Ear, nasopharyngeal & throat swab

Collect the ear discharge before the start of antibiotic therapy

• Use swab moistened with sterile, non-bacteriostatic saline to remove any debris or crust from ear canal
• Collect a specimen of the discharge on a thin, sterile cotton wool or dacron swab by firmly rotating swab in outer canal
• Place the swab in a container with the transport medium, breaking off the swab stick to allow the stopper to be replaced tighly
• Label the specimen and send it to the laboratory

• Swabs/container
• Saline

• There are no specific contraindications for collecting specimens with nasopharyngeal swabs
• However, clinicians should be cautious if the patient has had recent nasal trauma or surgery, has a markedly deviated nasal septum, or has a history of chronically blocked nasal passages or severe coagulopathy.

• Wash your hands
• Put on your PPE
  Ask the patient to take off her mask and blow her nose into a tissue to clear excess secretions from the nasal passages
• Remove the swab from the packaging
• Tilt the patient’s head back slightly, so that the nasal passages become more accessible
• Ask the patient to close her eyes to lessen the mild discomfort of the procedure
• Gently insert the swab into the nostril, parallel to the palate, along the nasal septum, just above the floor of the nasal passage, to the nasopharynx, until resistance is felt
• If you detect resistance to the passage of the swab, back off and try reinserting it at a different angle, closer to the floor of the nasal canal
• The swab should reach a depth equal to the distance from the nostrils to the outer opening of the ear
• Leave the swab in place for several seconds to absorb secretions, rotate several times and then slowly removing the swab while rotating it
• Ask the patient to reapply her mask
• Open the collection tube and insert the swab into the tube
• Break the swab at the groove and discard what remains of the swab and close the sample tube

• Nasopharyngeal swab
• Sample tube
• Personal Protective Equipment (PPE): gown, nonsterile gloves, protective mask

• Collect specimen in the acute phase of the disease and for bacterial infections before start of antibiotic therapy
• Throat swab cultures are contraindicated in patients with epiglotitis
• If diphteria, Vincent’s angina, thrush, gonococci or whooping cough is suspected, it should be stated on the request form
• Throat swabs should be collected for streptococcal sore throat, diphteria, Vincent’s angina,thrush and gonococcal pharyngeal infection
• Nasopharyngeal swabs are recommended for respiratory viruses infections such as COVID-19 and suspected cases of whooping cough

• Turn the patient’s face against the light, ask the patient to open his mouth wide and phonate an “ah”
• Gently depress tongue with a tongue depressor so that the throat is well exposed and illuminated
• Sample poster pharynx, tonsils and any areas of inflammation, exudation or ulceration with a sterile swab
• Care should be taken to avoid touching the tongue, cheeks or lips with the swab
• Insert swab into swab transport medium

• Tongue depressor
• Swab transport system with appropriate transport medium