Annex A General Clinical Laboratory - Secretary of Health

1 Republic of the Philippines Department of Health Health FACILITIES AND SERVICES REGULATORY BUREAU. Annex - A. I. SERVICE CAPABILITY OF General Clinical Laboratory (Place a on spaces provided before each item if available and X if not). GLASSWARES AND SUPPLIES Remarks SECTION SERVICES Primary and Secondary Tertiary (Quality Improvement). SPECIMEN Blood Extraction _ Slides _ Alcohol 70% All in Primary & Secondary plus: COLLECTION _ Cottons _ Capillary Tubes _ Labeling Materials _ Tourniquet _ Plastic calibrated loop and other _ Lancet _ Test Tubes necessary materials _ Sterile Medical tape _ Syringe(any gauge 21,22,23).

2 Other Body (Expiration Date). Fluids _ Sterile Screw Cap Specimen (Urine, Stool, _ Specimen container w/ cover or Screw Cap Container Sputum, etc.) (50mL) _ Sterile Swab _ Applicator Stick _ Non- Mercurial Thermometer: (Room and storage refrigerator). Other equipment and supplies _ Refrigerator II. SERVICE CAPABILITY OF General Clinical Laboratory . EQUIPMENT/ INSTRUMENTS GLASSWARES/ Remarks CATEGORY SECTION SERVICES MANUAL AUTOMATED REAGENTS SUPPLIES (Quality Improvement). _ Clinical Centrifuge _ 4 - parameter strips PRIMARY, Clinical Urinalysis (2,000 rpm) _ Slides SECONDARY & MICROSCOPY _ Microscope _10 - parameter strips _ Test tubes(10ml).

3 TERTIARY (Binocular Compound) _ Cover Slips _ 10 Parameters _ Test Tube Rack _ Strip Reader Control __ Low _ Applicator sticks __ Normal __ High Stool _ Normal Saline Solution Analysis _ Lugol's Iodine Special tests DOH-CLG-LTO- Annex A. Revision:00. 01/07/2016. Page 1 of 6. III. SERVICE CAPABILITY OF General Clinical Laboratory . EQUIPMENT/ INSTRUMENTS REAGENTS GLASSWARES/ REMARKS. CATEGORY SECTION SERVICES SUPPLIES (Quality Improvement). MANUAL AUTOMATED (Take note of Expiration Dates). PRIMARY, HEMATOLOGY Hemoglobin _ Spectrophotometer _ Hemoglobin Reagent _ Cuvettes / test SECONDARY & or its equivalent (Cyanmet Hemoglobin) tubes TERTIARY _ Sahli / micro _ Standard pipette Hematocrit _ Hematocrit Centrifuge _ Capillary Tube _ Hematocrit Reader _ Sealer Red Blood Cells _ Pipette Shaker _ RBC Diluent _ RBC / micro (Optional)

4 Pipette _ Tally Counter _ Hemacytometer _ Microscope w/ Cover Slips White Blood Cells _ WBC Diluent _ WBC / micro pipette Platelet Count (Qualitative for _ Platelet _ Petri Dish Primary Laboratory , Quantitative for _ Diluent Secondary and (as applicable). Tertiary Laboratory ). _ Hematology Staining _ Slides Differential Count _ Differential Counter Kit _ Oil immersion _ Staining Glasses DOH-CLG-LTO- Annex A. Revision:00. 01/07/2016. Page 2 of 6. CATEGORY SECTION SERVICES EQUIPMENT/ INSTRUMENTS REAGENTS GLASSWARES/ REMARKS. (Take note of SUPPLIES (Quality Improvement expiration date).)

5 MANUAL AUTOMATED. Complete Blood Hematology _ Diluents HEMATOLOGY Count Analyzer _ Lyse _____ _ Cleanse Solution Controls _ Low _ Normal _ High _ Other Reagents _ Test tubes Blood Grouping _ Serofuge or its Semi- _ Blood Typing Sera (Tube Method for equivalent automated _ Slides Hospital Based) machine;. Cross matching _ Water bath or its _ Anti- Human Globulin (Hospital Based) equivalent _ Enhancement solution(LISS). _ Normal Saline Soln. Others: (optional) _ Hematology Staining _ Staining Glasses _ Differential Counter Kit Peripheral Blood Smears _ Oil immersion Coagulation _ Coagulation Coagulation _ Calibrated Pipettes machine: Reagents _ controls DOH-CLG-LTO- Annex A.

6 Revision:00. 01/07/2016. Page 3 of 6. IV. SERVICE CAPABILITY OF General Clinical Laboratory . REAGENTS. CATEGORY SECTION SERVICES EQUIPMENT/ INSTRUMENTS (Take note of GLASSWARES/ REMARKS. MANUAL AUTOMATED expiration date) SUPPLIES (Quality Improvement). Routine Test: Controls SECONDARY Clinical _ Spectrophotometer or Indicate _ Normal _ Cuvettes & TERTIARY CHEMISTRY Blood Glucose its equivalent name of _ Pathologic _ Test tubes Total Cholesterol _ Calibrated Pipettes Machine _ Glass Blood Uric Acid _ Clinical Centrifuge Test Reagents Pipettes Blood Creatinine _ Water Bath or _ Glucose _ Pipette &.

7 Blood Urea equivalent _ Total Cholesterol Pipette tips Nitrogen _ Timer _ Uric Acid _ Test Tubes _ Refrigerator _ Creatinine Rack _ BUN. TERTIARY Other Special tests : Liver Profile (Optional for Secondary) Lipid Profile & Other Body Fluids V. SERVICE CAPABILITY OF General Clinical Laboratory . REAGENTS. CATEGORY SECTION SERVICES EQUIPMENT/ INSTRUMENTS (Take note of GLASSWARES/ REMARKS. MANUAL AUTOMATED expiration date) SUPPLIES (Quality Improvement). TERTIARY IMMUNOLOGY/ RPR/Syphilis _ Clinical Centrifuge Indicate name Indicate Test Kits _ Test tubes (Optional for SEROLOGY Test _ Microscope/ agglutination of Machine _____.)

8 Secondary) viewer (If applicable). ASO Titer CRP. Hepatitis Profile _ Micro plate/ Strip System HBsAg & _ Bead System others . _ ELISA and Washer Set _ Water Bath at 37 0C. Others: HIV Test (OFW) _ Test Kits / Reagents DOH-CLG-LTO- Annex A. Revision:00. 01/07/2016. Page 4 of 6. VI. SERVICE CAPABILITY OF General Clinical Laboratory . REAGENTS REMARKS. CATEGORY SECTION SERVICES EQUIPMENT/ INSTRUMENTS (Take note of expiration GLASSWARES/ (Quality Improvement). MANUAL AUTOMATED date) SUPPLIES. SECONDARY MICROBIOLOGY Gram Stain _ Microscope with Oil- (HB) immersion objective _ Gram's stain Kit _ Slides TERTIARY _ Staining Rack _ Loop _ Bunsen Burner _ Applicator Sticks _ Timer _ Forceps _ Cover Slips KOH _ 10% KOH.

9 _ Isolation Hood with Acid-Fast exhaust fan (Improvised) _ Acid-Fast Bacilli Stain Kit TERTIARY MICROBIOLOGY Bacilli Stain (optional for tertiary Laboratory ). Culture and _ Incubator Indicate name Culture Media Sensitivity _ Drying Oven of Machine _ BHI _ BAP _ MAC _ Graduated _ Autoclave _ CAP _ GBA _ BCA Cylinder _ Refrigerator _ SSA _ TCBS _ MHA _ Beaker _ Centrifuge _ TSB _ SFB _ APW _ Petri dish _ Thio broth _ TSA. _ Bunsen Burner or _ MHA w/ 5% sheep Blood _ Swabs Electric /Loop Incinerator _ Applicator Sticks _ Weighing Scale _ Biochemical Reaction _ Loop _ Biosafety cabinet (Conventional Method/ _ Glass Pipettes (Class II Type A with Commercially Prepared).)

10 Certification). _ Water Bath _ Sensitivity Disk/. _ Candle Jar Antimicrobial Disk _ Caliper/Ruler Table _ Mac Farland Standard Lamp ( ). _ Electric/Gas Stove _ Laboratory Thermometer Control Strains (ATCC). _ Calibrated Inoculating _ Pseudomonas Loops aeroginosa _ Timer _ Staphylococcus _ Colorimeter aureus _ Forceps _ Escherichia coli DOH-CLG-LTO- Annex A. Revision:00. 01/07/2016. Page 5 of 6. VII. SERVICE CAPABILITY OF General Clinical Laboratory . REAGENTS REMARKS. CATEGORY SECTION SERVICES EQUIPMENT/ INSTRUMENTS (Take note of GLASSWARES/ (Quality Improvement).