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.