Rapid Toxic Screen for a Suspected Chemical Event

Train Derailment Spill

• Specimen requirements:

  • For adult patients: 3 purple top tubes of whole blood (4 ml minimum/tube) drawn first and labeled #1, #2, and #3 in the order that they are drawn, 1 green top or gray top tube of whole blood, and 40-60 ml clean catch urine in a sterile cup.

  • For pediatric patients: 40-60 ml clean catch urine in a sterile cup unless directed otherwise by MTPHL in collaboration with the CDC.

  • Keep blood tubes at 1-10ºC and freeze urine specimens at -70⁰C. This is essential for transport as well.

  • All specimens must have two unique patient identifiers, the date of collection, the time of collection, and the initials of the collector on the tubes and cup as they are considered evidence.

  • If a bar code label is used, do not obscure the tube or cup lot number, and place the label so that when the tube or cup is upright, the bar code looks like a ladder.

  • 2 blank EDTA tubes, 2 blank green or gray top tubes, and 2 blank sterile Urine cups must be submitted for each lot of tubes and cups used. This is essential to determine background levels of the various chemicals that will be tested for.

• A Chain of Custody form and a Shipping Manifest listing each patient and their specimens obtained must accompany the specimens.
• Within 24 hours of the receipt of the specimens, the CDC will notify the MTLSB of the RTS results. MTLSB will immediately advise the submitting hospital laboratory of the results. IF the chemical agent is one that can be tested for by the LRN-C lab section, MTLSB will coordinate further testing of patient specimens. Physicians may want to test additional victims for treatment and insurance purposes, the worried well to assuage their concerns, or follow a known exposure patient’s recovery.
• In the case of a suspected Chemical Exposure Event: call the MTPHL 1-800-821-7284, 24/7, to answer questions and to coordinate the specimen acquisition and shipping/courier logistics.
• In a non-emergency, call Kim Newman, Laboratory Preparedness Specialist, with any questions (406-444-3068).