Packaging and Shipping Specimen
Specimens are not your usual cargo, and shipping them comes with a set of safety measures and restrictions that you must follow.

This article will discuss the correct procedure to ensure secure, safe, and lawful packaging and shipping of medical specimens to a lab for testing.

This document contains a variety of recommendations and governing regulations. However, it is not for an intensive training program. We, therefore, suggest that anyone involved in packaging and shipping specimen familiarize themselves with government and airline regulations upfront.

For instance, the US DOT website has technical data about acceptance and the Dangerous Goods act. These laws discuss both ground and air transport.

Most amalgamated and global agencies have the laws and requirements posted on their websites concerning the packing and movement of medical specimens. For instance, the USPS, FedEx, and other couriers have their own set of rules for packaging and shipping specimen and other hazardous substances.

And because the laws governing the packing methods of such materials change with time, getting the latest information concerning shipping medical specimen before making a move is a clever move.

In general, this guide offers knowledge on how to pack specimens, give necessary information on supplies, and discusses every all the does and don'ts.

What is Specimen Integrity?
Specimens have to be packed and shipped well for precise testing to ensure the patients receive timely and quality healthcare.

Clinical samples may not be fit for examination if subjected to extreme temperatures—either too hot or cold conditions, which explains why this measure was implemented.

If specimens turn out to be useless in giving accurate results, then another sample must be taken from the patient. 

This may not be taken lightly by the patient because it means the diagnosis and treatment of the patient will be greatly delayed.

For that reason, you must work with your laboratory to ensure the required medical specimen reaches the testing center in one piece. See to it that it arrives;  

• With the right temperature for testing
• Complete in the container, having no damages or even leakage
• Within as little time as possible
• And with all the rules and laid regulations are taken care of

These directives have been put in place to aid couriers to comprehend their duty in the transit process.

Observing the laid down guidelines for correct specimen preparation, packing, shipping, and documentation simplifies the whole process and satisfies the patient.

Packaging and Shipping Specimen: Everything You Need to Know.
For safety, compliance, and convenience, your lab should supply you with biohazard color-coded, temperature-specific carriers for your samples: 

All medical samples to be transferred to testing laboratories must be kept within the appropriate temperature: ambient, refrigerate, or frozen.

• Refrigerate Specimen carrier – pink
• Ambient Specimen carrier – white 
• Frozen Specimen carrier – yellow 

These specimens have to be separated by temperature, too, and every bag is stocked in a specific way. Your laboratory should provide a shipping box lined with Styrofoam containers. 

Styrofoam transportation coolers have accurate markings for dry ice and biohazards. One of these carriers is responsible for ensuring refrigerate /ambient specimens stay cool for up to 48 hours.

All samples must be transported in a well-enclosed container that does not leak or bear any damages. The color-coded boxes also have features that can absorb the full fluid content of the specimen.

Next, you have to fill the vital documents from your laboratory. For instance, Mayo Clinic Laboratories asks for the following info;

• Client name
• Account number
• Number of frozen bags
• Number of refrigerating bags
• Number of ambient bags
• Other material number and description

On this control document on the top part of it, print;

• Full and accurate name of the courier company
• The actual name of the individual on the run
• The city and state

Then add the client's name: the names of the facility from which the specimens were collected, whether hospital, clinic, or laboratories.

You have to indicate the number of bags for each temperature, including any other material you may come, such as X-rays or envelopes, in the package.

Lastly, indicate the time you took the specimens and add any other important details about it.

Preparing the Styrofoam:
Specimens are packed in the same Styrofoam. Its lid contains a pink label to help one tell refrigerate samples and a white label for ambient specimens.

Medical samples should be placed in color-coded bags that must be the same color as the color on the Styrofoam lid.

When packaging and shipping specimen, remember to cover everything before putting the samples carriers into the Styrofoam to avoid contamination, and for safety reasons.

Packing refrigerated medical samples;

• Put a cold cool pack at the bottom of a Styrofoam.
• At the corners of the cool box, put three to four paper towels.
• Identify the sample, and note the bags, ensure all bags are pink.
• Jot down the number of refrigerated bags on the documents provided by your lab.
• Uncover the top of refrigerate/ambient Styrofoam, separate any ambient samples from any recently gathered samples.
• Put in the pink refrigerate sample carrier in the Styrofoam then fit two paper towels over the specimens.
• Straight away, replace the Styrofoam top.

Packing ambient medical samples:
You still use the same refrigerated Styrofoam, however;

• Identify the sample and note the number of bags (ensure that all bags contain white labels).
• Document the number of Styrofoam and put double paper towels over the top of the pink bags.
• Place the white ambient specimen bags. Ambient specimens are placed on top of the refrigerated specimens, divided by paper towels.
• The remaining space inside the Styrofoam must be filled with cushioning materials like paper towels.
• At once, replace the Styrofoam cover.

Packing Frozen Medical Specimens:

• Assemble the frozen Styrofoam. The top of the Styrofoam should bear a yellow label to show frozen specimens
• Identify the frozen samples and note the number of bags. Ensure that each bag bears a yellow tag.
• Write down the number of frozen bags on the Specimen Control Document.
• Unlock the cover of the frozen Styrofoam and put a double-inch surface of dry ice in the base of the frozen Styrofoam.

The priority here is to prevent injury. Always put on cloth gloves and safety glasses when dealing with dry ice.

• Place the yellow specimen bag on top of the dry ice. Add bags up to the indicated point on the yellow sticker inside of the Styrofoam. While doing so, spare some space at the top to accommodate the cover well.
• Instantly put the yellow-labeled frozen lid onto the Styrofoam.

The frozen shipping container is not to be filled to leave room for better fitting of the Styrofoam covers.

Packing Stool Specimens. 
Your lab will provide you with stool specimen vessels. There is also a unique Styrofoam used for transporting one or double stool containers.

Large capacity stool boxes must never be placed together with other specimens. They must be transported separately, and these unique stool containers may be kept in a freezer or refrigerator. 

Here's the process of packing stool containers;

• Soon after putting all these specimens together, couriers must dispose of latex gloves and clean their hands. 
• If the stool containers are in the freezer, place a double-inch surface of dry ice at the bottom of the Styrofoam, but if the stool containers are in the refrigerator, place a cool park in the Styrofoam together with the two paper towels on top.
• Take the stool container box into the lab then wear a clean pair of latex gloves before going into the lab.
• Document all important info concerning the Styrofoam. 
• Record the number of containers packed in the Styrofoam in the correct places, either frozen or refrigerated.
• Put the stool containers in the 10-lb Styrofoam.

Packing Samples for Muscle Biopsy.
Your lab should supply you with special containers for muscle biopsy. It must carry a 10-lb Styrofoam to help you ship these biopsies in a little box between dry ice.

They have to be shipped intact with no opening in between unless ordered by your laboratory.

Packing Critical Ambient Samples. 
Critical ambient samples are like bone marrow and some whole blood specimens, which easily become useless in case they get cold. Your lab should also provide special containers for such specimens.

In most cases, you will find a10-lb Styrofoam placed within a white fireboard carrying box purposely built for packaging and shipping specimens of this nature. Six 25 Degrees-Celsius cool packs line the box.

Parking Other Materials:
Some materials can help with sample examination but are too big to fit into the lab-provided containers. 

Materials such as X-ray films in large envelopes may be a problem when shipping samples. Such cases can be handled in the following ways;

• In the "any other item" section of the document provided the lab, jot the number and description of every item.
• It is important to use an extra box since the materials must be kept in appropriate Styrofoam, mostly ambient/refrigerated.
• Put the envelopes into the Styrofoam if they fit but do not put them alongside the Styrofoam if they do not fit.

Finally, ship X-ray envelopes that do not fit in the Styrofoam in a separate envelope. 

General Instructions for Packaging and Shipping Specimen. 

• Do not remove the tops or covering of both Styrofoam simultaneously to avoid confusion.  
• Do not fill a Styrofoam to brim or force the specimen to fit in; if it does not, it is advisable to use another box.
• Record the actual number of bags on the Specimen Control Document.
• In case the specimens are not packed in lab bags, request staff to repack them.
• In case the temperature of a sample is not similar to the label on the box, request to know how it will be transported from the lab staff. If it is the wrong bag, then it must be replaced.

Lastly, ensure the safety of the specimens by keeping an eye on them while transporting to the carrier.

Safety in the Laboratory. 

• Always put on latex gloves in the laboratory and close any opening with a bandage.
• Clean hands thoroughly before stepping out of each laboratory.
• Avoid putting the box in a wet area.
• Do not wear open shoes while inside a laboratory.
• Do not get in contact with any container that looks soiled. For safety during transportation, request it to be repacked by the lab staff.

Lastly, inform the laboratory staff of any damages to your skin as these could serve as routes for the entry of infections.

Packing Courier Vehicle:

Always pack the courier vehicle with the following items;

• In excess dry ice together with cloth gloves and safety glasses.
• A pack of latex gloves provided by your lab.
• Paper towels
• Cleanup kits
• Packaging tape
• Mayo Clinic Laboratories stool containers in a 10-lb Styrofoam
• Double 10-lb box sets with the cool pack and dry ice.

Lastly, pack vital specimen documents on their own.

Shipping Instructions.

Preparing your shipping box;

• Wrap the specimens in the frozen Styrofoam with dry ice.
• If shipping through a courier service, go through all the formalities
• Place the specimen documents in the Styrofoam.
• Cover the shipping box and seal it with packaging tape.

Finally, ensure you indicate on the box the weight in kilograms of dry ice being transported.

Leaks and Spills.
For personal safety and well-being, take any spill as infectious waste. Avoid any leaking or soiled containers. Also, notify the lab staff of any potential dangers in case of a leak.

If a leak occurs away from the lab, the courier will clean it up using either a commercial cleanup kit or bleach, as indicated below.

• Ensure no one touches or walks over the spill.
• Wear gloves when dealing with the spill.
• In case of too much spill, use a paper towel to dry the place.
• Whatever is used to clear up the spill must be placed in a separate Styrofoam and taken to the lab for proper disposal.
• Sensitize others by indicating on the box of the specimen "LEAKING SPECIMEN"

Lastly, if a container is leaking from inside a bag, identify it, and fix it ASAP. Put it inside a lab bag and transport it in a different Styrofoam.

Final Words
As hinted earlier, the process of packaging and shipping specimen is different than when shipping a book to your mum or present to a daughter
You want to follow all steps carefully to avoid putting yourself and others at the risk of infections.