Aerobe Culture
PATIENT INFO |
Patient Name: |
Medical Record #: |
BD: / / Sex: F M |
PHYSICIAN INFO |
Physician Name : |
Address: |
Ph: ( ) - Fax: ( ) - |
Additional Report to: |
Ph: ( ) - Fax: ( ) - |
TESTS REQUESTED | |
Test Name: | ICD9 Code: (required) |
1. Aerobe Culture | |
2. | |
3. | |
4. | |
5. | |
6. |
SPECIMEN INFO |
Collection Date & Time: |
Collected By: |
Hospital: |
1 cm3 tissue in sterile container.
1 mL body fluid or abscess aspirate in sterile container or syringe.
Eswab is accepted but not preferred.
Syringe (needle removed, capped)
Eswab
Do not transport syringes with needle attached. Remove needle and apply luer-lok cap.
For skin collections, cleanse the skin prior to collection. Let dry for 30 seconds. Remove the swab from the collection kit package. Swab the surface of the skin or wound, collecting exudate if present. If a vesicle is present, collect both fluid and cells from the base of the lesion. Break off swab at the red score line into the transport tube containing 1.0mL liquid media.
Needle aspirates or tissue collections should be collected by a licensed provider according to departmental procedures.