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There is an absolute requirement that high risk samples are labelled as such before transport to the laboratory.  The HSE advise the provision of sufficient information on specimen request forms to staff in clinical diagnostic laboratories to enable them to apply the correct safety measures to control the risk. The lack of sufficient relevant clinical details provided on specimen request forms can result in samples being handled at the wrong biological containment level with resulting increased risk of infection to laboratory staff.

Samples must be considered High Risk if the patient has, or is suspected of having:

 CJDv Hep BHep C HIV  TB

 Any other disease classed as category 3 or above

Samples from patients with jaundice of unknown origin and patients known to engage in high risk activities, such as IV drug abuse, must also be considered high risk 

Blood from these patients should normally be taken by medical staff. If Phlebotomists are asked to take blood they must be informed of the situation. This is the personal responsibility of the doctor making the request.  If Phlebotomists are asked to take blood from patients being barrier nursed they must be informed of the situation.

Requests Made by Order Comms Electronic Requesting

The High Risk box must be ticked when making the request on Ordercomms. This ensures a subtle format change to the request form which, along with the use of double bagging, provides all the labelling required.

Requests made to Microbiology

For all high risk samples the high risk box on the Microbiology request form must be ticked.  Remember to complete the Microbiology request form with all patient details as usual. The sample should be double bagged by placing it inside a second Microbiology request form bag.

Other requests

Requests for departments other than Microbiology, (and where no Order Comms requesting is available), must clearly indicate the infection risk of the patient on the request card.  New request forms are in process for other disciplines which will follow the Microbiology approach in due course. The sample should be double bagged by placing it inside a second request form bag.


All high risk samples must be double bagged and  must NOT be transported using the vacuum tube system.


Any queries regarding high risk samples can be addressed to:

 Dr D Hamilton
Consultant Microbiologist

Mr Paul Sudworth 
Directorate Manager

Web page last updated: 1st February 2017


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