Tarangnan Community Hospital
Clinical Laboratory • Clinical Microscopy
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Document No.: WI-CM-002-A-V0 | CONTROLLED COPY Do not copy or remove |
| Parent document: SOP-CM-002, Sections 5.2–5.5 | Version: V0 | ||
| Applies to: Medical Technologists and Laboratory Aides | Effective date: MM-DD-YYYY | Supersedes: None | ||
Sysmex UC-1000 / MEDITAPE UC-10S Operation, Visual Backup & Sediment Card
Standardized bench procedure for macroscopic inspection, automated chemistry, manual downtime backup, and sediment examination
BIOSAFETY: Wear gloves; discard strips into biohazard waste; decontaminate spills per waste SOP.
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Patient Identification Check: Verify two patient identifiers — request form ↔ container match — before testing.
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Physical Evaluation: Mix uncentrifuged urine by gentle inversion 5 times. Pour at least 12 mL (30–50 mL preferred) into clear conical tube. Record Color (straw to amber/red/tea) and Clarity (clear, hazy, cloudy, turbid). SOP 5.2
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Daily Analyzer QC: Equilibrate Sysmex UC-CONTROL-L & H for 15 min. Mix by inversion. Dip strip ≤ 1 sec, blot edge, and run both levels on UC-1000. Verify all 10 parameters against target ranges. SOP 5.3.115 min eq
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Specimen Dipping & Blotting: Check strip-vial expiry and in-use opening date; keep the desiccant cap closed between dips (moisture degrades pads). Dip MEDITAPE UC-10S strip into uncentrifuged urine for ≤ 1 second. Drag edge against tube rim, then blot edge on absorbent gauze to prevent pad runover. SOP 5.3.2≤ 1 sec
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Sysmex UC-1000 Loading: Place strip flat on moving transport tray with reagent pads facing upward. Analyzer measures multi-wavelength reflectance, subtracts blank pad, and prints result. SOP 5.3.2
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STOP / DOWNTIME BACKUP Manual Visual Reading Mode (When Analyzer Down): Start stopwatch immediately. Compare strip horizontally against container label: Read 9 chemistry pads at 60 seconds; Read Leukocytes between 60–120 seconds. STOP: Do not read after 120 seconds (oxidation causes false positives). SOP 5.460–120 s
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Standardized Centrifugation: Centrifuge at least 12 mL urine in conical tube at 400 × g (≈1600 rpm — confirm on your centrifuge's conversion chart) for 5 minutes. Allow gentle coasting stop (NO manual brake). Decant leaving 0.5–1.0 mL; flick bottom gently. SOP 5.5.15 min
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Microscopic Sediment Examination: Transfer 1 drop (20 µL) resuspended sediment to slide; apply 22×22 mm coverslip without bubbles. Scan 10 LPF (10×) for casts & epithelial cells; count 10 HPF (40×) for RBCs, WBCs, bacteria, crystals. SOP 5.5.3
Chemical-to-Microscopic Correlation Rules (SOP 5.6)
| Dipstick | Sediment | Clinical / Resolution Protocol |
|---|---|---|
| Blood + | 0–1 RBC/HPF | Hemoglobinuria, myoglobinuria, or alkaline RBC lysis. Inspect clarity. |
| Blood − | >5 RBC/HPF | Ascorbic acid inhibition or intact unlysed RBCs; confirm with 2% acetic acid. |
| LE + | 0–2 WBC/HPF | Lysis of leukocytes in delayed/hypotonic urine; report lysed WBCs. |
| Nitrite + | 0 Bacteria | In-vitro bacterial reduction; review under subdued light for rods. |
| Nitrite − | Many Bacteria | Non-nitrate reducers (Enterococcus, Staph) or bladder dwell <4 hours. |
Standard Sediment Reporting Ranges (SOP 5.7)
| Element | Objective | Reporting Unit / TCH Criteria |
|---|---|---|
| Casts (Hyaline, Granular) | 10× LPF | Average count / LPF (e.g. 0–2 / LPF) |
| Cellular / Waxy Casts | 10× LPF | Flag critical finding; refer to Pathologist |
| Erythrocytes (RBCs) | 40× HPF | Average count / HPF (e.g. 0–2, 2–5, 10–20, >100) |
| Leukocytes (WBCs) | 40× HPF | Average count / HPF (e.g. 0–5, 10–20, Packed) |
| Epithelial Cells | 10× LPF | Squamous: Few / Moderate / Many per LPF |
| Bacteria / Yeast / Crystals | 40× HPF | Semi-quantitative: None / Few / Mod / Many |
| Prepared by: Chief Medical Technologist Signature / Date: ____________________ |
Reviewed by: Pathologist Signature / Date: ____________________ |
Approved by: Hospital Director Signature / Date: ____________________ |