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Nasopharyngeal Swab Procedure

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Last Updated: 02 July 2021

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General | Latest Info

Nasopharyngeal swabs are specifically manufactured to have long, flexible shafts made of plastic or metal and tips made of polyester, rayon, or flock nylon. In addition to Nasopharyngeal swabs, you will need personal protective equipment, including a gown, nonsterile gloves, protective mask, and face shield, as described below. Make sure that all sample tubes have been labelled and that appropriate requisition forms have been filled out before starting procedure. It is essential that you follow pertinent respiratory and contact precautions specified by the Centers for Disease Control and Prevention and by your own institution and that you put on PPE correctly. If possible, you should put on and take off PPE in presence of an observer to make sure there are no breaks in technique that may pose risk of contamination. First, put on a protective gown, wash your hands with soap and water, and put on a pair of nonsterile gloves. Then put on protective mask with a rating of N95 or higher, as recommended by CDC. Finally, put on face shield for face and eye protection. Masks are recommended for all patients suspected of having COVID - 19. Ask patient to take off her mask and blow her nose into tissue to clear excess secretions from nasal passages. Remove swab from packaging. Tilt patients head back slightly, so that nasal passages become more accessible. Ask the patient to close her eyes to lessen mild discomfort of procedure. Gently insert swab along the nasal septum, just above the floor of nasal passage, to the nasopharynx, until resistance is felt. Insert swab into nostril, parallel to palate. If you detect resistance to passage of swab, back off and try reinserting it at a different angle, closer to the floor of the nasal canal. Swab should reach a depth equal to the distance from nostrils to outer opening of ear. Cdc recommends leaving swab in place for several seconds to absorb secretions and then slowly removing swab while rotating it. Your institution may also recommend rotating swab in place several times before removing it. Ask the patient to reapply her mask. Open collection tube and insert swab into the tube. Break swab at groove and discard what remains of swab. Close labeled collection tube, wipe tube with surface - disinfectant wipe, and insert tube into open biohazard bag held by assistant. Depending on institutional practices, you may instead return the sample to its original packaging for transport. Follow CDC directions for direct processing of swab specimen or placement of swab in media with or without refrigeration.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

5. Discussion

Nasal epithelium is an entry point for initial infection and an important transmission point of SARS - CoV - 2 as in other viral upper tract respiratory infections. Cellular entry of coronavirus depends on binding of spike protein by cellular proteases. Sars - CoV - 2 uses ACE2 as a receptor for cellular entry. Binding affinity of S protein and ACE2 was found to be a major determinant of SARS - CoV - 2 replication rate and disease severity. Sample is obtained deep in the nose and in the Nasopharyngeal area because expression of ACE 2 receptors there is higher than in the proximal part of nose. However, it is not easy for untrained caregivers to reach the nasopharynx. Qian et al. From Wuhan publish their strategy for Nasopharyngeal specimen collection. According to their experience, one of the key points is training of professional testers, standardization of method and process for swab collection. Despite important number of publications concerning COVID - 19 in past months, there are still a lot of questions without answers. One of them is possible replication of SARS - CoV - 2 in adenoid tissue. Study published in Nature medicine by Sungnak and al. Show that SARS - CoV - 2 entry factors are highly expressed in nasal epithelial cells, especially in nasal secretory cells and ciliated cells. Adenoid tissue has not been tested but lymphocytes do not express these SARS - CoV - 2 entry factors. It is important to clear this point concerning children because correctly test is in effect adenoid swab. Regarding drawbacks of Nasopharyngeal swab sample collection method, other sample techniques are being study. Yale University researchers have performed RT - PCR on self - collect throat washing samples. Their findings suggest that saliva samples could be used for at - home coronavirus tests on a large scale nationally. This hypothesis is supported by study of Xu et al. That demonstrates high ACE2 receptor expression in epithelial cells of the oral mucosa and base of tongue. The results are very encouraging, This sample method gives results that are at least as accurate as Nasopharyngeal swabs, which are still much more commonly used for COVID - 19 screening in the United States. If confirm, saliva could be a promising option for mass - testing of SARS - CoV - 2: minimally invasive, reliable and reproducible test. On 8 May 2020, salivary test has been approved by the Food and Drug Administration. Management of children in the COVID - 19 era follows specific guidelines, and the preferred testing technique depends on who performed the test. Nurses are comfortable with nasal aspiration because this technique is used routinely in paediatric departments to diagnose viral upper respiratory tract infection, such as VRS infection. However, we still do not know if this technique is as reliable as Nasopharyngeal swab. If a trained caregiver is performing test, nasal pharyngeal swab may be done even in young children. Age limit may be determined by comprehension and collaboration of child.


How is the test done?

Ask your healthcare worker how you will be informed of test results. You may be asked to call for results, schedule appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors relating to your test. Sometimes there is no follow up after you have been notified of test results. At other times, follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.


METHODS

Synthetic fiber swabs with plastic shafts and sampling tubes containing 3. 5 mL viral transport medium was supplied by YOCON. Trained medical providers first label tubes with patient information, then obtain a pair of NPS and OPS specimens. For NPS, patients were instructed to blow their noses; providers gently passed swab into the posterior nasopharynx via nostril, rotate for 10 s, and withdraw slowly. For OPS, providers wipe pharyngeal tonsil and posterior pharynx with swab, avoiding tongue. Immediately after sampling, providers place swabs into transport media and tighten the tube cap. Swab samples were kept at 2 - 8C and immediately submitted to the Clinical Lab of Tongji Hospital designated by the Chinese Center for Disease Control and Prevention. Participants rat discomfort level experienced during respective sampling. Questionnaires were collected from 103 patients. An Arbitrary rating scale was used with 1 being no discomfort and 4 being unbearable discomfort. Participants also rat specific symptoms during sampling, including rhinocnesmus, runny nose, sneeze, cough, bleeding, nausea, vomit, and lachrymation, using a visual analog scale with 0 being no feeling and 10 being the strongest feeling.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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