These stop. We also clean all spills immediately,

These are some laboratory equipment we use daily in our
clinic:

 

The Centrifuge is a vital instrument used to
separate substances of different densities that are in a solution. The
centrifuge spins samples at high speeds, and pushes the heaviest components in
the sample to the bottom of the tube according to their densities. Plasma or
serum from a blood sample can be removed from the sediment and stored, shipped,
or analyzed. Centrifuges vary in size, capacity and speed capabilities. Our practice
has 2 types of centrifuges: a micro hematocrit centrifuge which is designed to
hold capillary tubes, and a clinical centrifuge which accommodates test tubes
of varying sizes.

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Both
centrifuges are IDEXX StatSpin VT and the main purpose is to produce the rapid
separation of whole blood, prepare urine sediment for microscopic analysis and
centrifuge micro hematocrit tubes for packed cell volume determination.

The procedure to use this machine
consists of first lifting
the cover and placing the sample tube in the rotor. We make sure to balance the
rotor, adding a second sample or a water-filled tube and then close and latch
the cover. We select the desired cycle setting pressing the Cycle Selector button until the
applicable LED is illuminated. Finally we press the Start button. After the spin cycle has completed, the rotor
decelerates to a complete stop in approximately 10 seconds and the latch
interlock automatically unlocks. We do
not open the lid until the centrifuge has come to a complete stop. We also clean all spills immediately, and
thoroughly remove any broken glass.

IDEXX recommends
that we perform periodic inspections and preventive maintenance on the IDEXX
StatSpin VT Centrifuge. We clean the outside surfaces and
switch overlay panel with a water-dampened cloth and mild detergent everyday. We
clean the inner surface with a mild detergent and, if necessary, a disinfectant
everyday as well. After every use we wipe all surfaces with a dampened cloth and
70% alcohol.

A refractometer, or total solids meter, is used to
measure the refractive index of a solution. Refraction is the bending of light
rays as they pass from one medium like air into another medium like urine with
a different optical density. The brand we use at work is Reichert Vet 360.

The Reichert Vet 360 is used for simple, rapid microanalysis
of body fluids. The three-scale reticle provides read out for urine specific
gravity of dogs and larger animals, cats, and total protein for all animals.
The remaining scale is calibrated for protein concentration of plasma or serum
based on human data.

Determinations are precise and rapid and require only a drop
of fluid sample. The value on the appropriate scale, as seen through the
eyepiece, is read where the sharp boundary between dark and light fields
crosses the scale. The instrument is temperature compensated for temperatures
between 60°F (16°C) and 100°F (38°C).

The way to use the refractometer at work first we hold the
instrument in a horizontal position and swing up the cover plate to expose both
the measuring prism and the bottom surface of the cover plate. Then we place a
drop or two of sample on the prism and close the cover plate over the prism immediately.
We usually avoid lifting the cover plate while taking a reading. After we point
the instrument toward a light source such as the lamp. Then we take a reading
at the point where the dividing line between light and dark fields crosses the
scale.  The value is directly read from
the scale.

To clean the refractometer use a soft tissue paper moistened
with water and wipe the prism and bottom surfaces of the cover plate. Then we dry
the surfaces with a soft tissue paper. If the surfaces are not well cleaned
before the next sample is loaded, an erroneous or fuzzy dividing line may
result.

Reichert Refractometers rarely need adjustment. To check
adjustment, we make sure the temperature of the instrument is between 70°F
(21°C) and 85°F (29°C) and then we take a reading with distilled water. If
reading departs from 1.000, adjusting the screw on the bottom of the instrument
can make the correction. Turn the screw first counterclockwise to move the
dividing line below 1.000, then clockwise to 1.000. We then make sure the final
adjustment is always clockwise.

A large
number of automated analyzers are available for use in the in-house veterinary
practice laboratory. These include hematology, clinical chemistry, electrolyte,
immunology, coagulation, and urine analyzers. The units may run single tests,
or they may be capable of running multiple tests on the same sample.

 

For our complete blood cell count we use
VetScan HM5 brand. It is a five-part differential on cat, dog, horse, cow, etc.
It measures 22 parameters, including direct eosinophil counts and eosinophil
percentage. Machine has a small, space-saving, elegant design with large
touch-screen display giving results within minutes.

 

It is
very easy to operate this machine first we enter all the patient information
like name, age, sex, identification number. Then we press the sample and press
start. Finally we wait few minutes and the results will show up and print.

 

Daily we
run the blood control on the machine by simply inserting the sample slot and
waiting for the results. We clean everyday with a soft damp cloth the case and
display of the machine. If there were any spills then we would use bleach to
clean it. Monthly we clean the air filter to ensure proper ventilation. We
check the filter frequently to ensure there not a lot of dust of animal hair.
Analyzer software is sent and installed immediately if there’s any issues we
mail it back to the company for further maintenance.

 

For the chemistry machine we use VetTest from
IDEXX. The VetTest Chemistry Analyzer is a blood and urine-testing instrument
that analyzes up to 12 biochemical tests simultaneously, using a single sample
of either serum, plasma, or urine, in about six minutes.

The VetTest
analyzer prompts you through a series of steps that helps prepare the pipettor,
introduce the sample and initiate analysis. After drawing enough total sample,
the pipettor dispenses 10 microliters onto each slide in succession. The sample
spreads over the top layer of the slide and is absorbed. As the sample filters
through the layers, biochemical reactions take place that produce progressive
color changes. The VetTest analyzer’s optical system measures the colors and
their intensity. Chemistry slides are supplied in
cartons and are packaged individually in sealed foil and we keep them in the
freezer. The
VetTest analyzer has been set to automatically provide an interpretation of
results.

The analyzer’s
software disk contains the calibration data for the various lots of slides.
IDEXX provides free software updates that contain new calibration data for new
slide lots so that we do not have to worry about calibrating them. IDEXX mails us, at no charge; a new software disk containing
updated calibration data for newly produced slides. We install the new disk
promptly in order to run new slide lots. The new disk also will contain
additional enhancements to the analyzer, such as new menu features and updated
reference or quality control ranges.

We perform a Quality Control to verify that the VetTest
Chemistry Analyzer is functioning properly once a month or if the results are
incorrect. The following Quality Control procedure verifies both the VetTest
optics groups and the integrity of your slides. The machine prompts us with the
steps for the control procedure.

We always disconnect the power before cleaning the VetTest
Chemistry Analyzer with a damp lint-free cloth and a mild liquid soap will
remove grease. We routinely dust off the VetTest analyzer with a damp cloth and
dust around the location. We routinely remove and dust off the right side cover
with canned air spray. Use a damp cloth to wipe any dried residue off the rotor
surfaces.

We keep the pipettor vertical when sample is in the tip.
Moisture or liquid may accumulate in the clear plastic line if a tip is left on
after a sample run, so we make sure to discard the tip when prompted to do so
by the VetTest analyzer. To clean the pipettor, we carefully wipe the pipette
tip (especially the end of the tip) with a twisting motion using a clean,
disposable lint-free tissue.

We use Midmark M9 Ultraclave autoclave machine. It is used to sterilize heat and moisture stable
reusable items (including dental hand pieces) that are compatible with steam
sterilization. This sterilizer is designed and built to minimize
electromagnetic interference with other devices. We usually sterilize packs and
gowns loading them into the autoclave and following the autoclave display
instructions and just wait.

We always make sure only distilled water is used in the
sterilizer. Since the sterilizer operates with high water temperatures, any
minerals dissolved in the water will form mineral deposits. This can prevent
valves from opening or closing properly and can also lead to corrosion in the
chamber and tubing.

Maintenance reminders are displayed on the screen at the
appropriate intervals to assist the operator. We do this maintenance once a
month. These reminders are removed from the display screen once a cycle is
started. We wash the exterior of the sterilizer each day with
watchdog.

We also perform a weekly maintenance like changing distilled
water on the autoclave. Clean Chamber / Trays (including Rack and Plate) First we disconnect the upper portion of the
reservoir drain tube from the panel clips, bend it downward, and drain the
reservoir water into a suitable container, e.g. a bucket, and dispose of the
water. Then we remove and wash
the trays, tray rack, and tray plate from the sterilizer.
Finally we refill reservoir
with distilled water or water that meets the referenced water purity
specifications. Weekly we also check
Pressure Relief Valve to assure it functions properly.

At
the hospital we have two microscopes
in the laboratory. One is used for performing routine parasite studies and
procedures that involve the use of corrosive or damaging materials. The second
microscope is reserved for use with cytology and hematology evaluations.

 

A
high-quality binocular compound light microscope is essential to evaluate
blood, urine, semen, exudates, and transudates; other body fluids; feces; and
other miscellaneous specimens. It may also be used to detect internal and
external parasites and to initially characterize bacteria.

 

Our compound
light microscopes have four objective lenses, each with a different
magnification power. The most common objective lenses are 4× (scanning), 10×
(low power), 40× (high dry), and 100× (oil immersion). Total magnification of
the object being viewed is calculated by multiplying the ocular magnification
power and the objective magnification power.

 

Care and
Maintenance for our microscopes consists of cleaning the lenses with only a
high-quality lens tissue after each use and kept covered when not in use. A
dirty field of study may be caused by debris on the eyepiece.

 

To
operate the microscope first we lower the stage to its lowest point and turn on
the light. Then we place the slide on the stage, with the appropriate side
facing up. After we move the 10x objective lens into position by turning the
nosepiece. While looking through the eyepieces we adjust the distance between
them so that the two fields appear to be nearly identical and can be viewed as
one. We use the coarse and fine focus knobs to bring the image into focus. We rotate
the nosepiece to move the high-dry objective lens into place and use the fine
adjustment knob to focus on the image.

                       
       

When finished we turn the light off,
lower the stage completely and rotate the nosepiece to move the low-power
objective lens into place. We make sure we
remove the specimen from the stage and clean the oil-immersion lens if it was
used and cover the microscope. We calibrate our microscopes once a week.

 

A
comprehensive laboratory safety program is essential to ensure the safety of
employees in the clinical laboratory area. The safety policy includes
procedures and precautions for the use and maintenance of equipment. All
employees working are aware of the location of these items and thoroughly
trained in their use. Laboratory safety are written and placed in an accessible
location within the clinical laboratory area.

The Occupational Safety & Health Administration (OSHA)
was created under the Department of Labor to enact and enforce those measures
necessary to ensure that every American has a safe and healthy work
environment. These “rules” are known as standards and are published in
Chapter 29 of the Code of Federal Regulations.

Our hospital
Banfield is part of a large chain so we get trained every 6 months with emails
and power points and staff meetings to make sure we are up to date on the
information. Our practice manager took the responsibility to be the OSHA
captain so he keeps up with the veterinary technicians and assistants keeping
up to date in any change. The corporation does send emails or flyers with any
other current information regarding OSHA policies.

 

Our practice follows
the protocols and policies to meet OSHA requirements. Our practice is OSHA
compliant because it is not an option it is the law. Some OSHA policies that
are in place always include the following:

 

Labels: in OSHA training meetings we make
sure all of our staff not only be told about hazardous chemicals, but to fully
understand their dangers and how to be safe around them. We have labels with
pictograms in any bottles, secondary container like a spray bottle for example
where another chemical is poured. The bottle has a label filled out by hand and
permanent marker mentioning the chemical name and pictogram (from GHS labels)
that shows the personal protection equipment required, or the Diamond Code
appropriately filled in if using National Fire Protection Association labels.
We also cover the labels with packaging tape since they tend to peel off. Other required signage includes five
extinguishers and an eyewash station.

 

Documents: Every
OSHA staff training meeting our practice manager makes sure everyone signs off
documents showing attendance to certify that we have been trained and
understood the risks, knowing proper use of hazardous chemicals and protective
equipment. All new employees are trained in OSHA compliance. Another important
document are our health records and emergency contact information for all the
staff.

The hospital
also has OSHA 300 forms in place, a hazard communication plan and an annual
safety review. The OSHA 300 form is a yearly detailed log of reportable
injuries that have occurred.  The OSHA 300A form is a summary of these
injuries. The 300A form is posted in the break room.

 

Radiation protection: every time we take a radiograph in
the hospital we are required to wear a gown, leaded gloves, a thyroid shield
and leaded glasses. We are also required to wear a dosimeter, also known as a
radiation badge. Dosimeters are sent in quarterly to be read. The radiation
exposure report from the dosimeter company is posted for all employees to see. The
risks of radiation are well known like fetal malformations and cancer top the
list.  Ideal situation is when there is
no holder inside the x-ray room, so when patient is sedated we just position
them correctly and take the radiograph.

 

Protection
control includes how to stay safe around animals that are thought to have
zoonotic diseases, including rabies. We also have an accident investigation
plan in place, including forms to be filled by the Banfield and signed by the
affected employee. We also have an evacuation plan in place and the process is
rehearsed every year.

 

Food and
drinks are never in the hospital area except in the break room. Lab samples,
medications and diagnostic chemical reagents are kept in a different fridge
from the food. A closed bottle or coffee cup with lid is accepted.

 

Hearing
protection is not very common but when there’s unusual barking or noise we can
wear earplugs.

 

Electrical Supply: sufficient electrical outlets and
circuit breakers must be available. Circuits must not be overloaded with
ungrounded three-prong adapters or extension cords.

Signs are
another important OSHA requirement to notify employees of specific health
hazards such as radiation, laser and anesthetic gases. Exits are clearly
marked. Emergency telephone numbers, including
fire, police, ambulance, and emergency maintenance personnel is assembled and
prominently displayed near each telephone.

The hospital also
has signs designating “employees only” areas because pet owners should never be
allowed in radiology. Clients are rarely allowed in the treatment area for
visitation. Other required signage includes fire extinguishers and an eyewash
station. Job Safety & Health Protection Poster
(OSHA 3165) is visible in the practice.

The OSHA recognizes that the handling of sharps (needles,
scalpel blades, etc.) is a serious safety hazard in veterinary hospitals, but
the Environmental Protection Administration (EPA) is the agency responsible for
most of the attention and regulations for disposable of medical wastes.
Although sharps could definitely be a regulated medical waste, not all waste
from a veterinary hospital is considered harmful to humans or the environment.

An
eyewash station is an OSHA requirement. It is located near the lab because that
is the area where there is the most risk of getting chemicals into your eyes. Our
eyewash station is tested monthly.

 

OSHA
requires shoes that are completely enclosed and that are impermeable. They
should be enclosed to prevent stabbing your foot with a sharp object, such as a
needle on a syringe. And they should be impermeable to prevent foot
contamination by chemicals, as well as contamination of skin by feces or urine
containing zoonotic agents.

 

A
complete list of hazardous chemicals present in the hospital is available. The
list mentions four pieces of information for each product: name, chemical,
manufacturer name and manufacturer contact phone number. OSHA requires that
employers protect their employees from workplace hazards that can cause injury.

 

A Material Safety Data Sheet (MSDS)
is a document that contains information on the potential hazards including
health, fire, reactivity and environmental and how to work safely with the
chemical product. The manufacturer of a product that contains a hazardous
chemical will prepare a material safety data sheet (MSDS) for that product. The
minimum information required by OSHA is as follows: manufacturer’s name and
contact information, hazardous ingredients/identity information,
physical/chemical characteristics, fire and explosion hazard data, reactivity
data, health hazard data, precautions for safe handling and use and control
measures. The MSDS is updated each time the material changes. Each manufacturer
has its own MSDS for its products. To avoid confusion the MSDS binder in our
practice is filed with tabbed alphabetical dividers by the product name .Our practice
keeps an MSDS binder for the chemicals that we label stored at an easy to see
shelf along with other reference books. Also we have an MSDS online library for
rapid access. Every time there is a new update our practice manager makes sure
all the staff is aware of it.