MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS EXAM 2 Field Center Procedures Manual of Operations Multi-Ethnic Study of Atherosclerosis Exam 2 Field Center Procedures Manual of Operations Table of Contents SECTION 1: OVERVIEW AND CLINIC EQUIPMENT.5 SECTION 2: OVERVIEW OF EXAM 2 COMPONENTS.11 2.1 Summary of Exam 2 components .11 2.1.1Exam 2 Procedures: .11 2.1.2Exam 2 Forms11 2.1.3Surveillance Phone Call Forms and Questionnaires:.11 2.1.4Events Forms .12 SECTION 3: CLINIC QUESTIONNAIRES adapters need are #6561E, 6561E, 6562E, 6566E. Harvard Trip Balance / Pan balance, VWR # 12344-051 Water tubes for balancing the centrifuge, VWR # 21008-102 Freezer (-70 C or colder) Refrigerator for storage of special blood tubes, media, etc (can be a household fridge, should not be used to store food, from Sears or a similar store) Test tube racks / cryovial racks (Simport # T315) Fixed volume pipettes with tips (MLA) and regular adjustable pipettes (Rainin, Finn, MESA Exam 2 Field Center Procedures Manual of Operations 9 etc) with tips. Volumes needed to pipette: 225 ul, 0.5 ml, 1.0 ml (200 to 1000 ul), 3 to 5 ml, 9 ml, and 14 ml. Graduated cylinder, Lab Safety 25 ml Nalgene 9A-22763 Blood tube rocker (Thermolyne Labquake Tube Shakers C400-110) Blood tube racks, Fisher Scientific # 60914764 Stopwatches or timers, VWR # 62344-756 1.2.5.3Other Equipment Refrigerator for storing food (i.e., a household fridge, should not be used to store blood samples or chemicals, can be ordered from Sears or a similar store) Ice machine, Ice Machine Sales Service # 351-FAV-161 Sharps containers (wall mounted and table-top), sharps disposal Lab safety # 9A-25703 Biohazard waste containers Lab Safety Supply # 6 gallon container - # 9A-29190 Emergency eye wash station Lab Safety Supply # 9A-2121S Personal protective equipment for phlebotomy and processing: face shield, Lab safety # 9A-1402, splash shields, other Personal Protective Equipment as needed. 1.2.5.4Examination Supplies Disposable ECG electrodes (Unitrace blue heart electrode) Single use thermometers Ultrasound transmission gel, Gloves (latex, vinyl, or others, any vendor) Kim wipes Pregnancy test kit Peel-off china marker 1.2.5.5Phlebotomy and Laboratory Supplies Butterfly needles (21 G) with luer adapter Vacutainer barrels Tourniquets #CK1126 Alcohol prep pads # 10-3001 Gauze (2x2) Kendall # 1806 Surgical tape - paper tape 3 M durapore Band-aids (first aid) # 1290033 Blood collection tubes: - 10 ml Serum (red-top) tubes - 10 ml EDTA (purple-top) tubes - 4.5 ml Citrate (blue-top) tubes Polypropylene (or polystyrene) disposable test tubes (10-15 mL) for pooling samples Revco Boxes and dividers (10 x 10 and 7 x 7 grids) (Revco box # 5954 with Revco 10x10 grid # 5958, Revco box # 5956 with Revco 7x7 grid# 5959) Isopropyl alcohol Distilled water 10% bleach solution (or approved biohazard disinfectant) 1.2.5.6Shipping Supplies MESA Exam 2 Field Center Procedures Manual of Operations 10 Styrofoam/insulated boxes (Polyfoam Packer # 355-CS for frozen shipments, #33- 12KD for refrigerated shipments) Ziplock bags for freezer boxes Dry ice Ice (gel) packs Absorbent material (old newspaper or paper towels) for layering between dry ice Elastic bands for freezer boxes Packing tape 1.2.5Vendors Vendors for non MESA-Retina but all components of Exam 2 must be completed. 1. A pregnancy test should be performed within 48 hours before the CT exam in all women of child-bearing potential who is scheduled to have a CT exam. This could be done in the clinic or in the Radiology Department. 2.Questionnaires and clinic procedures should be performed before the CT and/or MRI exams. 3.Anthropometry and blood collection should be performed while the participant is fasting. Blood pressure measurement should be done before venipuncture. CT, MRI, Eye exams, and questionnaires do not require fasting. 4. Blood drawing should be done after a 12-hour fast and before 10:30 am. II.EXAMINATION ORDER Guidelines for clinic order are similar to that of the Exam 1. Many elements are left to the discretion of the individual field center. A few key points are reiterated here: 1.Resting blood pressures should be obtained after the subject has been in the seated position for at least five minutes. 2.Venipuncture should be performed in the fasting state after blood pressure measurement. If a participant comes to the clinic non-fasting, perform exam components that do not require fasting, and schedule the participant for another clinic visit for fasting blood collection. 3.Questionnaires may be administered at any time during the examination. During the interviews, make every effort to avoid distractions, ensure privacy, and maintain confidentiality for the participant. Do not conduct interviews during the snack or in the waiting area in the clinic. III.GUIDELINES FOR EXAMINATION OF DIABETIC PARTICIPANTS 1.Diet-controlled diabetics must fast overnight and are treated the same as