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Central Nervous System Sample Collection

 

CSF Sample collection and handling

 

Cerebrospinal fluid (CSF) is collected for a number of clinical investigations, including bacterial and/or viral meningitis, subarachnoid haemorrhage or Guillain-Barre syndrome.

CSF is collected by lumbar puncture. The following information does not describe the lumbar puncture procedure but describes the specimens required for particular investigations.

Separate requests should be send for Clinical Biochemistry and Microbiology investigations

Sample collection

·         Please note: specimens for subarachnoid haemorrhage investigations should be taken >12hrs after the suspected event or onset of symptoms

·         Label three 28ml sterile universal containers and one yellow-top fluoride-EDTA tube each with the patient’s name, hospital number, date of birth, time and date of collection, and the sequence order of collection

·         The first specimen should be a minimum of 0.5 mL of CSF placed in a yellow-top fluoride EDTA tube for glucose and protein estimations. This specimen should be sent to Clinical Biochemistry

·         Microbiology ideally requires at least 5 mL of CSF (for an adult) divided into two sequentially numbered sterile 28 mL universal containers labelled ‘second’ and ‘third’. These two specimens must be delivered to the Microbiology Department as soon as possible. Use of the pneumatic tube delivery system should be avoided

·         If CSF spectrophotometric scanning is required (for the subarachnoid haemorrhage) or CSF Oligoclonal bands, a fourth CSF specimen is required, to be sent to the Clinical Biochemistry laboratory.  A minimum of 1 mL of CSF should be placed in the final (labelled ‘fourth’) sterile 28 mL universal container for the spectrophotometric scan. (NB 1 mL is about 20 drops from the Luer connector on a needle). Protect this sample from the light by placing it in a thick brown envelope outside the usual plastic specimen bag.

·         A blood specimen should be taken at the same time for serum bilirubin, total protein and glucose estimation that are needed to aid interpretation.

Samples should be delivered to the Pathology department as soon as possible. Use of the pneumatic tube system is best avoided.

Collection order

1

2

3

4

Investigation(s)

CSF Glucose and protein

Microbiology

Microbiology

CSF Spectrophotometry and/or oligoclonal bands

Sample type

 

Yellow-top fluoride EDTA tube

 

28 mL universal container

 

28 mL universal container

 

28 mL universal container

Department

Clinical Biochemistry

Microbiology

Microbiology

Clinical Biochemistry

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