Public Health and Environmental Laboratories

Type

Materials

Procedure

Nasal Swab

Dry Polyester Swab

Insert a dry polyester swab into the nostril. Using a gentle rotation, push the swab until resistance is met at the level of the turbinates (less than 1 inch into the nostril). Rotate the swab a few times against the nasal wall. Repeat in the other nostril using the same swab.
Put the tip of the swab into the plastic vial containing 3 ml of viral transport media and cut off the applicator stick. If a rapid antigen kit is going to be used, ideally two samples should be drawn in the manner described above. Package inserts accompanying the rapid antigen test kit should be followed when processing one of the two samples. If the test is positive, a second sample should be submitted to the Division of Public Health and Environmental Laboratories (PHEL) for additional testing to confirm the results of onsite testing.

Nasopharyngeal (NP) or Oropharyngeal (OP/throat) swab

Sterile Dacron or Nylon Swab
Do NOT use calcium alginate swabs or swabs with wooden sticks

Insert the swab through the nostril, parallel to the palate to the posterior nasopharynx (distance from the nostrils to the external opening of the ear). The swab should be left in place for a few seconds to absorb secretions. Slowly withdraw the swab with a rotating motion. Swab both nostrils with the same swab.
For OP swab, swab the posterior pharynx and tonsillar areas, avoiding the tongue. 
Put the tip of the swab into the plastic vial containing 3 ml of viral transport media and cut off the applicator stick.   
If a rapid antigen kit is going to be used, ideally two samples should be drawn in the manner described above. Package inserts accompanying the rapid antigen test kit should be followed when processing one of the two samples. If the test is positive, a second sample should be submitted to PHEL for additional testing to confirm the results of onsite testing.

Nasopharyngeal aspirates/wash

Suction apparatus
Sterile suction catheter
Sterile saline

Aspirate nasopharyngeal secretions through a catheter connected to a mucus trap and fitted to a vacuum source.
For NP wash have the patient sit with head tilted slightly backward.  Instill 1ml-1.5ml of nonbacteriostatic saline (pH 7.0) into one nostril. No saline is used for an aspirate.
Insert the catheter into the nostril parallel to the palate. Apply the vacuum and slowly withdrawn the catheter with a rotating motion. Mucus from the other nostril should be collected the same way. Specimen should be placed in a sterile vial.
If a rapid antigen kit is going to be used, ideally two samples should be drawn (e.g., one from each nostril) in the manner described above. Package inserts accompanying the rapid antigen test kit should be followed when processing one of the two samples. If the test is positive, a second sample should be submitted to PHEL for additional testing to confirm the results of onsite testing.