Blood Investigation

Mohammad irfan
 Blood investigation, or blood testing, refers to laboratory tests
performed on a blood sample to evaluate overall health, diagnose
medical conditions, monitor diseases, and assess treatment
effectiveness.
Indication for blood investigation

1. Assess Health: General health check-ups.

2. Diagnose Conditions: Identify diseases like diabetes,
anemia, infections.
3. Monitor Diseases: Track progress of conditions.
4. Evaluate Treatments: Measure effectiveness of
treatments.
Materials used
 Tourniquet
 needle/ syringe
 vacutainer holder
 vacutainer tubes
 Alcohol
 Gauze
 Band-Aid
 sharps container
 marker for tubes
safety
 Observe universal (standard) safety precautions.
 PPE'S will be worn at all times.
 Wash hands in warm, running water with a appropriate hand
washing product.
 Gloves are to be worn during all phlebotomies, and changed
between patient collections.
 Palpation of phlebotomy site may be performed without gloves
providing the skin is not broken.
 A lab coat or gown must be worn during blood collection
procedures.
 Needles are single use and are disposed of in an appropriate
'sharps' container .
 Gloves are to be discarded in the appropriate container
immediately after the phlebotomy procedure.
 All other items used for the procedure must be disposed of
according to proper biohazardous waste disposal policy.
 Contaminated surfaces must be cleaned with freshly prepared
10% bleach solution. All surfaces are cleaned daily with bleach.
 In the case of an accidental needlestick, immediately wash the
area with an antibacterial soap, and contact your supervisor.
Preparation of patient

 Check consult
 Identify and prepare the patient condition
 Select the site.
 Perform hand hygiene and put on gloves.
 Disinfect the entry site.
Preparation of environment

 Provide calm environment.

 Wear gloves and a lab coat or gown when handling blood/body fluids.
 Dispose of needles immediately upon removal from the patient's vein.
 Clean up any blood spills with a disinfectant such as freshly made
10% bleach.
Procedure of blood collection
 Introduce yourself to the patient, and ask the patient to state their
full name.
 Check that the laboratory form matches the patient's identity
 Ask whether patient has allergies ,phobias or has ever fainted during
previous injection or blood draws
 if patient is anxious or afraid, reassure the person and ask what
would make them more comfortable.
 Make the patient comfortable in a supine position (if possible).
 Place a clean paper or towel under the patient's arm.
 Discuss the test to be performed and obtain verbal consent.
 The patient has a right to refuse a test at any time.
Procedure
 Identify the patient, two forms of active identification are required.
 Ask the patient to state their name and date of birth.
 This information must match the requisition.
 Reassure the patient that the minimum amount of blood required for
testing will be drawn.
 Verify that any diet or time restrictions have been met.
 Order of Draw
 The following order of draw is the approved order as established by CLSI.
 This order of draw should be followed whenever multiple tubes are drawn
during a single venipuncture.
 Light Blue Top : 3.2% sodium citrate. These tubes are used for coagulation
tests and need to be completely filled to ensure the proper ratio of blood to
anticoagulant.
 Red Top : Plain and gel. Used for chemistry and reference tests.
 Green Top : With and without gel, contains lithium heparin. These tubes are
used primarily for chemistry tests.
 Lavender or Pink Top : Contains EDTA. Used primarily for hematology and
blood bank testing.
 Gray Top : Contains sodium fluoride/potassium oxalate. Used by chemistry
for glucose testing.
 Yellow Top : Contains ACD(acid citrate dextrose) solution A or B. Used for
Genetics testing.
Hemoglobin
 Hemoglobin is a complex protein found in red blood cells that plays a crucial role
in transporting oxygen throughout the body

 Normal Count: 14 - 16 g/dL

but it can vary from age to age
At birth : 25g/dL
After 3rd month : 20g/dL
After 1 year : 17g/dL
from puberty onwards: 14 - 16g/dL

 It can also vary in gender –

Adult males : 15g/dL
Adult females : 14.5g/dL
 If the count is low –
 chronic inflammation(inflammation is a body process that can result in
pain swelling warmth or redness)
 Low hematocrit and hemoglobin counts may be signs that your
medication is causing a loss of blood from your stomach and passing
through your bowel.
 Low counts also may indicate a decrease in red blood cell production.
 bone marrow problem

 If the count is more –

 blood volume increase
 in case of smoking
 high altitude
 WBC
 WBC tests measure the number of white blood cells
present.
 When you have an infection your body produces more
white blood cells.
 Some medications can decrease the number of white
blood cells which could increase your chances of
getting an infection

Total count (TC)

4000 - 11000/cu Mm of
blood
differential count (DC)-
Significans
 If the count is less-
 may be due to some medications
 decrease count indicate more prone for
infection

 If the count is more-

 Infections, bacterial or viral
 disease in bone marrow
 Rheumatoid arthritis
 disorder in immune system
 Smoking
 acute lymphocytic leukemia
 Stress, such as severe emotional or physical stress
 acute myelogenous leukemia(AML)
 Tuberculosis
 Allergy, especially severe allergic reactions

 Chronic lymphocytic leukemia

 Chronic myelogenous leukemia
 Drugs, such as corticosteroids and
epinephrine
Platelet count

 This test measures the number of "sticky" cells or platelets that help
the blood to clot (aspirin and some other medications make the
platelets less "sticky").
 If the number of platelets is low you could have too much bleeding.
 Some powerful arthritis medications in rare instances lower the
platelet count.

 Normal value
 2,50,000/cu mm of blood
 range- 2,00,000 - 4,00,000/cu mm of blood
Significance

 If the count is less- (thrombocytopenia)

 more bleeding
 TB
 infections and other disease

 If the count is more- (thrombocytosis)

 allergic conditions
 bone fracture
 rheumatic fever
 trauma
 Erythrocyte sedimentation rate
 (ESR)
This test also called "sed rate” determines if you have inflammation.
The sed rate can measure the amount of inflammation present.
 The test measures how fast red blood cells cling together, fall, and
settle toward the bottom of a glass tube in an hour's time, like
sediment.
 The higher the sed rate, the greater the amount of inflammation. As
inflammation responds to medication, the sed rate usually goes down.

 Normal Values by westergen method-

 in males-3-7 mm in one hour
 in females-5-9 mm in one hour
 in infants- 0-2 mm in one hour
Significance
 if the count is more - (more inflammation)
 TB
 Anemia
 Malignant
 tumors
 RA
 Rheumatoid fever
 liver disease

 If the count is less

 -allergic conditions
 sickle cell anemia
 polycythemia (increase in RBC)
Creatinine tests

 These measure kidney function.

 Creatinine is a normal waste product of the muscles.
 A high level of it means that the kidneys are not working well enough
to remove waste products from the body.

 Normal values
 male - 0.9 - 1.4 mg/dL
 female 0.8 - 1.2 mg/dL
Uric acid

 These tests measure the amount of uric acid in the blood.

 People with gout usually have high levels of uric acid which forms into
crystals that are then deposited in the joints and other tissues.
 However not everyone with a high uric acid level has gout.

 Normal values
 male: 3.4 - 7.0 mg/dL
 female : 2.4 - 5.7 mg/dL
After care
 Leave the dressing strip in place for 30 minutes to an hour.
 For the Rest of the Day.
 Avoid tight or restrictive clothing on the arm
 If bleeding occurs apply firm pressure with your fingers directly over the
needle site
 Avoid strenuous use of the arm, eg ; sports or heavy lifting
 if you have discomfort or swelling of the arm, elevate your arm and place
ice over the site for 10 minutes.
 Rest the arm as much as possible.
Thank you