Areas of Interest, Roles and Responsibilities and Performance
Medical Laboratory Science embraces a variety of disciplines like, Clinical Chemistry, Hematology, Coagulation, Microbiology, Immunology and much more; all of these are performed in a clinical or medical laboratory setting.
Medical Laboratory Scientists can be defined as detectives of Health Care System with a wide knowledge and expertise. Laboratory Scientists perform lab tests on body fluids and tissues to support in the diagnosis of diseases and management of health.
The practice includes collection and processing of specimens, performance of a broad range of analytical procedures, quality control and reporting of tests results.
The key role of a Laboratory Scientist is to perform qualitative and quantitative screening tests and procedures on samples from human body, as saliva, blood, urine, feces, and body’s tissues for support in the diagnosis and treatment of diseases.
The laboratory plays a special role and support in the health care system in diverse ways, confirming or ruling out a diagnosis, detecting an infection, or any abnormal marker’s value for a diagnosis of a disease.
The increase demand on laboratory in the last years has led to the introduction of more specialized and sophisticated procedures as automation and computerization.
The information that comes from results of blood analysis or of other type of specimen are crucial for the addressing of a disease and right steps to take for a physician.
Medical Laboratory Scientists, Technicians and Technologists work in different areas like: Clinical Chemistry, Hematology, Coagulation, Urine Analysis, Toxicology, Immunology, Microbiology, Blood Bank and more.
Brief description of each of these areas and main performances at glance.
Clinical Chemistry analyzes substances in blood that may help in diagnosis of variety of diseases like cardiovascular, diabetes, liver, and kidney diseases.
The markers researched in this area are for example, glucose cholesterol and triglycerides, for metabolic function, diabetes and cardiovascular diseases, urea and creatinine for renal function, transaminase enzymes like ALT, AST, GGT, for liver function, ALP and amylase for pancreatic function, electrolytes and inflammatory markers like CRP, ESR and Fibrinogen as for most of the diseases, and many more and specific parameters.
Generally, the methods utilize chemical reactions through the combinations of samples with chemical reagents operated with devices in automation as the Beckman coulters (the most common) to calculate the concentration of variety of substances and metabolites, or electrolytes.
Hematology is based on the study of blood cells characteristics like number and size, and which are executed with specific cells counters detectors, and morphology and pigmentation with the use of microscope for the detection of an acute infection and/or the diverse types of anemia, lymphoma, or leukemia. The most common method of stain for the observation under microscope is the Giemsa-Wright, and which, if well performed, gives a good separation of the parts of the blood cells, like nucleus, cytoplasm, and organelles, thanks to the differentiated coloration.
Neutrophils in a blood smear
Coagulation analyzes blood for blood clots factors and markers for prevention and diagnosis of bleeding or clotting problems and/or to monitor anticoagulant therapy in patients with heart attack or strokes.
Urine analysis involves chemical and cellular analysis of urine performed with chemical strips or dipsticks which are chemical reagents that when in contact with urine react changing color, the color resulting is then compared with a reference scale where colors are associate to a different pH, this is then followed by observation under microscope for the detection of various metabolic disease and infections of urinary tract.
Yeast cells in patient with urinary tract infection
Toxicology is the science that identify toxic substances and drugs in body fluids, and it is performed with different techniques, most utilized are immunoassay screens, gas chromatography and mass spectrometry.
Immunology examines the degree of immunity o resistance to diseases through the presence of specific immunoglobulins for chronic and acute infections, IgG, or IgA for chronic and IgM for acute infections. Serology which is a branch of immunology consist in the research of antibodies or antigens for the detection of bacterial and viral infections and it is executed with immunoassay like, for example, the ELISA method (Enzyme-Linked-Immuno-Sorbent-Assay)
Microbiology is the science that identify pathogenic microorganisms like virus, bacteria, fungi, and parasites responsible of diseases and determines the susceptibility of these pathogens to therapeutic treatments like antibiotics, antiviral and antifungal.
The specimens coming from different areas of the of the body are cultivated in specific cultures or incubated, usually in broth cultures, or specific cultures where inhibiting agents or other substances are added for enhancing the growth of a bacteria among others inhibiting at the same time the rest eventually present in the sample. Successively they are characterized and typed for the different chemical and metabolic characteristics and properties, then processed for antibiotic resistance.
There are different methods to identify the antibiotic resistance, or susceptibility, but a typical method used is the Kirby-Bauer which relies on the inhibition of bacterial growth thanks to the disc diffusion technique measured under standard conditions.
With the disc diffusion technique or method, antibiotics impregnated filter paper disc are placed on specific agar plates inoculated with the bacteria to be tested. If the bacteria are sensitive to the antibiotic they cannot grow in the zone around the antibiotic, or zone of inhibition while resistant bacteria will. (“Testing antibiotic resistance – Microbiology Nuts & Bolts”) The measure of the diameter of the zone will give the value of the minimum inhibitory concentration or MIC.
Blood Bank involves the determination of blood types performed as agglutination tests, where cells clump together forming a sort of cloth, through the utilization of controls of reference, positive and negative, as for the most tests in laboratory, and the preparation of blood products for transfusion.
Upon on the Board of Registry of the American Society of Clinical Pathology, today’s laboratory uses different complexes, precision instruments and a variety of automated and electronic equipment.
The success of a laboratory’s professional begins with the dedication to the profession and willing to help others.
Laboratorians must produce accurate and reliable tests results, have interest in science and sense of responsibility for affecting human lives.
More on ethics and responsibilities of Laboratory Scientists:
They must exhibit loyalty, honesty, and respect in work environment, adhere to the disclosure roles about client privacy as HIPAA regulations, showing patience, empathy, and consideration towards patients, promoting health care, prevent and control of diseases. They must follow safety procedure as those in HOSHA regulations, demonstrate a correct use of equipment during work time, wearing proper lab-ware, exhibit proper behavior and professional appearance. Especially important also is the correct use of reagents and laboratory’s supplies, reliability, and flexibility towards terms of employment.
This job requires huge sense of responsibility, attention, clarity, and scrupulosity.
This has been my job for a period, and I have always liked and performed following all these roles, but more than everything with sense of conscience, responsibility and scrupulosity, the most important things when dealing with human lives.
Thanks for Reading
Microbiology Nuts & Bolts
Board of Registry Guide, ASCP