Introduction to Medical Technology

What is the role of Medical Technologist?

•Plays a key role in the modern laboratory.

Areas of The Clinical Laboratory

1.Clinical Chemistry
➢ Glucose Test (FBS, RBS)
➢ Lipid Profile
- Cholesterol
- LDL
- HDL
- Triglycerides (TAG)
➢ Liver Function Test
- SGPT
- SGOT
- Bilirubin
➢ Kidney Function Test
- BUN
- Creatinine

2. Microbiology
➢ Culture and Sensitivity
➢ Gram Stain-Staphylococcus aureus, Escherichia coli
➢ AFB-Mycobacterium tuberculosis

3. Hematology
➢ Complete Blood Count
- Hemoglobin
- Hematocrit
- Red Blood Cell Count
- White Blood Cell Count
- WBC Differential Count
- Platelet (PLT) Count
4. Clinical Microscopy
➢ Urinalysis (AU)
➢ Fecalysis (FA)

5. Blood Banking
➢ Blood typing
➢ Crossmatching

6. Immunology and Serology

➢ Hepatitis B surface antigen (HbsAg) testing
➢ C-reactive Protein
➢ Anti – HIV testing

7. Histopathology
➢ Pap smear
➢ Cytological testing

A healthcare professional who performs diagnostic analytic tests on body fluids such as blood,
urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial
fluid, as well as other specimens.

By Heinemann:

• Application of principles
• Performance of laboratory procedures
• Diagnosis and treatment of diseases

By Anne Fagelson:

• Performance of Laboratory determinations and analyses

• Diagnosis and treatment of disease
• Maintenance of health
According to “The Philippine Medical Technology Act of 1969 (RA 5527)

➢ Medical technology is an auxiliary branch of laboratory medicine which deals with the
examination by various chemical, microscopic, bacteriologic, and other medical
procedures, techniques which will aid the physician in the diagnosis, study and
treatment of disease and in the promotion of health in general.

Characteristics of a Medical Technologist

• Ability to solve problems efficiently

• Enjoy challenges and responsibilities
• Perform procedures accurately and precisely
• Functions well even under pressure
• Able to communicate well
• Likes the sciences and performing laboratory procedures
• Flexible and a team player

Blood is a connective tissue consisting of plasma and formed elements

Blood is the body’s only fluid tissue

It is composed of liquid plasma and formed elements

Formed elements include:

• Erythrocytes, or red blood cells (RBCs)

• Leukocytes, or white blood cells (WBCs)
• Platelets
A healthcare professional who performs diagnostic analytic tests on body fluids such as blood,
urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial
fluid, as well as other specimens.

URINE

• Urine most frequently submitted specimen

• UTI –defined as bacteriuria within the renal tract and the presence of 100,000 (105) per
ml in the mid-stream sample of urine.
• Most common sites –urinary bladder and urethra.
• Escherichia coli –is the most common cause of UTI.

SPUTUM

• Sputum should represent lung secretions collected from a deep cough

• Early morning specimens collected on 3 consecutive days.
• Sputum often contaminated with mouth normal flora, thus concentration-digestion-
decontamination procedure is RECOMMENDED.

M. tuberculosis in Lowenstein-Jensen agar

Malachite green-inhibits the growth of contaminating bacteria. Rough, buff-colored colonies.

Usually positive in 14 to 21 days.

FECES

• Feces should be collected in the early stages of diarrheal diseases

• Specimen should be collected in the morning
• Formed stools should BE REJECTED.
• Rectal swab is acceptable if the collection cannot be made immediately.
Cerebrospinal fluid (CSF)

Method of Collection:

• Lumbar puncture, cisternal puncture, lateral cervical puncture or ventricular cannulas

L3/L4 or L4/L5

3 samples

• Tube 1 –chemical
• Tube 2 –microbiology
• Tube 3 –cytology

PERICARDIAL, PLEURAL, PERITONEAL FLUIDS

• Also known as serous fluids

• These are aspirated by physician

SYNOVIAL FLUID

• It is the fluid contained in the joint spaces.

• It provides information about joint diseases.
 History of Medical Technology
➢ 1500 B.C. –Intestinal parasites such as Taenia and Ascaris were mentioned in early
writings.
➢ Ebers papyrus –book for treatment of diseases containing description of the three
stages of hookworm infection
➢ 1096-1438 –(Medieval period) –quacks reaped fortunes from diagnosing disease by the
appearance of the urine.

ASCARIS LUMBRICOIDES

• Disease: Ascariasis; roundworm infection

• Site in host: small intestines
• Portal of entry: Mouth
• Infective stage: embryonated egg
• Sources of infection: eggs from soil or vegetables
• Lab Dx: eggs in stool

In GI tract, few symptoms in light infections

• Nausea
• Vomiting
• Obstruction of small bowel or common bile duct.

Pulmonary: symptoms due to migration

• Alveoli (pneumonia)—cough, fever wheeze, dyspnea, X-ray changes, eosinophilia

TAENIA SAGINATA

• Disease: Taeniasis; beef tapeworm infection

• Site in host: small intestines
 • Portal of entry: mouth
• Definitive host: human
• Intermediate host: grazing cattle
• Infective stage: larva
• Sources of infection: cysts in beef
• Lab Dx: segments and eggs in stool; Scotch tape swab

AENIA SOLIUM

• Disease: Taeniasis; pork tapeworm infection

• Site in host: small intestines
• Portal of entry: mouth
• Definitive host: human
• Intermediate host: pig
• Infective stage: larva
• Sources of infection: cysts in pork

HOOKWORM

- The human hookworms include two nematode (roundworm) species, Ancylostoma

duodenale and Necator americanus
- The second most common human helminthic infection (after ascariasis).
- Worldwide distribution, mostly in areas with moist, warm climate.
- Iron deficiency anemia is the most common symptom of hookworm infection, and can
be accompanied by cardiac complications.

- Hindu doctors made the scientific observation that the urine of certain individuals
attracted ants and that such urine has a sweetish taste.
 - 14thcentury Italian physician at the University of Bologna employed Alexandra Giliani to
perform certain tasks which would now be considered those of the medical
technologist.
- 17thcentury (1632-1723) Anton van Leeuwenhoek invented the simple microscope. He
was the first to describe the red blood cells, to see protozoa, and to classify bacteria
according to shape.
- 1628-1694 –Marcello Malphigi –described as the “greatest”of the early microscopist.
He was also the “Founder of Pathology”
- 1848 –Fehling –performed the first quantitative test for urine sugar.
- 19thcentury –production of aniline dyes which is used in staining bacteria for
microscopy.

History of Med. Tech in the United States

- The first chemical laboratory related to medicine was established at the university of
Michigan by Dr. Douglas.
- 1878, Dr. William H. Welch established another laboratory at the Bellevue Hospital
Medical College.
- 1885. Dr. W. Welch became the first professor of pathology at the John Hopkins
University
- 1896, Dr. William Osler –first clinical laboratory opened at the John Hopkins Hospital
- 1896, Another clinical laboratory was also opened at the university of Pennsylvania
(William Pepper Laboratory).
- 1908., Dr. James C. Todd wrote the book “A Manual of Clinical Diagnosis”. It was retitled
“Clinical Diagnosis by Laboratory Methods ”in its 6thedition by Dr. Todd and Dr. Arthur
Sanford.
- 1919 census, 100 technicians, all male employed in the United States. This increased to
3,500 in 1920. In 1922, 3,035 hospitals had clinical laboratories.
 - 1915, the state legislature of Pennsylvania enacted a law requiring all hospitals and
institutions to have an adequate laboratory and to employ a full time laboratory
technician.
- 1922, University of Minnesota-one of the first school to train laboratory workers. A
course bulletin was titled “Courses in Medical Technology for Clinical and Laboratory
Technicians.
- 1923, University of Minnesota first to offer a degree level program.
- 1940 United States required a 2 year collegiate education and a twelve-month actual
training in the laboratory for the preparation of its practice.
- 1950, Standard curriculum was formalized in preparation for a Bachelor of Science
degree.

History of Medical Technology in the Philippines

- End of World War II (1939-1945)-Medical Technology practice was introduced in the

Philippines by the 26thMedical Infantry of the 6thUS Army
- The US Army established the first Clinical laboratory at Quiricada St., Sta. Cruz, Manila
where the Manila Public Health Laboratory is presently located.
- February 1944-laboratory (MPHL) offered training program to high school graduates.
- June,1943-US Army left the Clinical Laboratory and endorsed it to the National
Department of Health.
- October 1, 1945, Dr. Alfredo Pio de Roda-organized the Medical laboratory and was
given the name Public Health Laboratory. He was assisted by Dr. Mariano Icasiano who
was then the Manila City Health officer.
- l1947-training of Medical technicians started under Dr. Pio de Roda and Dr. Prudencia
C. Sta. Ana. Trainees were mostly highschool and paramedical graduates.
- 1954, a six-month laboratory training with certificates upon completion was given to the
trainees. Dr. Sta. Ana prepared the syllabus for the training program.

Medical Technology Education in the Philippines

- Philippine Union College and Manila Sanitarium offered the first B.S. degree course in
Medical Technology.
- 1956, Dr. Jesse Umali-first graduate of B.S. MedTech from PUC; now OB-Gynecologist in
the USA. He is also the owner of the Omega Laboratory at Vito Cruz, Manila.
- 957, Dr. Antonio Gabriel and Dr. Gustavo U. Reyes offered Medical Technology as an
elective subject to 4thand 5thyear B.S. Pharmacy students.
- Rev. Fr. Lorenzo Rodriguez decided to offer Med.Tech. as a course at UST.
- June 17, 1957, issuance of temporary permit to first to third year students (Dep.Ed.)
- June,1960, issuance of permit for the internship program.
- June 14, 1961-Full recognition of the 4-year B.S. Medical Technology course.
- 1960, Mrs. Purificacion Sunico-Suaco pioneered B.S. Medical Technology course at the
Centro Escolar University. Their first graduates was in 1962.
- 1961, Dr. Horacio A. Ylagan and Dr. Serafin J. Juliano , started offering B.S. MedTech at
FEU under the College of Medicine.
- U.P. Manila offers similar course but the degree being conferred is B.S. Public Health
- 1961, Dr. Horacio A. Ylagan and Dr. Serafin J. Juliano , started offering B.S. MedTech at
FEU under the College of Medicine.
- U.P. Manila offers similar course but the degree being conferred is B.S. Public Health
- Postgraduate studies for Medical Technology
Among the schools that offered the course were the following:
• UST Graduate School-Philippine Women’s University
• Manila Central University
• U.P. Manila offered 1 year, non-thesis degree in Masters in Public Health
 Overview of Medical Technology
Medical Technology

➢ Also known as Clinical Laboratory Science or Laboratory Medicine

➢ Refers to the application of diagnostic, preventive, and therapeutic medicine to monitor
and improve the management of health conditions.

Notable scientist have provided definitions of Medical Technology:

- Anna Fagelson (1961)- defined it as the branch of medicine concerned with the
performance of laboratory determinations and analyses used in the diagnosis and
treatment determinations and analyses used in the diagnosis and treatment of disease
and the maintenance of health.
- Walters (1996) defined it as the health profession concerned with performing laboratory
analyses in view of obtaining information necessary in the diagnosis and treatment of
diseases as well as in the maintenance of good health.
- Ruth Heinemann (1963) defined it as the principle of natural, physical, and biological
sciences in laboratory procedures to aid in the diagnosis and treatment of diseases.

RUTH WILLIAMS

- A Medical Technologist
- Believes that medical technology began from the MEDIEVAL PERIOD (1096-1438) as
supported by the fact that urinalysis was a fad.
- Early Hindu doctors made the “SCIENTIFIC OBSERVATION” that the urine of certain
individuals attract ants, and that such urine has a sweetish taste.  QUACKS, calling
themselves doctors reaped fortunes from diagnosing diseases by the appearance of the
urine
Republic Act No. 5527

- Also known as “The Philippine Medical Technology Act of 1969”

- defined Medical Technology as an auxiliary branch of laboratory medicine which deals
with the examination of tissue, secretion and excretion of the human body and body
fluids by various electronic, chemical, microscopic and other medical laboratory
procedures or techniques either manual or automated which will aid the physician in
the diagnosis study and treatment of disease and in the promotion of health in general.

Clinical Laboratories

- Facilities that perform chemical and microscopic examinations of various body fluids like
blood, and tissues.
- A wide field where novelty plays a crucial role on sustaining health.
- These laboratories are found in a variety of settings, both in government and private
hospitals or free-standing (non-hospital) laboratories such as those found clinics, group
practices, physician’s offices, veterinary offices, government agencies and military
institution.

Types of Clinical Laboratories:

- Small Size Hospital (<100 beds) – perform only routine procedures

- Medium Size Hospital (100-300 beds) – has a laboratory that can perform all routine
tests including more complicated procedures.
- Large-sized Hospital (over 300 beds) – can handle large volumes of work and perform
complex tests.

Pathologist

- Director of a clinical laboratories.

- Licensed physician with a specialty in Pathology as certified by the Philippine Board of
Pathology.
 - Pathology is defines as the practice of medicine which contributes to diagnosis,
prognosis and treatment through knowledge gained by laboratory applications of the
biologic, chemical or physical science to man or material obtained from the man.

Area of pathology:

- Anatomic pathology – is the diagnosis of confirmation of diseases through autopsy

examination and cellular differentiation of autopsy and surgical tissues.
- Clinical pathology – specialized in chemical, microbiological, and hematological
procedures.

Medical Technologist

- Has a baccalaureate degree program from a college or university recognized by the

Commission on Higher Education.
- Completed a specified clinical internship in a training laboratory accredited by Bureau of
Heath Facilities and Services of the Department of Health.
- Has passed the licensure examination administered by the Board of Medical Technology
of the Professional Regulation Commission.
- Work as medical detective using microscopes to observe details in cells, ova and cysts of
parasitic organism.
- Measures substance in blood and other fluids.
- Compatibility testing of donor-recipient.
- Identifying organism causing infection and diseases.
- Uses of standards and control to improve the reliability of laboratory result.
- Work under pressure with speed, accuracy and precisions.

HISTORY OF MEDICAL TECHNOLOGY

- Ebers papyrus – the oldest preserved Egyptian compilation of medical texts, it was
written on 1500 BC. A book for treatment of diseases contains description of the three
stages of hookworm infection.
 - It contains chapters on contraception, pregnancy eye and skin problems, surgery, burns
and intestinal disease and parasites.
- HIPPOCRATES – Ancient Greek Physician, “Father of Medicine,”at around 300 B.C
advocates the use of “mind and senses” as diagnostic tools. He described four humors
or body fluids in the human body, namely, the blood, phlegm, yellow bile and black bile.
- Hippocrates associated the appearance of bubbles on the surface of urine to kidney
disease and chronic illness.
- Rufus of Ephesus (50 A.D) – made the first description of hematuria. He also attributed
hematuria to the inability of the kidneys to filter blood.

VIVIAN HERRICK

➢ Traces the beginning of medical technology back to 1500 BC when intestinal parasites
such as TAENIA and ASCARIS were mentioned in early writings.
- Rufus of Ephesus (50 A.D) – made the first description of hematuria. He also attributed
hematuria to the inability of the kidneys to filter blood.
- Isaac Judaeus- a Jewish physician and philosopher, in his book Kitab al Baul (Book of
Urine), he detailed the concepts of urine formation, urinary sediments, and urine
characteristics in relation to disease.
- He also formulated rules for the use of urine in patients diagnosis.
- He was considered One of the Founder of the Origins of Nephrology.
- Zacharias Janssen and his Father Hans- opened the door to the world of the invisible in
the 1590’s wherein they invented microscope.
- Athanasius Kircher- Jesuit Priest, one of the earliest microscopists who observed that
the blood of patients with plagues contained “worms”.
- Marcelo Malphigi- an Italian microscopists, was regarded the founding Father of
Modern Anatomic pathology. Renowned for his exploration of embryology of chick and
histology and physiology of the glands and viscera.
ANTONIE VAN LEEUWENHOEK (1632-1723)

➢ Invented and Improved the compound microscope.

➢ The first to describe red blood cells, to see protozoa, and to classify bacteria according
to shape.
➢ Invention of the microscope led to the rapid progress of microbiology and pathology. He
became the “Father of Microbiology”
- Frederick Dekkers - in 17th century, he observed protein in the urine precipitated when
boiled with acetic acid. This finding is the indicator of diagnosing proteinuria.
- Richard Lower – Cornish Physician, investigated and showed that it is possible to
transfuse blood from one animal to another.
- William Hewson – in 18th century, an English physiologist discovered that the blood
specimen collected was clotted, a plasma could be separated from the blood cells. Also
describe “coagulable lypmph” known as fibrinogen.
- RUDOLPH VIRCHOW - One of the youngest medical specialists Founded the ARCHIVES
OF PATHOLOGY in BERLIN in 1847
- Frederick Dekkers - in 17th century, he observed protein in the urine precipitated when
boiled with acetic acid. This finding is the indicator of diagnosing proteinuria.
- Richard Lower – Cornish Physician, investigated and showed that it is possible to
transfuse blood from one animal to another.
- William Hewson – in 18th century, an English physiologist discovered that the blood
specimen collected was clotted, a plasma could be separated from the blood cells. Also
describe “coagulable lypmph” known as fibrinogen.
- RUDOLPH VIRCHOW - One of the youngest medical specialists Founded the ARCHIVES
OF PATHOLOGY in BERLIN in 1847

HERMANN FEHLING

➢ Performed the FIRST QUANTITATIVE TEST in URINE SUGAR in 1848. MIDDLE OF

15th CENTURY Aniline Dyes were used in staining microorganisms
- Bacterial staining and microscopic study on bacteria were made possible
History of Medical Technology in United States

➢ Late 19thCentury the emergence of clinical laboratories in United States occurred due
to advances in medical science.
➢ Dr. William H. Welch (1878) – established another laboratory at the Bellevue Hospital
Medical College. In 1885, Dr. welch became the first professor of Pathology at John
Hopkins University.
➢ Dr. William Osler (1896) – first clinical laboratory was opened at John Hopkins
University. In this laboratory, routine examinations were carried out, special attention
being given to the search for malarial parasites in the blood.
➢ A clinical laboratory was also opened at the UNIVERSITY OF PENNSYLVANIA in 1896
(WILLIAM PEPPER LABORATORY).History of Medical Technology in United States
➢ Late 19thCentury the emergence of clinical laboratories in United States occurred due
to advances in medical science.
➢ Dr. William H. Welch (1878) – established another laboratory at the Bellevue Hospital
Medical College. In 1885, Dr. welch became the first professor of Pathology at John
Hopkins University.
➢ Dr. William Osler (1896) – first clinical laboratory was opened at John Hopkins
University. In this laboratory, routine examinations were carried out, special attention
being given to the search for malarial parasites in the blood.
➢ A clinical laboratory was also opened at the UNIVERSITY OF PENNSYLVANIA in 1896
(WILLIAM PEPPER LABORATORY).
➢ 1908 DR. JAMES CAMPBELL TODD - wrote the book : A MANUAL OF CLINICAL
DIAGNOSIS Retitled “ CLINICAL DIAGNOSIS AND MANAGEMENT BY LABORATORY
METHODS” by JOHN BERNARD HENRY
➢ The book describes the techniques and procedures of the laboratory test available then.
➢ in its 6th Edition by Dr. Todd and Dr. Arthur Sanford. - the book became the standard
reference for laboratories.
 ➢ In 1915, Pennsylvania State Legislature passed a Law requiring all hospitals to be
equipped with adequate laboratory employing trained technicians.
➢ In 1923, The University of Minnesota was the first to offer a degree program on medical
technology.
➢ A course bulletin titled : “COURSES IN MEDICAL TECHNOLOGY FOR CLINICAL AND
LABORATORY TECHNICIANS” was issued in 1922.
➢ They were the FIRST to offer a DEGREE LEVEL PROGRAM in 1923.
➢ 1936 AMERICAN BOARD OF PATHOLOGY ESTABLISHED
➢ 1919 census - 100 technicians, all male were employed in the UNITED STATES.
➢ This increased to 3500 in 1920. In 1922, 3035 hospitals had CLINICAL LABORATORIES

WORLD WAR II
➢ In 1944, US bases were put in Leyte during World War II in the Philippines. They brought
their Members of the US healthcare team.
➢ Marked effects in laboratory medicine
➢ The use of blood increased and the “closed system” of blood collection was widely used.
Instrumentation advanced and these instruments paved the measurement of the
intensity of color produced.
➢ Automated equipment appeared and quality control programs became common.
➢ The lab offered training programs to high school graduates as early as FEBRUARY,1944.
➢ 26th Medical Infantry Division of the 6th US army introduces Medical Technology. The
first Clinical Laboratory at 208 Quiricada St., Sta. Cruz, Manila was built.
➢ It is now known as the Manila Public Health Laboratory
➢ Left on June 1945 and endorsed the Laboratory to the National Department of Health.
The Department rendered the laboratory non- functional for sometimes.

Dr. Alfredo Pio de Roda

➢ recognized the deserted laboratory on Oct 1, 1945.
➢ He was supported by Dr. Mariano Icasiano who was the was then the Manila City Health
Officer.
➢ The laboratory later named Manila Public Health Laboratory
➢ 1947 Training of high school graduates to work as medical technicians
➢ No period of training was set and No certificates were given. By: Dr. Pio De Roda Dr.
Prudencia Sta. Ana.
 ➢ 1954 A 6 months laboratory training with certificate upon completion was given to the
trainees. Dr. Sta. Ana prepared the syllabus for the training program.
➢ The First Four-year Bachelor of Science in Medical Technology program was offered by
the Philippine Union College (now Adventist University of the Philippines) and the
Manila Sanitarium (now Manila Adventist Medical Center) in 1954.

Medical Technology Education in the Philippines

➢ Dr. Antonio Gabriel and Dr. Gustavo Reyes of the FACULTY of Pharmacy, University of
Sto. Tomas offered medical technology as an elective subject to 4th and 5th year B.S.
Pharmacy students.
➢ The Training program offered by Dr. Pio De Roda did not last long.
➢ The FIRST B.S. Degree course in Medical Technology was offered by the PHILIPPINE
UNION COLLEGE and MANILA SANITARIUM.
➢ After 2 years, PUC produced its first graduate, Dr. Jesse Umali, now a successful OB-
Gynecologist
➢ Rev., Fr. Lorenzo Rodriguez decided to offer it as a course because of the popularity of
medical technology among pharmacy students.
➢ JUNE 17,1957 Temporary permit was issued by the Dept. of Education, for first to third
year students.
➢ JUNE 1960
➢ The permit for the internship program was issued.
➢ June 14,1961
➢ Full recognition of the 4 year B.S. Medical technology course was given on June 14,
1961.
➢ POST GRADUATE STUDIES
➢ Offered to B.S. Medical Technology graduates MS in Medical Technology
➢ UST Graduate School
➢ Philippine Women’s University
➢ Manila Central University MS in Public Health(one year, non thesis degree)
➢ University of the Philippines Manila
➢ AUF, CEU and OLFU