Sputum and Vomit: Collection, Analysis, and Types
1. Sampling of Nasal Discharge
It involves introducing a sterile swab through the nose and gently rotating it until reaching the nasopharynx. The swab is then placed in a properly labeled transport tube and sent to the laboratory.
2. Sampling of Throat
Contact the sterile swab with the tonsils, pharynx, and any other potentially affected area, avoiding the tongue and buccal walls. A tongue depressor can facilitate this maneuver. Once sampled, the swab is placed in its container, properly labeled, and sent to the laboratory.
3. Concept of Sputum and Objective Analysis
Sputum is the elimination of tracheobronchial secretions during coughing.
The aim of a sputum sample is to diagnose bronchopulmonary pathology by studying its macroscopic physical characteristics: color, volume, consistency, and odor. Microscopic analysis determines the various elements present in the sample (cytology and microbiology).
4. Classification of Sputum: Mucus and Muco-Purulent
Sputum can be classified based on its appearance and the elements present:
- Mucous
- Purulent and muco-purulent
- Serous
- Hemoptysis
Mucous sputum has a large amount of mucus, is whitish, and very sticky. Muco-purulent and purulent sputum primarily contain pus and mucus, with a yellowish-green color.
5. Classification of Sputum: Serous Sputum and Hemoptysis
Sputum can be classified based on its appearance and the elements present:
- Mucous
- Purulent and muco-purulent
- Serous
- Hemoptysis
Serous sputum appears white or pink, is abundant, and has little consistency. Hemoptysis presents as streaks or frank blood, or a blood sample resulting from hemorrhage (bleeding in the lower respiratory tract).
6. Collection of Sputum Sample: Material Resources
It is advisable to collect samples in the early morning hours, as more secretions accumulate overnight. If the sample is for microbiological study, samples should be collected on three consecutive days.
Material resources:
- Sterile bottles, properly identified
- Specific material and vacuum system for uncooperative patients (conscious or tracheostomized)
7. Protocols in the Collection of the Sputum Sample
A mouthwash should be performed beforehand to prevent sample contamination. Ask the patient to breathe deeply two to three times consecutively and cough forcefully on the last breath to release the sputum. If difficulty arises, saline sprays and drainage physiotherapy maneuvers can be applied. Collect the sample by placing the open sterile bottle directly near the mouth. Close the bottle properly, label it, and send it to the lab.
8. Concept of Vomiting
Vomiting is the sudden expulsion of gastric contents through the mouth. It is a reflex caused by stimulation of the emetic center in the medulla oblongata. This stimulation causes contraction in the pyloric region and relaxation of the lower esophageal sphincter.
9. Classification of Vomiting According to Content
- Food (includes food)
- Aqueous (presence of gastric juice is important)
- Bilious (presence of bile)
- Hemic, called hematemesis. The blood comes from either esophageal or gastroduodenal bleeding. If the blood has been digested at the gastric level, it presents a dark color, also called coffee ground.
- In exceptional cases, there may be purulent (pus) and fecaloid (feces) vomiting.
10. Classification of Vomiting According to Mechanism of Production
- Digestive or direct vomiting: affects the stomach and duodenum and is due to functional or organic causes.
- Non-digestive or indirect vomiting: reflections are made by bodies located in anatomical pathology other than above.
11. Specimen Collection of Vomit: Objective Analysis
If the patient is conscious and cooperative, explain the technique of inducing vomiting (mechanical stimulation of the uvula and pharyngeal) and collect it in a sterile container, staying with the patient if necessary. The analysis helps diagnose possible anatomo-functional alterations of the digestive system or the existence of other factors such as abnormal blood, drugs, toxins, or pathogens.