ENT and skin/wound swabs

Clinical Procedures > Swabs and smears

Introduction

Wash hands
Introduce self
Ask Patient’s name and DOB
Explain procedure and obtain consent

Gather equipment

Equipment list

Swabs – CHECK EXPIRY
- Blue = bacterial
- Green = viral
- NB: colours may vary between hospitals.
Sterile saline (to moisten swab if swabbing dry area, e.g. nose, skin)
Tongue depressor and torch (if taking throat swab)

Clean tray and place swab inside in partially open packet
Put on gloves and apron (and surgical mask depending on patient’s isolation status)

Performing the swabs

Throat swab

Patient should sit with their head tilted backwards with light shining into their open mouth
Ask the patient to protrude their tongue, while you depress it with a tongue depressor if required to visualise tonsils
Quickly but lightly rub the swab over both tonsils and the posterior pharyngeal wall

NB: warn the patient they may gag during the procedure. Viral nose and throat swabs are usually combined; in this case, collect the throat swab first, then use the same swab to take the nasal sample. Some kits have two swabs which go in the same container – a thin one for the nose and a thick one for the throat.

Nasal swab

Wipe the nose if excess secretions are present
Gently insert a swab horizontally into one of the patient’s nostrils by 2-5cm until you feel resistance, aiming posteriorly along the floor of the nasal cavity
Gently rotate the swab for 5 seconds

Ear swab

Place swab in outer ear
Rotate to collect secretions

Wound/skin swab

Expose site
Moisten end of a swab with sterile saline if the area is dry
Roll the swab along moist or purulent area

MRSA screening swabs

Nasal: insert a moistened swab vertically into the anterior nare (approximately 2cm) and rotate swab against anterior nasal mucosa for 5 seconds (repeat on the other nostril using the same swab)
Groin: gently roll a moistened swab back and forth against skin on both sides of groin

To complete

Place swab into container without touching anything else (some kits may require you to snap the swab in half; some may require you to rub the swab on the collection tube wall and then discard it)
Close the container
Thank patient
Discard waste and clean tray; then discard gloves and apron; wash hands
Fill in the samples and request form details
- Name, DOB, hospital/clinic number, address, GP name and address
- Specimen site
- Clinical details
Send to lab
Document in patient’s notes

Learn how to interpret the results too…

We have notes on bacteria which may grow in swabs and antibiotics

Try a simulated station

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