Introduction To Medical Technology PDF

INTRODUCTION TO MEDICAL TECHNOLOGY: SCOPE, NATURE AND HISTORICAL PERSPECTIVE MARK ANTHONY R. LOBIGAS, RMT PMLS Lecturer LEARNING OBJECTIVES:  Trace the history of Medical Technology.  Understand the nature, scope, and characteristics of Medical Technology....

INTRODUCTION TO MEDICAL TECHNOLOGY: SCOPE, NATURE AND HISTORICAL PERSPECTIVE MARK ANTHONY R. LOBIGAS, RMT PMLS Lecturer LEARNING OBJECTIVES:  Trace the history of Medical Technology.  Understand the nature, scope, and characteristics of Medical Technology.  Internalize the different roles a medical technologist is playing in the clinical laboratory setting, and in the society.  Be knowledgeable with the different sections in the laboratory.  MEDICAL TECHNOLOGY IS ALSO KNOWN AS: Clinical Laboratory Science Medical Laboratory Science What is Medical Technology? Ruth Heinemann -is the application of natural, physical and biological sciences to the performance of laboratory procedures which aid in the diagnosis and treatment of disease. Anne Fagelson -is the branch of medicine concerned with the performance of laboratory determinations and analyses used in the diagnosis and treatment of the disease and maintenance of health. Walters -is the health profession concerned with performing laboratory analyses in view of obtaining information necessary in the diagnosis and treatment of disease as well as in the maintenance of good health. What is Medical Technology? RA 5527 (The Philippine Medical Technology Act of 1969) -is an auxiliary branch of laboratory medicine which deals with the examination of tissues, secretion and excretion of human body and body fluids by various chemical, microscopic, bacteriologic and other medical laboratory procedures which will aid the physician in the diagnosis strictly and treatment of disease and in the promotion of health in general. What is common among them? Performing laboratory procedures (samples) Analysis (results) Diagnosis and treatment (disease) CLINICAL LABORATORY CLINICAL LABORATORY HISTORY OF CLINICAL LABORATORY SCIENCE HISTORY OF CLINICAL LABORATORY SCIENCE BRONZE AGE The first accounted records of parasites & parasitic infections were documented in the earliest archaeological materials Mysticism, magic, & supernatural beliefs dominated this period Priests were regarded as healers & exorcists There was no clear knowledge regarding the anatomy of internal organs, but it was generally known that the heart beat or throbbed HISTORY OF CLINICAL LABORATORY SCIENCE IRON AGE Practices in disease prevention improved Ancient physicians based their first medical diagnoses on what they could observe with their eyes & ears The oldest known test on body fluids was done on urine In ancient times, Greek physicians made diagnoses by pouring urine on the ground & observing whether the urine attracted insects HISTORY OF CLINICAL LABORATORY SCIENCE Around 300 BC Ancient Greek physician first had the examinations of human body fluids Hippocrates, considered the “father of medicine”, investigated and studied the FOUR HUMORS – blood, phlegm, yellow bile, black bile URINE One of the body fluids that underwent examination, Hippocrates concluded that the appearance of bubbles, blood and pus in urine indicated kidney disease Uroscopy - “water casting” in Medieval Europe was widely practiced. Patients submitted their urine specimen in decorative flasks HISTORY OF CLINICAL LABORATORY SCIENCE 18th Century  Mechanical techniques and cadaver dissection were used to provide a more objective and accurate diagnosis and to understand the insides of the body. 1880 Emergence of the causative agents of tuberculosis, diphtheria, and cholera and its detections in the late 1890s. HISTORY OF CLINICAL LABORATORY SCIENCE 19th Century  Physicians began using machines to diagnose and conduct therapy.  John Hutchinson: Spirometer, measures vital capacity of the lungs  Jules Herisson: Sphygmomanometer Early 20th Century ELECTRON MICROSCOPE use for visualization of small cells including tumor cells and these discoveries persisted through robotics, keyhole surgery procedures, genetic engineering, and telemedicine (information technology) HISTORY OF CLINICAL LABORATORY SCIENCE 20th CENTURY TO PRESENT This era of sophistication Discovery of powerful antibiotics against infectious agents. Penicillin & Streptomycin were examples of these antibiotics by Alexander Flemming & biochemists Selman Waksman, Alber Schatz, & Elizabeth Bugie. In 1908, James Campbell Todd wrote a book entitled Clinical Diagnosis: A Manual of Laboratory Method. Later, the book was edited by John Bernard Henry. It was then named Clinical Diagnosis & Management by Laboratory Methods. This book became the fundamental source in the practice of laboratory medicine HISTORY OF MEDICAL TECHNOLOGY IN THE PHILIPPINES HISTORY OF MEDICAL TECHNOLOGY IN THE PHILIPPINES 6TH Infantry Division of the US Army Established the first clinical laboratory in the Philippines located at Quiricada St., Sta. Cruz, Manila Now known as Manila Public Health Laboratory Dr. Pio de Roda (October 1, 1945)  Re-organized the abandoned laboratory when the US army left, with the help of Dr. Mariano Icasiano who was a Manila City Health Officer at the time  Along with Dr. Prudencia Sta. Ana, they conducted a training program for aspiring laboratory workers and organized a six-month formal syllabus for the training program with certificate for the trainees upon completion. Eventually, Dr. Tirso Briones joined them. HISTORY OF MEDICAL TECHNOLOGY IN THE PHILIPPINES 1954  Approval of the four-year course in Bachelor of Science in MT by the Bureau of Private Education  Manila Sanitarium and Hospital (MSH) opened the first school of Medical Technology under the management of Mrs. Willa Hedrick  The Philippine Union College (now Adventist University of the Philippines) acquired the MedTech School of MSH Dr. Jesse Umali First graduate of the Medical Technology program, now an OB- gynecologist HISTORY OF MEDICAL TECHNOLOGY IN THE PHILIPPINES 1957 MedTech program was initially offered as an elective for Pharmacy students in UST 1960 CEU offered Medical Technology program First batch graduated in 1962 1961 MedTech was officially declared as a program in UST  HISTORY OF MEDICAL TECHNOLOGY IN THE PHILIPPINES University of the Philippines – offered the same course but the degree is conferred to as BS in Public Health.  NATURE OF THE MEDICAL TECHNOLOGY  NATURE OF THE MEDICAL TECHNOLOGY Program course shall be called as: Bachelor of Science in Medical Technology Bachelor of Science in Medical Laboratory Science It is a four year program consisting of a one year internship with rotational duties in different sections during the 4th level in a CHED- accredited training laboratory. A licensure examination is given to all applicants for registration as Medical Technologist.  NATURE OF THE MEDICAL TECHNOLOGY Medical Technology: To improve the detection, diagnosis, treatment, and monitoring of diseases which holds linkages with many other disciplines for specific diagnostic or therapeutic purposes. Its nature is contextual, interdisciplinary, interdependent, and system-based.  NATURE OF THE MEDICAL TECHNOLOGY Clinical Laboratory  Performs the testing in detection, diagnosis, and treatment of diseases.  70% of all decisions performed by medical doctors are based on laboratory test results,  The place where specimens collected from individuals are processed, analyzed, preserved, and properly disposed. Clinical Laboratory Scientists  The one who does perform these tests, usually look for the presence of bacteria, parasites, and other microorganisms in the body. They also prepare specimens for examination, to count cells, and look for abnormal cells in the blood and other body fluids. R.A. 5527 (Medical Technology Act of 1969) The act governing medical technology profession in the Philippines. ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Perform Clinical Laboratory Testing Must be capable of performing the most basic to the most advanced laboratory tests. Should be able to conduct tests such as urinalysis and stool examination, should be able to perform hematologic, microbiologic, serologic, chemical and other procedures in the different areas of laboratory science.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Perform Special Procedures Perform special procedures in diagnosing diseases. These may include the operation of advanced diagnostic equipment. Special procedures can also include molecular and nuclear diagnostics.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Ensure Accuracy and Precision of Results Should be conscious of the accuracy and precision of both the testing process and its results. Accuracy and precision impact the interpretation of the results by the physician to provide proper medication in the treatment of diseases.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Be Honest in Practice Must value honesty, particularly in conveying or reporting the results of any laboratory procedure. Should act according to the Medical Technology profession’s Code of Ethics and his or her pledged Oath of practice. A medical technologist must be honest at all times in the conduct of test procedures to come up with accurate and precise results.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Ensure Timely Delivery of Results Must be aware of the urgency of delivering results on time, especially in cases that require urgent treatment. When physicians request immediate result, one should take notations on “STAT” or even observe the source of the requests  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Demonstrate Professionalism Must be able to perform his or her functions according to the professional Code of Ethics for medical technology professionals. Should be aware of the laws and regulations governing the practice of medical technology and should not exploit its function beyond its boundaries.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Uphold Confidentiality Ensuring confidentiality is one of the core duties within the medical practice Confidentiality requires health care providers to keep a patient’s personal health information private unless the patient consents to release the information.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Collaborate with Other Health Care Professionals A requirement to collaborate with other health care practitioners in order to build a well-functioning team. Collaboration is the act of working together in order to achieve a desired outcome. Teamwork is a must.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Conduct Research MedTechs must also be engaged in research activities to update their skills.  ROLES AND RESPONSIBILITIES OF MEDICAL TECHNOLOGY PROFESSIONALS Involvement in Health Promotion Programs Cooperate with other health care professionals in health promotion campaigns such as promoting the ideal attitudes on hygiene, community sanitation, waste segregation, and disease prevention Offer free laboratory testing such as blood typing, urinalysis, fecalysis, blood sugar testing, cholesterol testing, and other tests beneficial to the entire community. Collaborate with other health care professionals once diagnoses are done.  SECTIONS OF THE CLINICAL LABORATORY SECTIONS OF THE CLINICAL LABORATORY CLINICAL CHEMISTRY Intended for the testing of blood and other body fluids to quantify essential soluble chemicals including waste products useful for the diagnosis of certain diseases. Blood and urine are specimens used in this section. FBS, Lipid Profile, SGPT, SGOT, Liver Profile, Creatinine, BUN, BUA, TPAG, Electrolytes SECTIONS OF THE CLINICAL LABORATORY CLINICAL MICROBIOLOGY Subdivided into four sections: Bacteriology, Mycobacteriology, Mycology, and Virology. At present, the work in this section is more focused on the identification of bacteria and fungi on specimens received. Although not as automated as clinical chemistry, automated instruments are available such as those used for blood culture and antimicrobial susceptibility testing.  SECTIONS OF THE CLINICAL LABORATORY HEMATOLOGY AND COAGULATION STUDIES Deals with the enumeration of cells in the blood and other body fluids. Complete Blood Count, Hemoglobin, Hematocrit, WBC Differential Count, Red Cell Morphology and Cell Indices Coagulation studies focus on blood testing for the determination of various coagulation factors.  SECTIONS OF THE CLINICAL LABORATORY CLINICAL MICROSCOPY Determines the macroscopic appearances of urine such as: color, clarity/transparency, pH, specific gravity and the microscopic examination to detect cells, parasites and bacteria and to quantify these. In this section, stool or fecal sample is also examined to identify presence of parasitic worms or ova.  SECTIONS OF THE CLINICAL LABORATORY BLOOD BANK/ IMMUNOHEMATOLOGY Main activities performed here are the blood typing and compatibility testing Also performed are the screening of all antibodies and identification of antibodies Considered the most critical in the clinical laboratory  SECTIONS OF THE CLINICAL LABORATORY IMMUNOLOGY AND SEROLOGY Analyses of serum antibodies in certain infectious agents are performed. Serologic tests such as, Hepa B, Syphilis, DRT and some antibody screening tests. Automated analyzers and kits are commonly used in this section  CLASSIFICATIONS OF CLINICAL LABORATORIES ACCORDING TO FUNCTION 1. Clinical Pathology  Concerned with the diagnosis and treatment of diseases performed through lab testing of blood and other body fluids 2. Anatomic Pathology  Concerned with the diagnosis of diseases through microscopic examination of tissues and organs 3. Molecular Pathology  Deals with the analysis of certain genes, proteins and other molecules in samples from organs, tissues or bodily fluids’  Based on the principles, techniques and tools of molecular biology as they are applied to diagnostic medicine in the laboratory ACCORDING TO INSTITUTIONAL CHARACTERISTICS 1. Institution-based  Operates with the premises or part of an institution (Hospitals, schools, med clinic, medical facilities) 2. Free-standing  Not part of an established institution  Free-standing out-patient clinical lab is a common example ACCORDING TO OWNERSHIP 1. Government-owned  Clinical labs are owned, wholly, or partially, by national or local government units  Laboratories of DOH-run gov’t hospitals  San Lazaro Hospital, Jose R. Reyes Memorial Medical Center, UP-PGH  EVMC 2. Privately-owned  Owned, established, and operated by an individual, corporation, institution, association, or organization. ACCORDING TO SERVICE CAPABILITY CATEGORY PRIMARY SECONDAR TERTIARY LIMITED Y Provides the Provides the Provides the Provides one (1) or SECTION following minimum following service capabilities: minimum service following minimum service capabilities two (2) specialized tests that are not capabilities of a of a secondary classified under primary category category plus the Anatomic or plus the following following category: Molecular: category:  Hormones  Trace Metals  Urinalysis  Tumor Markers  Fecalysis  Allergy Panels  Fecal Occult CLINICAL Blood Test This classification  Pregnancy shall also apply to MICROSC Kits (Rapid facilities offering DOH-program related OPY Lateral Flow) tests, e.g., Kato-Katz  Wet Smears for Schistosomiasis, for Malarial Smear, Filarial Smear, Slit- Trichomonas ACCORDING TO SERVICE CAPABILITY CATEGORY SECTION PRIMARY SECONDARY TERTIARY  FBS/RBS  Serum  Other Clinical  OGTT Electrolytes Chemistry CLINICAL  Lipid  ALT, AST Tests CHEMISTR Profile  Hospital- Y  Creatinine Based: ABG  BUN  BUA ACCORDING TO SERVICE CAPABILITY CATEGORY SECTION PRIMARY SECONDARY TERTIARY  CBC  For hospital-  Forward based: CLINICAL and Coagulation HEMATOL Reverse studies (PT, OGY ABO aPTT) grouping and Rh (D) Typing ACCORDING TO SERVICE CAPABILITY CATEGORY SECTION PRIMARY SECONDARY TERTIARY  Dengue Any machine-  Syphilis based  Hepatitis B serological and IMMUNOLO  HIV immunological GY & (screening) testing such as, SEROLOGY using Rapid but not limited Test Kits to:  Tumor markers  Function Tests ACCORDING TO SERVICE CAPABILITY CATEGORY SECTION PRIMARY SECONDARY TERTIARY  TB or Nucleic  Gram  Culture and Acid Stain Sensitivity Amplification  KOH (aerobic/ana MICROBIOL Test in gov’t erobic) OGY facilities ACCORDING TO SERVICE CAPABILITY CATEGORY SECTION PRIMARY SECONDARY TERTIARY  Pap Smear For Hospital- based:  Cytology ANATOMIC  Histopatholog PHYSIOLOG y Y NATIONAL REFERENCE LABORATORY NATIONAL REFERENCE LABORATORY Research Institute for Tropical Medicine (RITM)  NRL for dengue, Influenza, TB, and other Mycobacteria, Malaria and other parasites, Bacterial enteric disease. Measles and other viral exanthems, Mycology, Enteroviruses, Antimicrobial resistance and engineering diseases NATIONAL REFERENCE LABORATORY San Lazaro Hospital (SACCL)  NRL for HIV/AIDS, Hepatitis, Syphillis and other Sexually Transmitted Infections NATIONAL REFERENCE LABORATORY East Avenue Medical Center  NRL for environmental and occupational health; toxicology and micronutrient assay NATIONAL REFERENCE LABORATORY National Kidney and Transplant Institute  NRL for Hematology inc., Immunohematology and Immuno-pathology and Anatomic Pathology  NATIONAL REFERENCE LABORATORY  NRL pathology for Cardiac Philippine Heart Center Disease NATIONAL REFERENCE LABORATORY  NRL in in atomic pathology Lung Center of the Philippines for pulmonary disease  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL PATHOLOGIST  A duly registered physician who is specially trained in methods of laboratory medicine and always considered to head a clinical laboratory and monitor all laboratory results. A laboratory result without the signature of a pathologist may not be considered valid.  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL MEDICAL LABORATORY TECHNICIANS  A person certified by and registered with the Board of Medical Technology and qualified to assist a medical technologist and/or qualified pathologist in the practice of medical technology.  Qualifications:  Fail to pass the medical technology licensure examination given by the Board of Medical Technology but obtained a general rating of at least 70% and provided finally that RMLT when employed in the government shall have civil service eligibility not  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL PHLEBOTOMIST  An individual trained to draw blood either for laboratory tests of for blood donations.  Arterial collection can only be performed by a specially trained phlebotomist. Phlebotomy is a skill confined not only to medical technologists but to other health care practitioners as well, provided that they were given certificates.  In the Philippines, an RMT is required to be skilled in phlebotomy, although in other countries,  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL CYTOTECHNOLOGIST  A lab personnel who works with the pathologist to detect changes in body cells which may be important in the early diagnosis of diseases. They select and section minute particles of human tissues for microscopic study using microtome and other equipment.  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL HISTOTECHNOLOGIST  Also referred to as histotechnician, who is responsible for the routine, processing, and staining of biopsies and tissue specimens for microscopic examination by a pathologist.  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL NUCLEAR MEDICAL TECHNOLOGIST  Works alongside nuclear physicians. They apply their knowledge of radiation physics and safety regulations to limit radiation exposure, prepare and administer radiopharmaceuticals, and use radiation detection devices that measure the quantity and distribution of radionucleotides deposited in the patient or in the patient’s specimen.  DEFINING THE PRACTICE OF OTHER LABORATORY PERSONNEL TOXICOLOGIST  Studies the effects of toxic substances on the physiological functions of human beings to develop data for use in consumer protection and industrial safety programs. END.