PRINCIPLES OF MEDICAL TECHNOLOGY - Pathologist

PRACTICE 1 - Medical Technologist

- Medical Technician
OVERVIEW OF THE MEDICAL
TECHNOLOGY/MEDICAL LABORATORY Medical Technologist acts as…
SCIENCE PROFESSION MEDICAL DETECTIVES
OUTLINE
● Historical Perspective
Roles of Medical Technologist
● Medical Technology/Medical Laboratory Science Practices ● Observe, identify, and analyze organisms and
● Medical Technology Education
cells causing infection and disease.
LEARNING OUTCOMES ● Perform blood tests.
● Trace the history of Medical Technology Globally and in the Philippines.
● Enumerate the scope of Medical Technology Practices. ● Measure substance in blood and other body
● Discuss the scope of medical technology curriculum and different job fluids.
opportunities.
● Operate complex apparatus, instruments and
MEDICAL TECHNOLOGY machines.
is also known as: ● Use standards and controls to improve
Clinical Laboratory Science reliability of results.
Medical Laboratory Science ● Work under pressure with accuracy and
precision.
What is Medical Technology (according to) ? ● Adhere to high ethical standards of
performance.
Ruth Heinemann
-is the application of natural, physical and biological PROBLEMS ENCOUNTERED IN MEDICAL
sciences to the performance of laboratory procedures TECHNOLOGY PRACTICE IN THE PHILIPPINES 1.
which aid in the diagnosis and treatment of disease. Data Integrity
2. Salary & Budgeting
Anne Fagelson 3. Licensing
-is the branch of medicine concerned with the 4. Immigrations
performance of laboratory determinations and analyses 5. Limited production and distribution of PPE during
used in the diagnosis and treatment of the disease and COVID pandemic.
maintenance of health. 6. Lack of Health Programs
7. No opportunity growth
Walters 8. Overload work
-is the health profession concerned with performing 9. Machine & Diagnostics (user- unfriendly interfaces)
laboratory analyses in view of obtaining information 10. Precision
necessary in the diagnosis and treatment of disease as
well as in the maintenance of good health. HISTORY OF MEDICAL TECHNOLOGY
GLOBAL AND LOCAL

RA 5527 (The Philippine Medical Technology Act of

EARLY BEGINNINGS
1969)
-is an auxiliary branch of laboratory medicine which
400 B.C.
deals with the examination of tissues, secretion and
- Hippocrates (Father of Medicine) described the
excretion of human body and body fluids by various
“four humors” in man; BLOOD, PHLEGM,
chemical, microscopic, bacteriologic and other medical
YELLOW BILE and BLACK BILE
laboratory procedures of technic which will aid the
- Urine was regarded as a composite of these
physician in the diagnosis strictly and treatment of
humors.
disease and in the promotion of health in general.
600 B.C.
What is common among them?
- Hindu physicians recorded the sweet taste of
- Performing laboratory procedures (samples)
diabetic urine as well as polyuria in diabetes.
- Analysis (results)
- Diagnosis and treatment (disease)
1500 B.C.
- Vivian Herrick identified Taenia and Ascaris.
CLINICAL LABORATORY
- “Ebers Papyrus” was discovered.
It is a facility that performs chemical and microscopic
- “Ebers Papyrus” – the oldest preserved
examinations of various body fluids (e.g. blood tissues).
Egyptian compilation of medical texts.
Inside the Clinical Laboratory
 - University of Minnesota is one of the first
1632 schools to establish training for workers in 1922
- Anton Van Leeuwenhoek invented the and first to offer a degree program in 1923.
compound microscope.
- He was the first to describe the red blood cells, World War II
protozoa, and to classify bacteria according to - “Closed system” of blood collection was
shape. adopted.
- Advanced instrumentation.
1628-1694 - Automated equipment.
- Marcelo Malphigi (Founder of Pathology) - Quality control programs.
- Greatest of the early microscopists.
- Contributed to Embryology and Anatomy. IN THE PHILIPPINES

1847 Jan. 9, 1945

- Rudolph Virchow - First Clinical Laboratory in Phil. at Quiricada
- Founder of the “Archives of Pathology” in St., Sta. Cruz, Manila was established and is
Berlin. known as the Public Health Laboratory.

1848 Oct. 1, 1945

- Herman Fehling - Dr. Pio de Roda and Dr. Mariano Icasiano
- Performed the first quantitative test for urine reopened Manila Public Health Laboratory.
sugar.
1947
15th Century - Dr. Pio de Roda and Dr. Prudencia Sta. Ana
- Discovery of dyes (aniline dyes) made possible offered training for highschool and paramedical
the staining and study of microorganisms such graduates.
as bacteria.
1954
IN THE UNITED STATES - 6-month laboratory training was offered.
- Formal education of Medical Technology
1878 began.
- Dr. William H. Welch - Dr. Sta Ana Prepared the syllabus for the
- Established a laboratory at Bellevue Hospital training program
Medical College.
- Became the first professor of Pathology at HISTORY OF MEDICAL TECHNOLOGY
John Hopkins University (1885). EDUCATION IN THE PHILIPPINES

1896 MRS. WILLA HILGERT HEDRICK

- Dr. William Osler opened the first clinical Founder of Medical Technology Education in the
laboratory at John Hopkins Hospital. Philippines
- The William Pepper Laboratory was also
opened at the University of Pennsylvania. 1954
- Philippine Union College of Baesa
1908 - First to offer BS Medtech.
- Dr. James C. Todd wrote “A Manual of - Dr. Jesse Umali was its first graduate after 2
Clinical Diagnosis” which became the standard years.
reference for laboratories.
1957-1958
1921 - Dr. Antonio Gabriel and Dr. Gustavo Reyes
- The Denver Society of Clinical Pathologists of UST offered MT as an elective to pharmacy
was organized. students. Due to its popularity, it was decided to
- The American Board of Pathology was be offered as a course.
organized in 1936.
1960
World War I - CEU offered MT course
- Produced a great demand for technicians. - First batch graduated in 1962.
1963
 - an organizational meeting headed by Crisanto Nature of the Field of Study
G. Almario was held at the Public Health Program course shall be called as:
Laboratory, MANILA which was attended by -Bachelor of Science in Medical Technology or
professionals and members of the academy from -Bachelor of Science in Medical Laboratory Science
the allied medical profession. - It is a four year program consisting of a one
1964 year internship with rotational duties in
- PAMET had its first national convention at FEU different sections during the 4th level in a
Medical Auditorium 1966- The Clinical CHED-accredited training laboratory.
Laboratory Act was approved - A licensure examination is given to all
1969 applicants for registration as Medical
- PAMET registered at the securities and Technologist.
Exchange Commission (SEC) -RA 5527 The
Philippine Medical Technology Act of 1969 was Program Goals
enacted into law The program aims for the graduates to:
1970 - Develop knowledge, skills, professional attitude
- The board of Medical Technology was created and values in the performance of laboratory
pursuant to RA 5527, The first MT Licensure procedures.
exam was conducted and Maridel P. Pasag, the - Acquire critical thinking skills.
first board topnotcher -PASMETH was created - Engage in research and community-related
and registered with the international Association activities.
of Medical Laboratory Technologists - Participate in activities promoting the
1972 profession and engage in the life-long learning
- President Ferdinand E. Marcos declared the 3rd undertakings.
week of September as MEDTECH WEEK - Develop collaborative and leadership qualities.
1973- Angeline Jose was elected as the first
female president of PAMET . Expected Performance Outcomes of Graduates
1975 The graduates must be able to:
- UST Graduate school offered MSMT- first - Demonstrate technical competence in the
school to offer this 1983- Prof. Lina C. Somera performance of clinical laboratory tests.
awarded as the “Most Outstanding Medical - Demonstrate analytical and critical thinking
Technologist” skills in the workplace.
1999 - Engage in the proper collection, analysis and
- Norma Chang-PAMET President, also elected projection of health information.
president for ASEAN Association of Medical - Demonstrate interpersonal skills, leadership
Laboratory Technologists. qualities and ethical practice of the profession.
1662-1662 - Apply research skills in relevance to areas to
- Dr. Horacio Ylagan and Dr. Serafin Juliano areas of Medical Technology/Laboratory
applied for the offering of BSMT courses in Science practice.
FEU which was approved in 1662. - Participate in community oriented activities.
- First batch graduated in 1663. - Engage in life-ling learning activities.
- Demonstrate effective teaching and
U.P – offers the same course but the degree is conferred communication skills.
to as B.S. Public Health.

Program Curriculum
Professional Organizations of Medical Technology in The Course shall be at least four years, including a
the Philippines: 12-month long internship in accredited laboratories and
-The Philippine Association of Schools of Medical shall include the following subjects:
-Technology and Public Health, Inc. (PASMETH) GENERAL EDUCATION
The Philippine Association of Medical Technologists CORE COURSES
(PAMET) PROFESSIONAL COURSES

MEDICAL TECHNOLOGY EDUCATION IN THE Scope of Licensure Examination

PHILIPPINES The given examination covers the following subjects
with its specific percentage:
 Clinical Chemistry 20% 2. Anatomical Pathology
Microbiology and Parasitology 20% Clinical Pathology:
Hematology 20% 1. Clinical Chemistry
Blood Banking and Serology 20% 2. Hematology
Clinical Microscopy 10% 3. Microbiology
Histopathologic Techniques and MT Laws 10% 4. Clinical Microscopy
5. Immunology
6. Molecular Biology
Employment Opportunities of Medical Technology 7. Immunohematology
8. Cytogenetics
Graduates
9. Endocrinology
● Medical technologist (generalist/specialist) 10. Toxicology
● Clinical laboratory supervisors 11. Therapeutic drug monitoring
● Chief medical technologist Anatomical Pathology:
● Laboratory owners 1. Surgical Pathology
● Sales and public relations representative 2. Immunohistopathology
● Educational representatives (company/health 3. Cytology
program) 4. Autopsy
● Researcher (industrial/medical) 5. Forensic Pathology
● Teachers/Instructors (secondary/tertiary levels) 6. Molecular Pathology
● Employment abroad
C. Based on Institutional Character
(Medical Technologist Specialist, Phlebotomist, 1. Institution-based
Industrial/Medical Researcher, Medical Doctors, 2. Freestanding
Medical Sales Representatives)
D. Based on Service Capability
UNIT 2 1. General Clinic Laboratory
CLINICAL LABORATORY 2. Special Laboratory
General Clinical Laboratory
OUTLINE
● General overview
a. Primary Category
● Classification of medical laboratories 1. Routine hematology (CBC)
● Organization of the laboratory
● Laboratory Sections
2. Qualitative platelet determination
● Information flow in the clinical laboratory 3. Routine urinalysis and fecalysis
● Three phases of the laboratory testing
● Laboratory policies 4. Blood typing – for hospital-based
b. Secondary Category
LEARNING OUTCOMES
● Identify and differentiate the classification of clinical laboratory settings. 1. Routine clinical chemistry
●
●
Construct an organizational chart/architectural plan.
Explain the roles, functions and services offered by the different sections of
2. Quantitative platelet determination
the laboratories. 3. Cross matching
● Justify and explain various information on a laboratory requisition.
● Identify the different phases of laboratory testing.
4. Gram staining
5. KOH staining for fungal disease
CLINICAL LABORATORY c. Tertiary Category
● Facility 1. All secondary lab services
● Specimens (whole blood, serum, plasma, urine, 2. Special chemistry (Cardiac markers)
stool, etc.) from the human body 3. Special hematology (coagulation tests)
● Collected, processed, examined or analyzed 4. Immunology/Serology (HIV, hepa profile,
● Prevention, diagnosis, and treatment tumor markers)
5. Microbiology – culture of sensitivity
CLASSIFICATION OF CLINICAL LABORATORY d. Limited Service Capability
DEPARTMENT OF HEALTH Special Clinical Laboratory
Administrative Order no. 20017-0027 a. Assisted reproduction technology laboratory
b. Molecular and cellular technology
A. Based on ownership c. Molecular pathology, Forensic pathology, and
1. Government Anatomic laboratory
2. Private
E. National Reference Laboratory
B. Based on Function 1. Confirmatory testing
1. Clinical Pathology 2. Surveillance
 3. Resolution of conflicting results ✔ Patient’s demographic data, name data,
4. Training and research address, birth data
5. Evaluation of diagnostic kits and reagents ✔ Test selection – should be marked clearly
✔ Date and time of collection
F. Satellite Testing Sites ✔ Identification of the person who performed
● Testing site owned by a licensed laboratory but the collection, name of ordering physician
situated in a location some distance from the ✔ Additional comments
main laboratory. ❖ Laboratory Directory
⮚ Stability of the specimen
G. Mobile Clinical Laboratories ⮚ Minimum volume
● Laboratory testing unit ⮚ Test schedule
● Moves form one testing site to another testing ⮚ Specimen processing
site ⮚ Method
● Has a temporary testing location
● Shall have a base laboratory LABORATORY REPORTS
● Permitted to collect specimen only ⮚ to transmit test results
● Operate within a 100-km radius from its main ⮚ Reference rangers
lab ⮚ Date and time of the specimen collection
⮚ Name, address of the laboratory
LABORATORY SECTIONS ⮚ Name and identification number of patient
⮚ Source of specimen
A. SPECIMEN PROCESSING ⮚ Date and time the report was generated
B. HEMATOLOGY SECTION
C. COAGULATION SECTION THREE PHASES OF LABORATORY TESTING
D. CLINICAL MICROSCOPY
E. PARASITOLOGY A. PREANALYTICAL PHASE
F. CLINICAL CHEMISTRY ❖ occurs first in the laboratory process
G. CLINICAL MICROBIOLOGY ⮚ Patient preparation
H. IMMUNOLOGY/SEROLOGY SECTION ⮚ Paperwork and data entry
SEROLOGY TESTS ⮚ Specimen collection, processing, storage, and
● Pregnancy test – detects B-HCG transportation
● Dengue Test ⮚ Responsible Personnel
● HbsAg – for hepatitis ***Phlebotomist, laboratory technician
● Bacterial Agglutination test
a. Widal test –typhoid fever B. PREANALYTICAL PHASE
b. Weil-Felix – nonspecific test for typhus ❖ Considered the “actual” laboratory testing or
fever the diagnostic procedures, processes and
I. IMMUNOHEMATOLOGY/BLOOD BANK products
J. HISTOPATHOLOGY/ CYTOPATHOLOGY ⮚ Proper instrument maintenance
⮚ Reagent supplies
Why is Laboratory Testing Performed? ⮚ Quality control
1. To assign a diagnosis ⮚ Responsible Personnel
**confirm clinical diagnosis ***Medical Technologist or Medical Lab
**to establish an appropriate plan of action Scientist
2. Prevention by early detection of diseases ❖ Ensure accuracy, precision, reliability of
through screening tests. the test procedure
3. Ongoing assessment of the patient’s progress ❖ Validates the following:
and treatment. ⮚ Test reagents/kits
⮚ Testing process
INFORMATION FLOW IN THE CLINICAL ⮚ Training of the lab personnel
LABORATORY performing the test

❖ Laboratory requisition C. POST-ANALYTIC PHASE

⮚ A form used by physicians to document the tests ❖ Includes the following:
that are to be performed on patients. ⮚ Review and analysis of results
⮚ Contains the following ⮚ Recording and reporting of test results
⮚ Storage and disposal of specimen
 ⮚ Releasing of results
⮚ Responsible Personnel
***Medical Technologist, Section
Supervisor, Chief Medical Technologist, office
clerk or staff

LABORATORY POLICIES
2. Yellow Bile (Choleric)
A. Laboratory hour and emergency work ● Sometimes referred to as red bile, this
● Definite working hours bodily fluid was associated with the
● Outside regular working hours organize a gallbladder and, like blood and black
system for testing urgent specimens. bile,was believed to be produced in the
liver. It was associated with childhood
B. Range of tests to be performed and those to be as well as anger
referred to higher level
❖ Range of tests to be performed
1. The number of staff available
2. The availability of material resources
3. The types of health institutions
(hospital or health center)
❖ Referral of specimens (when necessary) 3. Black Bile (Melancholic)
Example specimens for HIV detection ● Black bile, connected to pensive
and water samples for bacteriological sadness and old age, was believed to be
analysis. associated with an "imagined
receptacle" in the spleen
C. Collection of laboratory specimen
1. The specimen containers should be clearly
labeled with the patient’s name, identification
number, date of collection and time of collection
2. A fully completed request form should
accompany each specimen with the detail
mentioned above. 4. Blood (Sanguine)
● Blood, related to happiness and
D. Workload capacity of a laboratory optimism, was believed to be a mixture
- Should match to the number of staff of the pure blood humor and small
- Their level of training amounts of the other three humors,
- Size of the laboratory which were all produced as a by product
- The availability of laboratory facilities of the body's production of blood

Four Humors
Bloodletting.
● A rudimentary and qualitative assessment of
disorder through measurement of body fluids
(300 BC to 180 AD)
● Instigated by Hippocrates and Galen
● Greeks believed that the body was made up of Hippocrates
four main components or Four Humors ● Considered the Father of Medicine
● Author of Hippocratic and Oath
1. Phlegm (Phlegmatic)
● Phlegm is an umbrella-term for all Galen
whitish secretion besides milk and
● Greek physician and philosopher
semen, which can either be acidic,
● Instigated a rudimentary and qualitative
watery, salty, or sweet.
assessment of disorder through measurement of
the body fluid

900 AD
 ● Urine was one the body fluids that underwent ● Devised by Manuel Garcia using two mirrors
examination to observe throat and larynx
X-ray-
Hippocrates ● Invented by Wilhelm Roentgen when he
● Advocated the tasting urine, listening to the discovered by accident that radiation can
lungs and observing outward appearances in the penetrate solid object of low density/
diagnosis of disease. Electrocardiograph 1903-
● He concluded that the appearance of bubbles, ● Developed by William Einthoven to measure
blood, and pus in urine indicate kidney disease electrical changes during heart beat
and chronic illnesses. Kenny Method 1910-
Galen ● Devised by Elizabeth Kenny in the treatment
● Describe diabetes as the “diarrhea of the urine” of polio (then called infantile paralysis)
● Establish relationship between volume intake Invention of an new stretcher (It called sylvia stretcher
and urine volume The first book detailing the in 1927)
characteristics of urine (e.g color,density, Drinker Respirator 1927-
quality) was written ● Invented by Philip Drinker to help patients
with paralytic anterior poliomyelitis recover
Medieval Europe normal respiration
Heart-lung machine 1939-
● Uroscopy (water casting) Uroscopy is the ● First visual technology invented by Hermann
historical medical practice of visually von Helmholz
examining a patient's urine for pus, blood, or Cardiac Catheterization and Angiography-
other symptoms of disease. Oldest forms of ● 1941- Firsat operated bt Forsmann in 1929;
diagnostic testing developed by Moniz Reboul, Rousthoi between
11th century 1930 and 1940 was made to see the heart and
● Medical practitioners were not allowed to lung vessels and valse through inserting a
conduct physical examinations of the patient’s cannula in an arm vein into the heart with an
body. injection of radiopaque dye for x-ray
● Thus, they relied solely on the patient’s visualization
description of the symptoms and their Eduard Jenner 1796
observation ● Discovered Vaccination to establish immunity to
18th century smallpox -Immunology
● Medical techniques and cadaver dissection were Agostino Bassi 1835
used to provide an objective and accurate ● Produced disease in worm by injection of
diagnosis and to understand the inside of the Organic material- beginning of bacteriology
body. Marie François Xavier Bichat
19th century ● Identifies organs bt their types of tissues-
● Physicians began using machines for diagnosis Histology
or therapeutics. Among the devices Gregor Mendel 1866
● Enunciated his law of inherited characteristic
from studies on plants
● John Hutchinson ‘s (spirometer) Joseph Lister1870
○ Measuring the vital capacity of the ● Demonstrated that surgical infection are case by
lung airborne organism
● Jules Herisson’s (sphygmomanometer) Robert Koch 1877
○ Measuring blood pressure ● Presented the first pictures of bacilli
Elie Metchnikoff 1886
Stethoscope- ● Described phagocytes in blood and their role in
● Invented by Rene Laënnec used to acquire fighting infection
information about lungs and heart Ernst Von Bergmann 1886
Microscope- ● Introduces steam sterilization in surgery
● Devised by Antonie Van Leeuwenhoek father Karl Landsterner 1902
of Microbiology ● Distinguished blood groups though the
Ophthalmoscope- development of the ABO blood group system
● First visual technology invented by Hermann August Von Wassermann 1906
Von Helmholtz ● Developed immunologic test for Syphilis
Laryngoscope- Howard Ricketts 1906
 ● Discorevers microorganism whose range lies 6. Accountability
between bacteria and viruses called rickettsiae 7. Fidelity
Hans Fischer 1929 8. Confidentiality
● worked out the structure of hemoglobin
Jonas Salk 1954
● Developed poliomyelitis vaccine
Autonomy
James Wasrgard 1973
● Introduce th westgard rules for quality control in  The freedom to make decisions about oneself
the clinical laboratory  The right to self-determination
Baruch Samuel Blumberg 1980
● Introduces the hepatitis B vaccine  Healthcare providers need to respect patients’
Kary Myllus 1985 rights to make choices about healthcare, even if
● Developed the polymerase chain reaction (PCR)
Andre Van Steirteghem 1992 the healthcare providers do not agree with the
● Introduces the Intracytoplasmic Sperm patient’s decision.
INjection (IVF)
James Thomson 1989 Nonmaleficence
● Derives the first human Stem Cell Line  Requires that no harm be caused to an
individual, either unintentionally or
ETHICS CONSULTATION PROCESS deliberately
Ethics
 An individual’s own code for acceptable behavior  This principle requires MedTechs to protect
 They arise from an individual’s conscience individuals who are unable to protect

 They act as a guide for individual behavior themselves

 They are Learned Beneficence

Deontology Theory  This principle means “doing good” for others
 Ethics deals with the “rightness” or “wrongness” of  Nurses need to assist clients in meeting all their
human behavior needs
 Concerned with the motivation behind the behavior
◦ Biological / Psychological / Social
 Bioethics is the application of these principles to
Justice
life-and-death issues
 Every individual must be treated equally
 This requires MedTechs to be nonjudgmental
 Ethics is the study of values in human
conduct or the study of right conduct. Ethics
offers a critical, rational, defensible, systematic, Fidelity
 Loyalty
and intellectual approach to determining what is
 The promise to fulfill all commitments
right or best in a difficult situation.
 Ethics consultations results in  The basis of accountability

RECOMMENDATIONS…  Includes the professional's faithfulness or loyalty

to agreements & responsibilities accepted as
part of the practice of the profession
Ethical Principles
1. Autonomy
2. Beneficence
3. Non- Maleficence
4. Justice
5. Veracity
 This ethical principle is the foundation of
the nurse-patient relationship. Fidelity
comes into play when we uphold our
commitment to provide adequate pain
control when we provide quality care,
comfort, and support when needed when
we represent the interests of our clients
and we tell the truth.

Medical Confidentiality
 Anything stated to nurses or healthcare providers by
patients must remain confidential
 The only times this principle may be
violated are:
◦ If patients may indicate harm to themselves or others
◦ If the patient gives permission for the information
to be shared
Veracity
 This principle implies “truthfulness”
 Nurses need to be truthful to their clients'
 Veracity is an important component of building
trusting relationships
Accountability
 Individuals need to be responsible for their
own actions
 Nurses are accountable to themselves and to their
colleagues,
Ethical Dilemma _
 Occur when a problem exists between ethical
principles
 Deciding in favor of one principle usually
violates another
 Both sides have “goodness” and “badness”
associated with them