Nasopharyngeal swab
The patient wears a surgical mask. She is informed about the procedure
that is about to be performed. The patient must be seated in a
comfortable position with his head resting on the back of the chair. The
patient’s head must be placed on a horizontal plane parallel to the
floor. The patient is asked to lower the mask by uncovering only her
nose and keeping the mouth closed. After opening the swab in a sterile
manner, the operator positions the patient laterally in order to avoid
direct droplet from sneezing or coughing. The swab is inserted gently
into the nostril. The insertion must be parallel to the floor of the
nasal fossa. The swab is kept medial and facing the nasal septum (do not
insert the swab upwards, as in this case the swab stops at the level of
the nasal turbinates and the viral RNA sampling may not be significant).
It is important to use the mark on the swab stick as a depth reference
(Figure 2). However, when the operator feels an obstacle to further
introduction, it means that the swab will have reached the posterior
wall of the nasopharynx. With clockwise and counterclockwise movement,
repeatedly rub the swab against the posterior wall of the nasopharynx
(Figure 3), for about 10-15 seconds. Extract the swab from the nostril
taking care not to contaminate it upon exit, introduce it into the test
tube and break it at the mark on the stick. In case of difficulty in
introducing the swab into a nasal fossa due to deviation of the nasal
septum or hypertrophy of the inferior turbinates, proceed with the same
technique in the contralateral nasal fossa. The endoscopic vision shown
in the video has a didactic purpose only, the nasopharyngeal swab should
not be performed with the aid of the endoscope.