We are more than 6 months into the pandemic caused by novel coronavirus Covid-19. Let us review how to appropriately obtain a nasopharyngeal swab.
Before entering into the room, be sure to call your parents and tell them you love them. Wash your hands with soap & water or alcohol-based sanitizer for at least 30 minutes. If someone else has gowned up and beat you to collecting the specimen, your job is done. If not, sigh. Sigh once more, but this time more dramatically for all to hear. Put on a N95 mask and eye protection, and enter the room. Alternatively, quit medicine.
Your patient should already be wearing a mask. If not, kindly remind them to put on a mask while you find your supervisor and say you’ve been exposed and need to be quarantined for 6 months.
If the patient doesn’t wish to be swabbed, respect their wish for a few seconds then smack a little sense into them; it’s a pandemic for Pete’s sake.
Remove the swab from the packaging. Save the packaging because hoarding is appropriate during a pandemic. Ask the patient to pull their mask down and tilt their head back. If your patient’s neck snaps back completely exposing Pez, please take one and enjoy.
The swab should be inserted into the nostril, but it’s not uncommon to accidentally end up in the rectum or vagina.
Advance the swab along the nasal floor and septum until you feel resistance. Plant and steady your back foot, and drive the swab past the resistance; this will ensure pathology has an adequate brainstem sample.
According to the Centers for Disease Control and Prevention, the swab should be placed for several seconds, rotating the swab for the entire duration. According to Infection Prevention at Gomerblog, the swab should be placed for several days, with a medical student rotating the swab for the entire duration. If you have several medical students available, hold the swab steady and rotate the patient for the entire duration.
Open the collection tube and place the swab into the tube, while repeating saying, “OHGODOHGODOHGODOHGOD.” Immediately run out of the room in a panic and throw it at the first person you see. It is now a game of Hot Potato; don’t lose! Place both the collection tube and the person holding the collection tube into a biohazard bag. Walk the swab down to Pharmacy. There, they will tell you that you are in the wrong department. Walk the swab down to Laboratory Services.
Wait anywhere from 24 hours to 7 days for the result to come back as indeterminate.
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