lifting objects, keep knocked off a shelf.
long hair pulled back, avoid dangling

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 - Never mouth pipette corrosive Explosive chemicals
chemicals.
- Always pour corrosive chemicals at - Heat, flame, or friction can cause
below eye level, slowly with great explosive chemicals to explode.
care to avoid splashing. - Example: picric acid (must be stored
- When opening a container of under water)
corrosive chemicals, and when o If picric acid is allowed to dry,
pouring it, wear protective materials. it can become explosive.
o This can occur if the
Toxic, harmful, and irritating chemicals chemical is left to dry in pipes
without being flushed away
- Chemicals which can cause death or with adequate amount of
serious ill-health if swallowed or water.
inhaled, or if the chemical is allowed
to come into contact with the skin
- Examples: potassium cyanide,
sodium nitroprusside, formaldehyde
solution, chloroform, barium
chloride, and methanol;iodine and
sulphanilic acid chemicals can cause
inflammation and irritation of the
skin, mucous membranes, and
respiratory tract.

Carcinogens: cause cancer by ingestion,

inhalation, or by skin contact (ex. Benzene,
ortho-toluidine, alpha and beta-
naphthylamine, nitrosamines, and selenite.)

- Highly toxic chemicals such as - Should be kept in closed containers

potassium cyanide must be kept in a and labeled as carcinogenic, handle
locked cupboard. with special precautions.
- Stock solutions or solids of harmful
and irritating chemicals should be
stored safely in cap board, not on an
open shelf.
- Handle with great care by wearing
- Always wear protective plastic or
protective gloves.
rubber gloves, and face mask.
Oxidizing chemicals: includes chlorates, - Carcinogens must not be allowed to
perchlorates, strong peroxides, potassium come in contact with the skin
dichromate, and chromic acid. because some carcinogens can be
absorbed through the skin. (ex.
- Must be stored away from organic Beta-naphtylamine)
materials and reducing agents
- They can produce much heat when Preventive measures
in contact with other chemical,
1. Adequate floor, bench, and storage
especially flammable chemicals
space for staff to work safely.
- Handle oxidizing chemicals with
2. Ample light is essential, especially in
great care
the examination areas of the
- Most are dangerous to skin and
laboratory.
eyes and when in contact with
3. A sufficient supply of wall electric
reducing agents
points to avoid the use of adapters.

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4. Overcrowding must be avoided.
5. Good ventilation is essential with
adequate provision of fume
cupboards.
6. There should be a system for
marking “high risk” specimens.
7. Discard containers that contain
infectious microorganisms after each
use.
8. The floor should be well constructed
with a surface that is non-slippery,
and impermeable to liquids.
9. Walls should be smooth, free from
cracks, and impermeable to liquids.
10. Doors of the lab should be opened
to the outside direction.
11. Sectioning of the lab, into separate
rooms or working areas.
12. Bench surfaces should be without
cracks, washable and resistant to
the disinfectants and chemicals used
in the lab.
13. Adequate number of hand basins
with running water.
14. Provision of protective clothing.
15. Fire extinguishers should be placed
at accessible points.
16. Ensure that all work in the laboratory
is done with a safety conscious
attitude.
17. All staff must ensure that the
conditions of their work do not create
any haard for those working near by.
18. Lab coats should be fully buttoned
up while working and removed
before leaving the lab.

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