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INTRODUCTION TO HEMATOLOGY

OVERVIEW

5 liters of blood
Parts:
o Formed elements

Red Blood Cells

White Blood Cells

Platelets
o Plasma/Serum

RED BLOOD CELLS

Transports oxygen and carbon dioxide


6 to 8 m
Dec = Anemia
Inc = Polycythemia

HEMOGLOBIN

Hemoglobin + Drabkin Reagent (potassium


cyanide and potassium ferricyanide) =
cyanmethemoglobin
Sodium lauryl Sulfate

HEMATOCRIT

Volume of packed red blood cells to the


volume of whole blood (PCV)

OTHER INDICES

Basophil
Lymphocyte
Neutrophil

NEUTROPHIL

Phagocytic cell
Neutrophilia/Nuetropenia

BAND

Less differentiated WBC

EOSINOPHIL

Bright orange red granules


Immune system regulation and parasitic
infection

BASOPHIL

Dark-purple irregular cytoplasmic granules


Histamines and other proteins

LYMPHOCYTES

Host immunity (humoral/cell-mediated)


Lymphocytosis/Lymphopenia

MONOCYTES

Immature macrophage
Phagocytic cell

LEUKEMIA

Uncontrolled proliferation of WBC


(chronic/acute)
Identified using Wrights stained smears,
cytogenetics, flow cytometry/molecular
profiling, immunochemistry

PLATELET
RETICULOCYTES

0.5%-2%
Slightly larger than MATURE RBC
Indicates ability of bone marrow to
respond to anemia
Observed by supravital staining (RNA)

WHITE BLOOD CELLS

Maintains blood vessel integrity


(hemostasis)
2-4 m
Anucleate

HEMATOLOGIC PROCEDURES

Complete blood count


Blood film examination
Coagulation studies

Monocyte
Eosinophil

HEMATOLOGY - 1
KTY.PRELIMS.2015

QUALITY ASSURANCE AND QUALITY


CONTROL

Internal External

SPECIMEN COLLECTION - PHYSIOLOGIC


FACTORS THAT CAN CONTRIBUTE TO PREANALYTICAL VARIATION

Posture
Diurnal Rhythm
Exercise
Stress
Diet
Smoking

VENIPUNCTURE PROCEDURE
1. Prepare accession order
2. Patient identification
3. Sanitize hands
4. Verify dietary restrictions/preparations
5. Assemble supplies
6. Prepare patient
7. Locate the vein
8. Put on gloves (PPI)
9. Cleanse the area
10. Inspect needle
11. Perform venepuncture (1-2 inches below
the site and insert the needle bevel up, 30
degrees from the skin).
12. Fill collection tubes according to proper
order of draw
13. Release the tourniquet
ORDER OF DRAW
1.
2.
3.
4.
5.
6.

Blood culture tubes (yellow stopper)


Coagulation tubes (light blue)
Serum tube (with or w/o separator)
Heparin tube (green)
EDTA tube (purple/pink)
Sodium fluoride/oxalate (black/gray)

VENIPUNCTURE IN CHILDREN

Uses smaller gauge needles (g 22-23) or


winged blood collection set

COMPLICATIONS ENCOUNTERED
ECCHYMOSIS

Most common
Leakage of small amount of blood in the
tissue around the puncture site

HEMATOMA

Leakage or large amount of blood

OTHER COMPLICATIONS

Fainting
Hemoconcentration
Hemolysis
Petechiae
Allergies
Nerve damage
Seizure
Vomiting

SPECIAL CASES

Edema
Obesity
Burn Patients
On intravenous fluids
Mastectomy patients
Hard to extract patients

SKIN PUNCTURE OVERVIEW

Most commonly used for pedriatic patients


Can be used on special adult cases
Mixture of blood (venules, arterioles,
capilliaries), interstitial and intracellular
fluids
May generate slightly different laboratory
results

ORDER OF DRAW

Tube for blood gas


Slides (EDTA microcollection tube)
EDTA microcollection tube
Other microcollection tubes with
anticoagulant
Serum microcollection tube

SPECIMEN REJECTION

Test order requisition did not match


Unlabeled tubes
Hemolyzed
Wrong collection time
Wrong tube
Clotted
Contaminated (IVF)
Lipemic

HEMATOLOGY - 2
KTY.PRELIMS.2015