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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.
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