Introduction to Medical Technology PDF

INTRODUCTION TO MEDICAL TECHNOLOGY: OVERVIEW AND Perform complex chemical and biological, hematological, HISTORY (PART 1) immunologic, microscopic, and bacteriological tests...

INTRODUCTION TO MEDICAL TECHNOLOGY: OVERVIEW AND Perform complex chemical and biological, hematological, HISTORY (PART 1) immunologic, microscopic, and bacteriological tests Know how to use state-of-the-art instrumentation in order to: I. OVERVIEW ○ Microscopically examine blood and other body fluids ○ Make cultures of body fluids and tissue sample to The job of a Medical Technologist is vital in treating determine the presence of bacteria, fungi, diseases and saving lives. The most relevant example is parasites, or other microorganisms the pandemic being faced today. ○ Analyze samples for chemical content or a Medical Laboratory Scientists or Medical Technologists are chemical reaction and determine concentrations front liners in battling these. of compounds, such as blood glucose and cholesterol levels ○ Type and crossmatch blood samples for A. MEDICAL TECHNOLOGY/MEDICAL LABORATORY SCIENCE transfusion Think of a laboratory ○ It is not just a place where Medical Technologists The application of procedures, information and devices to perform tests, but it consists of different sections, develop highly sophisticated solutions to medical problems focusing on different things at the same time. or issues as the prevention of disease or the promotion and ○ All these for only one goal, which is to help monitoring of good health. diagnose a patient Refers to diagnostic or therapeutic application of science and technology to improve the management of health conditions. C. THE CLINICAL LABORATORY Combines the challenges of medicine, the basic sciences of biology and chemistry, and the clinical sciences into a very satisfying professional career Uses sophisticated biomedical technologies and scientific It is an applied science as it employs scientific investigation methodologies to test patients' blood or tissues and body to come up with a diagnostic finding fluids. Study and practice of diagnostic medicine Medical Technologists (Phlebotomists) are also the ones The people who work in this field are called Medical who collect blood from patients, which would fall under the Laboratory Scientists or Medical Technologists Phlebotomy Section. B. MEDICAL TECHNOLOGIST / Clinical Chemistry CLINICAL LABORATORY SCIENTIST Analyzes body fluids and biochemical substances present to correlate with the patient’s status. Are medical investigators performing sophisticated Quantitative science that deals with the measuring of the analyses using state of the art instrumentation to generate amounts of analytes (important body substances) in body accurate test results. fluids. The work that Medical Laboratory Scientists do can help Testing or chemical analysis of the concentration of diagnose 60%-70% of the patients with the different glucose, cholesterol, vitamins, electrolytes, proteins, drugs, laboratory tests we perform. and other analytes in the body. Needs to be accurate and precise as much as possible as Testing can be done in the Clinical Chemistry Department we are accountable for each result that is sent out e.g. Sugar Levels, Cholesterol Levels, Lipid Levels Involved in all phases of sample analysis ○ from the collection, to the analysis, and to the releasing of the results Hematology Direct and supervise laboratory operations Collaborate in the diagnosis, care, and treatment of Examines blood components to evaluate various blood patients disorders and conditions. Study of blood and blood disorders. 1  Microscopic examination of blood. Microscopic examination of tissue in order to examine any Processed in the Hematology Department. signs of disease. e.g. Complete Blood Count (CBC) which entails Red Blood Studies tissues through biopsy on a cellular level. Cells (RBC), White Blood Cells (WBC), and platelets Testing for cancer and metastasis from the cells. Clinical Microscopy II. HISTORY OF MEDICAL TECHNOLOGY PROFESSION IN THE PHILIPPINES AND ABROAD Involves microscopic examination of body fluids for the identification of abnormalities and pathogens. e.g. Fecal/Stool Analysis, Urinalysis There is no specific date and time when Medical Lab Science started. Medical Lab Science just gradually came together through Immunohematology a series of discoveries that was eventually handpicked into the MLS that we know. Deals with blood typing, cross-matching, and the evaluation of immune-related disorders. It is also synonymous with “Blood Banking,” where patients or donors can donate their blood, have it tested for A. EARLY BEGINNINGS transfusion, and give it to a certain recipient. ​Determine the appropriate blood products that can be transfused to an individual and to procure a safe blood Hippocrates supply. Age of Pericles, 460 BC Antigen-Antibody testing and blood products for transfusion Lived in Classical Greece, during Age of Pericles Greek Physician ​Father of Scientific Medicine Immunology and Serology Established the Basics of Clinical Medicine ○ Examine the patient Uses Antigen-Antibody testing for determination of ○ Observe the symptoms infection ○ Make a Diagnosis The importance of vaccines and how they work can be ○ Treat the patient. found here Founder of Hippocratic School of Medicine Introduced medical terms universally used by physicians Microbiology and Molecular Biology including ○ Symptoms Identifies microorganisms including bacteria, viruses, and ○ Therapy fungi using both traditional and molecular techniques. ○ Diagnosis Studies the cellular and chemical components of bacteria, ○ Trauma parasites, viruses, and etc. ○ sepsis Uses state of the art instrumentation to generate accurate Described a great number of diseases without superstition. identification of these organisms Determined the correlation between anatomical and Identification and growing of bacteria. chemical laboratory findings and the causes of diseases. Ex. Testing COVID-19 samples Triad of Regimen: The use of drugs, surgery, and bloodletting in treating diseases and infection Formulated the Hippocratic Oath: code of ethics for Histopathology practicing physicians Analyzes tissue samples, or representative tissue samples (biopsy), to diagnose diseases and cellular abnormalities under a microscope. The study and diagnosis of diseases of the tissue. 2 Vivian Herrick Early 1550 BC The one who traced the beginning of Medical Laboratory science Determined parasitic infection caused by ○ Ascaris lumbricoides Nematode, Roundworm “Bitok” in Cebuano Figure 3. Scabies in a microscope ○ Taenia species Cestode, Fat Worm, Tapeworm Current record is around 80 ft. long that Prof. Ruth Williams was surgically removed from the Medieval Period, 1098-1438 intestine Published in a book called Ebers Papyrus (or Papyrus Can be found in her book “An Introduction to the Ebers): 3 Stages of Hookworm Infection Profession of Medical Technology” Believed that Medical Technology began during the Medieval Period (1096-1438) ○ Supported by the fact that Urinalysis was a fad during the Medieval Period ○ Medieval doctors associated nearly every known disease with urinary characteristics ○ Some doctors from the Indian subcontinent recorded several observations and determined that urine of certain patients that attracted ants Figure 1. Intestinal Parasite: Ascaris lumbricoides had a sweet taste Anna Falgelson 14th Century Italian Physician Disagreed that it started in the Medieval Period; believed that Medical Technology started in the 14th century Mondino de Luzzi employed Alexander Gillani at the University of Bologna to perform tasks considered to be Figure 2. Intestinal Parasite: Taenia species that of a medical technologist ○ Includes drawing blood and testing it for certain chemicals or analytes (substance or sample Anenzona being analyzed) Early 1550 BC Confirmed beginnings of the study of Medical Technology when Alexander Gilliani died from a lab acquired infection Arabian physician Proved that parasites are the etiological agent of skin diseases, such as scabies Anton Van Leeuwenhoek ○ Caused by an infestation on the skin by human 17th Century, 1632-1723 itch-mite Sarcoptes scabiei ○ Common symptoms are: intense itching and Father of Microbiology pimple-like skin rash People are limited on what they can see He was a 17th century Dutch cloth merchant who discovered the vast realm of tiny microbes Greatest lens maker although untrained in Science 3  Developed a method for making lenses by heating thin filaments of glass to make tiny spheres ○ The lenses were of such high quality that he saw things no one else could ○ Size of a thumb compared to the ones used in laboratories Discovered microscopic life forms Figure 6. RBC, Cocci (purple), and Bacilli (red) (from left to right) Leeuwenhoek and his successors opened up, by far, the largest realm of life All bacteria on Earth outweigh humans by more than 1,100 times (outnumber Humans by an unimaginable margin) ○ Means that if every human on the planet were to step on one side of a giant scale and all the bacteria on Earth would be placed on the other side. The result would be that the humans would shoot violently upwards. Figure 4. Microscopic observation by Anton Van Leeuwenhoek “Scientists’ understanding of microbes has progressed a long way since Leeuwenhoek, including the development of antibiotics against bacteria and vaccines against viruses. But it was Anton Van Leeuwenhoek who opened the eyes of life's vast microscopic realm.” Rudolf Ludwig Virchow 1821-1902 German scientist Emphasized the study of the manifestation of diseases Figure 5. The microscope created by Anton Van Leeuwenhoek and infections, which are visible by means of a microscope at the cellular level. Father of Microscopic Pathology Invented the first functional crude microscope ○ Theory that all cells arise from pre-existing cells Improved the compound microscope ○ Groundwork of cellular pathology: the study of First to visualize and describe the appearance of red disease at a cellular level blood cells, blood flow, and capillaries His work made it more clear that diseases occur at a ○ RBC: circular or discoid in shape cells with a white cellular level central pallor in the center His work led to scientists being able to diagnose diseases First to classify or differentiate bacteria based on their more accurately shape “He allegedly stole the idea from Robert Remak but it ○ Cocci: circles hasn’t been proven” ○ Rods/Bacilli: rectangles Invention of the microscope led to the rapid progress of microbiology and pathology Dr. William Occam 1800 Used laboratory findings as preliminary evidence in diagnosing and evaluating a patient’s disease. 4 Dr. Calvin Ellis University College at Cambridge 1854-1870 1858 Microscopist In 1858, all part-time clinicians were reinforced as Dean of Harvard Medical School teachers by whole time professional units applying the Worked at the Massachusetts General Hospital new laboratory methods to medical practice and First to utilize the microscope in examining specimens in medical teaching at the University College at Cambridge the process of evaluating disease and infections. Had a special care for the microscopic department We must place the diagnosis of disease upon a scientific Medical Education Reforms basis ○ “Nothing must be regarded as settled until it is Science was highly developed through medical education proven” reforms “Snap” diagnoses 1871 ○ Aren’t to be respected ○ Harvard University Introduced reforms ○ Intuition = Charlatanism emphasizing on “learning by doing” ○ Every step in the diagnosis should be proven ○ Followed by University of Pennsylvania University of Michigan Baron Karl Wilhelm Von Humboldt 1876 Apothecaries Act of 1815 ○ Opening of John Hopkins School of Medicine ○ Provided 2 years of instruction in the basic Apothecary: chemist or pharmacist sciences. ○ They can mix multiple medications together as requested by a physician Dr. William H. Welch Initiated and formulated the Apothecaries Act of 1815 ○ The act was utilized to formally use laboratory Late 1870’s findings in the treatment of diseases and ○ Along with Michell Prudden and their students infections throughout England and Wales. ○ The first to apply clinical pathology to medical ○ Required instruction in anatomy, botany, diagnosis. chemistry, material medical, and “physic.” 1876 ○ Involves six months of practical working ○ Worked alongside Julius Cohnheim and Rudolf experience in a hospital. Virchow in Germany Member of the Parliament of the UK 1878 ○ Made the act to introduce compulsory ○ Established another laboratory at the Bellevue apprenticeship and formal qualifications for Hospital Medical College apothecaries ○ He used it for teaching and giving microscopical “You should be educated before you become an courses. apothecary” 1884 ○ Became the first professor of pathology at John Hopkins University B. MEDICAL TECHNOLOGY MODERN ERA IN THE UNITED STATES 1893 ○ Became the first dean of John Hopkins School of Medicine Science was highly developed through medical education reforms Late 19th Century Emergence of clinical laboratories in the US occurred Figure 7. Blood counting machine 5 Dr. William Osler William Pepper Laboratory (clinical laboratory) opened at the University of Pennsylvania (acc. to Comac’s article) Father of Modern Medicine: one of the greatest diagnostician to wield a status quo 1880 1900 ○ Insisted that students learn from seeing and talking to patients US Census listed 100 male technicians ○ Establishment of medical presidency ○ Evidence that clinical laboratories had been ○ Teaching hard work, medical history and life long established in 1896 learning 1920: increased to 3,500 male technicians A clinical professor at the University of Pennsylvania 1922: 3,035 hospitals had clinical laboratories Hospital ○ Introduced and used the microscope and blood counting machine in the hospital-based Reference Book/Guide for Laboratories laboratory 1908 ○ However, these instruments were not well understood by physicians. “Manual of Chemical Diagnosis” ○ Approximately 8% of his publications dealt with ○ Publication of a laboratory guide by Dr. James hematology, oncology, or the microscope C. Todd ○ Became the standard reference for all laboratories throughout the 60s, 70s, and Dr. Silas Douglas perhaps until the 80s until the names became buried and forgotten by generations of Nation’s First Laboratory at the University of Michigan successive editors, although historical hommage opened is in the introduction ○ Chemical laboratory related to medicine “Clinical Diagnosis by Laboratory Methods” ○ Considered the largest and best-equipped ○ Retitled on the 6th edition Dr. Douglas was the first to give laboratory instructions ○ Collaborated with with Dr. Arthur Stanford ○ Edited by Davidson and Henry 1887 National Insurance Act 1911 University Hospital in Philadelphia was established ○ Built by Dr. Douglas, Dr. Osler, and Dr. George Complete revolution in the development of laboratory Dock science ○ Followed later at the University Hospital in Ann Formally approved by the Insurance Act as the basis of Arbor diagnosing diseases ○ Dr. Osler ordered and mandated all patients to undergo routine lab examinations, including urinalysis and blood examinations. World War I John Burdon-Sanderson 1914-1918 ○ Concluded the use of laboratory methods elucidates or explains pathological problems World War I was an important factor in the growth of the clinical laboratory and produced great demands for technicians Opening of Clinical Laboratories in the US ​Medical Laboratory was practiced first before it was made 1896 into a course; people only realized its importance later on especially during World War I John Hopkins Hospital opened its first clinical laboratory Practicing physicians began to teach their assistants to do ○ By Dr. William Osler the test for them ○ 12x12 size room ○ Equipped at a cost of $50 (currently PHP2,500) 6 State Legislature of Pennsylvania US Bases Built in Leyte 1915 1944 Law was enacted requiring all hospitals and institutions to The United States brought members of the healthcare have complete laboratory facilities with full–time team to the Philippines to resolve the health problems of technicians soldiers and Filipinos during World War II (1939-1945). 2-Year College Education First Clinical Laboratory in the Philippines 1940 1945 US required a standard 2-year curriculum on collegiate By the end of World War II, the first clinical laboratory in education with 1-year actual training in the laboratory the Philippines “26th Medical Laboratory of the 6th for the preparation on its practice United States Army” was built and located at Quiricada Street, Sta. Cruz, Manila. The laboratory still stands in Manila, but is now known as “The Public Health Laboratory” Bachelor of Science Degree 1950 Training as Lab Technicians February 1944 Standard curriculum was formalized for a Bachelor of Science Degree The 26th Medical Laboratory of the 6th United States Army Onwards from 1950, more laboratories and more provided 1-year training to high school graduates to universities offered the course of medical technology in the work as laboratory technicians. US Clinical Laboratory Endorsement June 1945 III. MEDICAL TECHNOLOGY IN THE PHILIPPINES The staff of the 26th Medical Laboratory of the 6th US Army left the facility after endorsing the newly established World War II Clinical Laboratory to the National Department of Health. 1939-1945 On December 7, 1941, Pearl Harbor was invaded by Japan. Dr. Pio de Roda Three days after, Japan invaded the Philippines causing September 1945 the wrath of the US to flare up. Sickness and death due to illness were rampant Filipino Physician and Bacteriologist ​“Closed system” blood collection Took the effort to preserve the remnants of the said ○ Blood was collected and contained directly to the laboratory with the help of Dr. Mariano C. Icasiano (first tubes for better storage and preservation of City Health Officer of Manila). elements in the blood ○ Relatively safer as to decrease exposure to air ○ Less chances of infection and contamination Public Health Laboratory Instrumentation advanced and automation was used and October 1, 1945 quality controlled problems became more common A medical laboratory, Public Health Laboratory, was formally organized and re-established by Dr. Pio de Roda with the help of Dr. Prudencia Sta. Ana. 7 Free Training of Medical Technicians Dr. Antonio Gabriel & Dr. Gustavo Reyes 1947 1957-1958 Free training of medical technicians under the Offered Medical Technology as an elective subject to 4th supervision of Dr. de Roda and Dr. Prudencia Sta. Ana. and 5th year B.S. Pharmacy students in UST. Both are members of the UST Pharmacy Faculty. Rev. Fr. Lorenzo Rodriguez later on offered pharmacy as Dr. Willia Hilgert Hedrick a course due to its popularity among pharmacy students 1953 Founder of Medical Technology Education in the Medical Technology Course Philippines 1959-1961 American medical practitioner and missionary of the Seventh Day Adventist June 17, 1959 With the help of Mrs. Antoinette Mckelvey, prepared the ○ The Bureau of Private Education officially course curriculum approved the first 3-year academic course Established the first complete laboratory in Microbiology, June 19, 1960 Parasitology, and Histopathology at the Manila Sanitarium ○ The 4th year as an internship year was Hospital approved ○ The permit was issued in Centro Escolar University (CEU) Delegated Mrs. Purificacion Sunico-Suaco to work on offering the Dr. Prudencia Sta. Ana medical technology course at the said 1954 university. Recognition permit was later granted Dr. de Roda instructed Dr. Sta. Ana to prepare a syllabus by the Bureau of Education and had its for training medical technicians first batch of graduates in 1962 A 6-month training period was required June 14, 1961 A certificate was issued to successful trainees. ○ B.S Medical Technology course was approved Dr. Tirso Briones later joined the two doctors ○ Full recognition of the 4-year BSMT course at “The training program didn’t last long since the Philippine UST Union College and Manila Sanitarium Hospital started to offer the first bachelor of B.S Med Tech” Far Eastern University (FEU) Philippine Union College 1961 Adventist University of the Philippines 1954 FEU School of Medical Technology was opened under the joint auspices of the Institute of Medicine (now known as The first 4-year B.S. Medical Technology Course was Nicanor Reyes Medical Foundation) and Institute of Arts offered by Philippine Union College of Baesa, Caloocan, and Sciences. Rizal through its sister company, the Manila Sanitarium Produced its first graduates of BSMT in 1963. Hospital. Followed by several colleges and universities throughout the country which began offering the Bachelor’s degree in Medical Technology Dr. Jesse Umali 1956 The first student who graduated BSMT in the Philippines Later went on to pursue medicine and became an obstetrician-gynecologist. Owner of OMEGA LAB and Vita Cruz 8  IV. VELEZ COLLEGE histopathology, and high-performance chromatography for drug analysis. All laboratory methods comprise scientific procedures, College of Medical Technology irrespective of whether the technology is conventional or 1967 automated. MT is a science because it employs scientific investigation Enrollment with 104 female students and 31 male to come up with findings students Procedures help both patient and physician with The pioneering faculty members came mostly from the meaningful diagnostic results/findings Cebu Institute of Medicine (CIM). In short, substantial procedural pertains to all scientific Known to produce board topnotchers and almost always activity involved with a very high passing rate (95% above), compared to e.g. Laboratory Diagnosis, Scientific Method the national passing rate in the licensure examination (MTLE) given by Profession Regulation Commission (PRC). Laboratory Diagnosis Dr. Ibarra T. Panopio Formulation of Problem ○ Make an observation First Dean of the College ○ Example: To determine what a px blood glucose A US-trained pathologist concentration is Head of Pathology in Cebu Velez General Hospital and Hypothesizing Perpetual Succour Hospital ○ Propose a hypothesis that is a list of potential answers to the problem ○ Scientific guess or theory ○ Example: To test if there is a significant relationship between a px’s glucose INTRODUCTION TO MEDICAL TECHNOLOGY: NATURE AND SCOPE concentration and his/her carb intake OF MEDICAL TECHNOLOGY / MEDICAL LABORATORY SCIENCE Experimentation (PART 2) ○ Test the hypothesis through experimentation ○ Example: Perform a laboratory test to determine the blood glucose concentration I. MLS AS A MULTIFACETED CLINICAL LABORATORY SCIENCE Presentation, Analysis, and Interpretation of Data ○ Interpret a laboratory result ○ If a lab result is not normal, it can either be an Multifaceted: having many aspects. increase (hyper) or decrease (hypo) MT is not confined to having just one accent. ○ Example: Common stigma: Medtechs just work in the laboratory. If the patient’s blood glucose However, as MLS, the work can extend beyond or overlap concentration is increased, then it might many fields be the effect of their increased “There is more to medical technology that meets the eye.” carbohydrate intake, and the patient is hyperglycemic. If the patient’s blood glucose A. SUBSTANTIAL PROCEDURAL concentration is decreased, then the patient is hypoglycemic. Substantial Procedural ○ Substantial: Essential, very important Conclusion and Recommendation ○ Once the interpretation has been done, the ○ Procedural: Generating by means of procedure results are ready to be given to the patient Procedure of Scientific Activities ○ Example: The px is hyperglycemic. The result is Medical Technology uses a wide range of technologies to forwarded to the attending physician, who will diagnose certain diseases and infections. prescribe proper medication and provide medical Such technologies include the use of an autoanalyzer in advice. sophisticated tertiary category, flow cytometry in 9  MTs can only give the patient the results of our findings from the samples, but never diagnose ○ Normal ○ Increased/Decreased ○ Positive/Negative ○ Presence/Absence of Something B. INVESTIGATIVE COMPLICITY Figure 8. Susceptibility Testing Paramount field of scientific investigation ○ Paramount: of highest importance Susceptibility Testing Encompasses scientific inquiry of various societal health problems Used to determine Involves a wide range of laboratory investigations ○ the potential effectiveness of specific antibiotics ○ Drug Testing to rule out drug addiction on the bacteria ○ Molecular and Nucleic Acid Analysis for genetic ○ if a bacteria has developed resistance to certain disease diagnosis antibiotics ○ Forensic Investigation Whole Plate: bacteria is inoculated into the culture medium ○ Scientific Research White Circles: are antibiotics Researchers are essential for ○ providing primary research ○ technical support for developing core medical technologies The technologies we enjoy today are products of Zone of Inhibitions: transparent halo around antibiotics investigative research ○ With: bacteria being grown in the culture is MLS is part of investment of healthcare susceptible/sensitive to that specific antibiotic ○ Without: bacteria is resistant to antibiotic Results of tests can be used to select drugs that will likely be most effective in treating the infection C. INTERMEDICAL PROCEDURAL INTERFERENCE D. ASSIDUOUS PARTNER Intervention in Medicinal Procedures In every aspect of medical procedures, a physician always resorts to the laboratory findings in giving the right Most Notorious Nature of MLS: Explicit application of prognosis of diseases and infections. Science and Technology Example Science ○ A bacterial infection needs a microbiological ○ Typically inquiry-based analysis. ○ Builds knowledge slowly through repetitive ○ Following the procedure, the assigned medical inquiry and sophisticated methods technologist may provide scientific findings ○ Scope is infinite supporting the use of specific antibiotics that Technology may be prescribed by the physician. ○ Typically application-based ○ Applies scientific knowledge through experiments, practice, and trial and error using creative, social, and political methods ○ Scope is well-defined and has a specific focus Science and Technology are inseparable and must be learned simultaneously MLS embraces the techniques and procedures laid down by science and technology 10  Practical Applications of MT Procedure so rapid during the 2nd half of this century, that we often ○ Use of Polymerase Chain Reaction (PCR) for DNA describe it as “living in the time of biological revolution”. amplification This leads us to the second aspect that comprises the ○ Use of High-Performance Liquid nature of MLS as a prelude to biomedical research. Chromatography (HPLC) or an automated Rapid advances in biomedical research have indeed instrument to detect for the presence of certain stimulated the development of numerous effective drugs medical technologies, but their translation into clinical use E. CIRCUMSTANTIAL MEDICAL EVIDENCE has raised complex medical, economic, and social issues. Evidentiary information in medicine that is provided by A. INSTRUMENT SELECTION, OPERATION, MAINTENANCE, AND MLS TROUBLESHOOTINGS MT services assist physicians and healthcare providers. Laboratory findings as proof on medical findings and prognosis to assist physicians. It is mandatory in the field of medical technology that MT is the clinical eye of physicians instrumentation must include the entire process of Example selection, operation, maintenance, and troubleshooting. ○ When blood glucose determination has been Life-Blood Theory: offers an explanation for this basic conducted and the lab results reveal that the knowledge in instrumentation, especially in bioresearch, patient is hyperglycemic because the blood particularly in dealing with cell culture and stem cell glucose concentration is above the upper limit of therapy and management. the reference values. A clinical laboratory cannot exist without these ○ The finding of hyperglycemia is then correlated technologies, hence, the phrase, “medical technology”. with the clinical manifestation as observed and The discipline has evolved from the use of a single diagnosed by the physician. microscope to actually having to operate a machine. ○ The results can be established as evidentiary It is through these instrumentations that clinical information that the patient might be diabetic. laboratories can be of service to patients in need. In Figure 9, the blood glucose concentration is above the In almost all modern laboratories, it is the machines that do upper limit of the reference values. the testing of patients’ samples. ○ It is indicated by the red capital H Thus, it is very important to select the right machine and ○ Meaning the result is high or greater than the to consider how easy it is to operate, to maintain, and to normal value troubleshoot. B. UTILIZATION OF A COMPUTERIZED INFORMATION SYSTEM FOR DATA INPUT, RETRIEVAL, AND ANALYSIS Automation and computer literacy is the mantra of the present generation. Automation extends to clinical laboratories as well, Figure 9. Blood Glucose Determination especially those laboratories employing LIS where services are offered through networking. Data input, retrieval, and analysis is better nowadays through the utilization of a computerized information system. II. MT AS A PRELUDE TO BIOMEDICAL RESEARCH Laboratory Information Management System (LIMS or LIS): a computerized system for laboratory data. The use of a computerized system is becoming more common in laboratories around the world. The increase of fundamental knowledge concerning Appropriately designed and installed LIS brings accuracy human health and the mechanisms of disease has been and accessibility to the flow of samples and data in a clinical laboratory. 11  LIS is basically like the Learning Management System E. CLINICAL TRIALS (LMS) that we are currently using, but its purpose is more on keeping patient data and results rather than student activities and scores. Clinical Trials: most important concerns of bioresearch Clinical trials are mandatory steps, especially during the process of proving the efficacy and effectiveness of the C. QUALITY CONTROL, QUALITY ASSURANCE, AND PERFORMANCE proposed vaccines or herbal plants, for example. IMPROVEMENT Performed in clinical laboratories. Therefore, good instrumentation, component technologists, and standardized procedures are required. Quality control and quality assurance have been established in every aspect of clinical laboratory. It is usually carried out using a set of standard, control, III. THE SCOPE OF MT and pooled sera for clinical chemistry purposes QC is performed daily, weekly, or monthly depending on either A. INVESTIGATING NOSOCOMIAL INFECTIONS ○ the working status of the instrument ○ viability of the reagents and chemicals ○ in case of a new procedure, especially Nosocomial: when patients contract an infection during a when proposing bioresearch project prolonged hospital stay when the medical technologist is a new The process of investigation is within the function of hire or the researcher is proposing the medical technology. applicability of the proposed Investigation is usually carried out by microbiological research procedure analysis through isolation and identification. Once the causative agents have been identified, the next step is to perform culture and susceptibility testing, D. INVENTORY CONTROL which then help determine which broad spectrum antibiotic may inhibit or kill the causative agents of infection. B. EXTENDING SERVICES TO MOLECULAR ENGINEERING Essential part of an effective healthcare technology management. In order to be effective in performing lab procedures, the Within the ambit of medical technology service function, it inventory must be updated continually so that it provides, is noteworthy to mention that molecular genetics or at any given movement, a correct look at the status of molecular engineering such as gene therapy, diagnosis, medical equipment within the healthcare facility. and screening have been embraced in the field of A set of laboratory procedures are used for all bioresearch medical technology. procedures. The inventory of procedures and instruments to be used control the entire flow of bioresearch. C. INCLUDING MT IN PUBLIC HEALTH EDUCATION THROUGH Without this inventory, one cannot ensure the projection of SEMINAR/WORKSHOPS accurate and reliable results. e.g. While culturing green algae, the inventory of materials and procedures to be used determine the feasible As a health practitioner, the medical technologist imparts attainment of bioresearch objectives. education as mandated by the Commission on Higher A simple error in inventory control can already make a big Education (CHED) in the Philippine setting or Ministry of impact on patient care. Health in other Asian countries such as Hong Kong. It is one of our duties to spread public health information and we learn or get the knowledge by taking part in seminars or workshops organized by accredited organizations We have the responsibility to combat fake news on social media regarding public health 12  D. BIOLOGICAL AND MEDICAL RESEARCH It is within the function of medical technology to screen blood donors, and perform cross matching and blood typing before blood transfusion. So, in terms of scientific research, medical technology as a Not a common knowledge because many people think that laboratory medicine, can provide solutions to health this is the work of nurses and volunteers, but this is actually problems and issues. part of our job as medical technologists. J. INNOVATIVE TECHNIQUES AND TECHNOLOGY E. NEW DISCOVERIES THROUGH RESEARCH Medical technology encompasses innovative techniques and technologies in laboratory diagnosis. Scientific research offers innovative techniques and It has pioneered new technologies and techniques to technology, which is pivotal to the role of Medical provide a wide spectrum of laboratory services. Technology. K. PREVENTION AND CONTROL OF DISEASES AND INFECTION F. PIONEER IN LABORATORY MEDICAL DIAGNOSTIC SERVICES Medical technology serves as a clinical eye of a medical Medical technology employs diagnostic procedures. doctor, and provides information on the prevention and control of diseases and infection. G. LABORATORY DIAGNOSIS IV. ROLES OF MT/MLS PROFESSION IN THE DIAGNOSIS AND TREATMENT OF DISEASE Laboratory diagnosis involves a series of procedural methods that are performed in a clinical laboratory. It employs sophisticated methods or procedures, wherein A. EXAMINATION OF LAB SPECIALIST the findings can be potential evidence in evaluating the health status of the patient. We work along pathologists in helping them diagnose Registered MT’s assigned to a clinical laboratory are diseases. We do not release lab results without their equipped with technical skills and theoretical knowledge approval. to examine samples of blood and other body fluids. Results are submitted to chief pathologist for review before they are recorded and released H. EVALUATING THE EFFICACY OF DRUG TREATMENT THROUGH MICROBIOLOGICAL ANALYSIS Blood Chemical Constituent Analysis The department of microbiology deals with microbiology For the determination of blood chemical constituent analysis, including the concentrations ○ identification of microbes, through culture and Basic concept of clinical chemistry staining morphology, biochemical properties and Proteins, lipids, carbohydrates, hormones, vitamins, drugs, reaction electrolytes and non-protein compounds ○ performing quality control procedure or All of these can be tested in your blood by Medical monitoring Technologists or Medical Laboratory Scientists I. ENGAGING IN BLOOD DONATION AND BLOODLETTING SERVICES FOR THE PUBLIC 13 Fecalysis (S/E) Clinical Microscopy To test samples for presence or absence of parasitic ova, larva and adults. These organisms are commonly observed when performing physicalities or stool exams. Adult forms are quite big but immature forms are not. Fecalysis is performed to confirm the presence or absence of the parasite in our body. Figure 10. Ascaris Lumbricoides Ova or Egg Figure 11. Dipstick Urinalysis (U/A) Clinical Microscopy To test urine chemicals and formed elements Common and simple because the sample is easy to obtain and urinalysis uses strips. Each of these colors correspond to a specific parameter. Dipsticks: strips dipped in urine Parameter: a property or compound in urine that we are testing for Common parameters include: ○ pH ○ Specific gravity ○ Glucose ○ Protein ○ Bilirubin ○ Ketones If a parameter is found abnormal in urine, it will allow the MedTech to give the health practitioner an idea of the patient’s health status. Change of color in each parameter chemical pad is observed in order to determine which ones are normal and not. 14  Crossmatching (Xm) Microbiological Analysis To test samples for the identification of microbes and antibiotic reactions. Fundamental Steps: ○ Culture ○ Biochemical Tests ○ Susceptibility Testing We use different types of media for different types of bacteria, which is why there are different color backgrounds Figure 14. Gel Card Method Culture: grow bacteria or fungi and sometimes viruses in enriched media contained in blades. Perform blood compatibility on samples Testing the patient’s serum or plasma with the donor’s blood Crucial to avoid complications after blood transfusion Positive Result (left): blood transfusion is not possible, hence incompatible (graded as 4+) Negative Result (right): blood transfusion is possible, hence compatible Figure 12. Blood Agar Biochemical Tests: to test for biochemical reactions Histopathological Analysis ○ Not a test belonging to clinical chemistry. ○ Biochemical test is testing for the chemical Detection and identification of abnormalities found on compounds produced by the bacteria. tissues ○ Specific bacteria produce a pattern, through this, Blood is a connective tissue we can identify the bacteria that's causing the In histopathology, we get samples when we perform patient's disease. biopsies or organ removals, the process of which are as follows: ○ Cut a little bit from tissue ○ Fix tissue in formalin ○ Process using different chemicals ○ Mount on paraffin ○ Cut and place them on slides ○ Then stain them ○ Pathologist would check for tissue abnormalities Figure 13. Media That We Use To Do Chemical Testing Susceptibility Testing: to determine the potential effectiveness of a specific antibiotic on the bacteria. ○ A way to find multidrug-resistant strains ○ If a bacterium is already strong or resistant, it will not be killed by the drug that's supposed to kill it. ○ Never self-medicate, especially with antibiotics. ○ Bacterium is already strong or resistant because it cannot be killed by the drug. Figure 15. Tissues Viewed Under A Microscope 15 Serological & Hematomical Analysis Figure 17. Red Blood Cells and Diff. Types of White Blood Cells Serological: the detection of antigen and antibody reaction in vitro (outside the body) B. SETTING AND IMPLEMENTING A QUALITY CONTROL PROGRAM Hematological: the determination of blood formed element levels Med techs are frontliners who not only collect the swab Every section in a clinical laboratory must have its own samples but also perform the test during the pandemic. quality control program and implementation is usually Example: Covid Antibody Test done periodically ○ Has labels such as C, IgG, IgM, and S This is done so test results are as accurate and precise as ○ C and S: Control and Sample possible to avoid false results ○ IgG and IgM: antibodies produced by the body Quality control procedure in a school-based laboratory that may be present or absent in the sample may include when a patient is currently or has been infected ○ standardization of solutions by the virus, depends on which antibody is ○ calibration of instruments and apparatuses positive Example: ASO Titre / Anti-streptolysin O Titre ○ Help in the diagnosis and treatment by means of hematological analysis C. LABORATORY SAFETY MEASURES ○ CBC: most common test procedure done in the laboratory ○ At least two microliters of blood sample can say As a mandate, all registered medical technologists must that one is anemic or suffering from set and practice laboratory safety measures in a clinical polycythemia Vera laboratory Submit results to Chief Pathologist for review before This work is more transparent in a school-based release laboratory than clinical laboratory because the students are affected to a greater extent, not being fully aware of the laboratory safety procedures This is unlike in a clinical laboratory, where laboratory safety procedures are well disseminated to all practicing medical technologists through a work orientation session prior to their hiring and assuming their positions in the laboratory D. REGULAR CALIBRATION OF INSTRUMENTS AND EQUIPMENT This is required to test the workability of the instruments e.g. Optimizing your phone’s performance by deleting running apps Figure 16. COVID-19 Test Kits Instruments are calibrated by the supplier annually They include the spectrophotometer, autoanalyzer, electrophoresis apparatus, autoclave, incubator in both school-based and hospital-based laboratories It is necessary for the medical technologists to record the calibration period and the name and credentials of the person calibrating the instruments E. OPERATION OF LABORATORY INSTRUMENTS RANGING FROM A SIMPLE MICROSCOPE TO COMPLEX AUTOMATED EQUIPMENT 16  These operations and manipulations (quality control and calibration) of instruments are routine for medical technologists, whether it is part of their daily work or a case of troubleshooting The onus is on the assigned medical technologist to report major issues, such as defective instruments, to the supplier’s technical team and to the pathologist or concerned program head F. CONDUCTING OF RESEARCH ACTIVITIES AND EXPLORATION OF NEW DISCOVERIES IN THE FIELD OF SCIENCE AND BIOTECHNOLOGY Research activities done by medical technologists assigned to a school-based laboratory are carried out for professional growth They also assist medical technology students in doing their undergraduate thesis The involvement of the medical technologists in research activities is usually supported by the institution, as the research outcome should benefit the entire institution concerned G. COLLECTION OF LABORATORY SPECIMENS FOR EXAMINATION In a clinical laboratory ○ The standard operating procedure (SOP) os that the medical technologist should observe the right protocol in specimen collection and processing In a school-based setting ○ The collection of specimens is usually carried out by the students, but under the supervision of their professors who are also registered medical technologists ○ The specimens collected are usually the subject of the experimentation in a school-based laboratory ○ These include blood, feces, urine, saliva, and microbial cultures ○ Precautionary measures are observed during such experimentation The handling and management of laboratory specimens are monitored by the government agency affiliated with the concerned institution 17