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Universal Umbilical Cord Collection
Chain of Custody Procedure
Overview
Umbilical Cord Collection
Cut a 6 inch segment of the umbilical
cord. This will be the collected specimen.
Pinch the speci...
Umbilical Cord Collection
Rinse the exterior/outside of the specimen
with normal saline or an equivalent rinsing
solution....
Umbilical Cord Collection
Pat the specimen dry and place it in the
specimen container.
Umbilical Cord Collection
Place the newborn’s ID number on the
specimen container (the newborn’s name
is optional). The ID...
Universal Umbilical Cord Procedure
Logging a specimen IN to storage:
1. Place the specimen in a sterile urine
collection c...
Universal Umbilical Cord Procedure
2. On the collection log, the Collector (the individual collecting the
specimen for tem...
Universal Umbilical Cord Procedure
3. Once a specimen is ready to be sent to the lab, the Processor (the
individual removi...
Universal Umbilical Cord Procedure
4. Insert the Patient
Information from the
specimen container into the
Patient/Donor Se...
Universal Umbilical Cord Procedure
5. On the Custody and
Control form, mark
the panel(s) to be
performed in the
Test Reque...
Universal Umbilical Cord Procedure
6. Place the bar-coded specimen seal
from the bottom of the Custody and
Control form, o...
Universal Umbilical Cord Procedure
7. In the Sendouts
Section the sendouts
technician (if applicable
to your facility) wil...
Universal Umbilical Cord Procedure
Collection
instructions are
available online at
www.USDTL.com.
Office: 800.235.2367
Email: perinataltesting@usdtl.com
Website: www.USDTL.com
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Universal Umbilical Cord Tissue Collection

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Collection and short-term storage of the umbilical cord on ALL newborns. Umbilical cord is sent to the laboratory if the mother meets the hospital’s conditions for determining a potentially exposed newborn, or if the newborn shows signs or symptoms of withdrawal. If neither criteria is met, the umbilical cord is discarded.

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Universal Umbilical Cord Tissue Collection

  1. 1. Universal Umbilical Cord Collection Chain of Custody Procedure Overview
  2. 2. Umbilical Cord Collection Cut a 6 inch segment of the umbilical cord. This will be the collected specimen. Pinch the specimen between the finger and thumb, then run your fingers down the specimen 3-4 times to drain excess blood. Discard any excess blood.
  3. 3. Umbilical Cord Collection Rinse the exterior/outside of the specimen with normal saline or an equivalent rinsing solution. Important: Prevent the umbilical cord and specimen from coming in contact with ethanol-based liquids or vapors previous to and during the collection process. This includes ethanol-based hand sanitizer and alcohol prep pads.
  4. 4. Umbilical Cord Collection Pat the specimen dry and place it in the specimen container.
  5. 5. Umbilical Cord Collection Place the newborn’s ID number on the specimen container (the newborn’s name is optional). The ID number may be the medical record number, hospital laboratory accession number, or any other unique identifying number of the collection facility’s choosing. The hospital patient ID label/sticker may be utilized to satisfy this step.
  6. 6. Universal Umbilical Cord Procedure Logging a specimen IN to storage: 1. Place the specimen in a sterile urine collection cup labelled with the newborn information. Seal the specimen container with a tamper proof seal provided by your facility. The tamper proof seal should be applied so that it crosses the top of the specimen container and runs down both sides of the container (as shown) without crossing over the newborn information label. Sign/Date the seal and refrigerate specimen until it is sent out for testing or destroyed.
  7. 7. Universal Umbilical Cord Procedure 2. On the collection log, the Collector (the individual collecting the specimen for temporary storage) fills in the Patient Identification Name/Number and Signs/Dates the log. This step initiates the chain of custody. An editable collection log template can be downloaded at www.USDTL.com/assets/collection_log.pdf Example Collection Log Section
  8. 8. Universal Umbilical Cord Procedure 3. Once a specimen is ready to be sent to the lab, the Processor (the individual removing the specimen from temporary storage) will verify that the Patient Information from the specimen matches the Patient Information from the collection log. The Processor will then Sign/Date and Mark the appropriate box in the Purpose Section on the collection log (e.g. test or destroy). Logging a specimen OUT of storage:
  9. 9. Universal Umbilical Cord Procedure 4. Insert the Patient Information from the specimen container into the Patient/Donor Section on the Custody and Control Form. Verify that all information matches between the specimen, collection log, and Custody and Control form. Verify that your facility’s tamper proof seal is still intact and has not been compromised. Umbilical Cord Meconium Blood Spot Hair Urine Other CONTROL # PATIENT / DONOR Name Last First ID # Date of Birth / / Time of Birth  :  (24hr clock, military time) CLIENT FOR USDTL USE ONLY Revision2016.12.15 FORENSIC NEWBORN DRUG TESTING CUSTODY AND CONTROL FORM Meconium collector(s) sign, date and time stamp each individual collection through collection completion. Signature of Specimen Collector(s) __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ Date Time MECONIUM COLLECTOR(S) VERIFICATIONSPECIMEN TYPE 5 Drug Panel 7 Drug Panel 9 Drug Panel 12 Drug Panel 13 Drug Panel Alcohol Biomarker (Cord EtG, Meconium FAEE, Blood Spot PEth) Cotinine (nicotine biomarker, Cord Only) Designer Stimulants (Cord Only) Other Collector Certification: I certify that I have collected, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time __/__/__ __:__ TESTING REQUESTED The default panel is the company’s preset selection and will be tested if no additional selection is made. If not using the default panel, check all that apply. Processor Certification: I certify that I have processed, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time Sendouts Section Certification: I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matched that on the specimen, and the specimen was released for transport to USDTL for testing. Sign Name X / /Print Name Date __:__Time Laboratory Certification I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matches that on the specimen, and the specimen was transferred to temporary laboratory storage. Sign Name X / /Print Name Date __:__Time CERTIFICATION (at least one certification section must be signed to be processed by the laboratory) DRUG TESTING PANELS & OPTIONS United States Drug Testing Laboratories, Inc. 1700 S. Mount Prospect Road|Des Plaines, IL|60018 Main: 847-375-0770|www.USDTL.com|Fax: 847-375-0775 ® KATHYPETRICK•AMERICANSOLUTIONSFORBUSINESS•952-470-1020 COPY 1 LAB COPY 4594751 SPECIMEN SEAL SPECIMEN SEALB(SPLIT) A4594751 CONTROL NO. 4594751 45947514594751 CONTROL NO. / / Date (Mo. Day Yr.) Sealed by / / Date (Mo. Day Yr.) Sealed by USE TO SEAL SPECIMEN USE TO SEAL SPECIMEN FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY
  10. 10. Universal Umbilical Cord Procedure 5. On the Custody and Control form, mark the panel(s) to be performed in the Test Requested Section. Check ALL that apply. Umbilical Cord Meconium Blood Spot Hair Urine Other CONTROL # PATIENT / DONOR Name Last First ID # Date of Birth / / Time of Birth  :  (24hr clock, military time) CLIENT FOR USDTL USE ONLY Revision2016.12.15 FORENSIC NEWBORN DRUG TESTING CUSTODY AND CONTROL FORM Meconium collector(s) sign, date and time stamp each individual collection through collection completion. Signature of Specimen Collector(s) __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ Date Time MECONIUM COLLECTOR(S) VERIFICATIONSPECIMEN TYPE 5 Drug Panel 7 Drug Panel 9 Drug Panel 12 Drug Panel 13 Drug Panel Alcohol Biomarker (Cord EtG, Meconium FAEE, Blood Spot PEth) Cotinine (nicotine biomarker, Cord Only) Designer Stimulants (Cord Only) Other Collector Certification: I certify that I have collected, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time __/__/__ __:__ TESTING REQUESTED The default panel is the company’s preset selection and will be tested if no additional selection is made. If not using the default panel, check all that apply. Processor Certification: I certify that I have processed, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time Sendouts Section Certification: I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matched that on the specimen, and the specimen was released for transport to USDTL for testing. Sign Name X / /Print Name Date __:__Time Laboratory Certification I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matches that on the specimen, and the specimen was transferred to temporary laboratory storage. Sign Name X / /Print Name Date __:__Time CERTIFICATION (at least one certification section must be signed to be processed by the laboratory) DRUG TESTING PANELS & OPTIONS United States Drug Testing Laboratories, Inc. 1700 S. Mount Prospect Road|Des Plaines, IL|60018 Main: 847-375-0770|www.USDTL.com|Fax: 847-375-0775 ® KATHYPETRICK•AMERICANSOLUTIONSFORBUSINESS•952-470-1020 COPY 1 LAB COPY 4594751 SPECIMEN SEAL SPECIMEN SEALB(SPLIT) A4594751 CONTROL NO. 4594751 45947514594751 CONTROL NO. / / Date (Mo. Day Yr.) Sealed by / / Date (Mo. Day Yr.) Sealed by USE TO SEAL SPECIMEN USE TO SEAL SPECIMEN FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY {
  11. 11. Universal Umbilical Cord Procedure 6. Place the bar-coded specimen seal from the bottom of the Custody and Control form, over the top of the container and then Initial and Date the bar-coded specimen seal. Place the seal so that the information on both seals is still readable (as shown).
  12. 12. Universal Umbilical Cord Procedure 7. In the Sendouts Section the sendouts technician (if applicable to your facility) will Print, Sign, and Date to release the specimen to the courier. Umbilical Cord Meconium Blood Spot Hair Urine Other CONTROL # PATIENT / DONOR Name Last First ID # Date of Birth / / Time of Birth  :  (24hr clock, military time) CLIENT FOR USDTL USE ONLY Revision2016.12.15 FORENSIC NEWBORN DRUG TESTING CUSTODY AND CONTROL FORM Meconium collector(s) sign, date and time stamp each individual collection through collection completion. Signature of Specimen Collector(s) __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ __/__/__ __:__ Date Time MECONIUM COLLECTOR(S) VERIFICATIONSPECIMEN TYPE 5 Drug Panel 7 Drug Panel 9 Drug Panel 12 Drug Panel 13 Drug Panel Alcohol Biomarker (Cord EtG, Meconium FAEE, Blood Spot PEth) Cotinine (nicotine biomarker, Cord Only) Designer Stimulants (Cord Only) Other Collector Certification: I certify that I have collected, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time __/__/__ __:__ TESTING REQUESTED The default panel is the company’s preset selection and will be tested if no additional selection is made. If not using the default panel, check all that apply. Processor Certification: I certify that I have processed, labeled and sealed the specimen identified on this form. I hereby release this specimen for transport to the sendouts section / USDTL. Sign Name X / /Print Name Date __:__Time Sendouts Section Certification: I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matched that on the specimen, and the specimen was released for transport to USDTL for testing. Sign Name X / /Print Name Date __:__Time Laboratory Certification I certify that the specimen received with this form was sealed in the appropriate container with the seal intact, and the identification number and/or name on this form matches that on the specimen, and the specimen was transferred to temporary laboratory storage. Sign Name X / /Print Name Date __:__Time CERTIFICATION (at least one certification section must be signed to be processed by the laboratory) DRUG TESTING PANELS & OPTIONS United States Drug Testing Laboratories, Inc. 1700 S. Mount Prospect Road|Des Plaines, IL|60018 Main: 847-375-0770|www.USDTL.com|Fax: 847-375-0775 ® KATHYPETRICK•AMERICANSOLUTIONSFORBUSINESS•952-470-1020 COPY 1 LAB COPY 4594751 SPECIMEN SEAL SPECIMEN SEALB(SPLIT) A4594751 CONTROL NO. 4594751 45947514594751 CONTROL NO. / / Date (Mo. Day Yr.) Sealed by / / Date (Mo. Day Yr.) Sealed by USE TO SEAL SPECIMEN USE TO SEAL SPECIMEN FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY FOR POSITION ONLY
  13. 13. Universal Umbilical Cord Procedure Collection instructions are available online at www.USDTL.com.
  14. 14. Office: 800.235.2367 Email: perinataltesting@usdtl.com Website: www.USDTL.com

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