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Haemoglobin,PCV,ESR - 2 Copy

The document provides an overview of hemoglobin estimation, hematocrit, and erythrocyte sedimentation rate (ESR) interpretation. It details various methods for measuring hemoglobin and packed cell volume, along with their advantages and disadvantages. Additionally, it outlines normal values, indications for testing, and the practical assessment structure for students in a hematology course.

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4 views41 pages

Haemoglobin,PCV,ESR - 2 Copy

The document provides an overview of hemoglobin estimation, hematocrit, and erythrocyte sedimentation rate (ESR) interpretation. It details various methods for measuring hemoglobin and packed cell volume, along with their advantages and disadvantages. Additionally, it outlines normal values, indications for testing, and the practical assessment structure for students in a hematology course.

Uploaded by

tejasbhise4141
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Haemoglobin,

Hematocrit(PCV)
Erythrocyte Sedimentation
Rate(ESR)

Dr Smita Bhadekar
Objective
Hemoglobin estimation and Interpretation of
report.

Hematocrit and Erythrocyte sedimentation


rate: Interpretation of report.
Haemoglobin
Hemoglobin is the major constituent of red
cell cytoplasm.
Hemoglobin molecule is composed of
heme(iron +protoporphyrin) and globin
polypeptide chain.
Indication of Haemoglobin
estimation
1.Diagnosis and severity of anaemia.
2.Screening for Polcythemia.
3.Gives erythropoietic status of an individual.
4.Follow up of patients during treatment of anemia.
5.Estimation of red cell indices.
6.Selection of Blood Donor.
Methods of Estimation
 Colorimetric methods
Visual:
Sahli’s Method, Tallqvist, WHO,Spencer, Alkali Hematin, Haldane.
Photoelectric method:
Cyanmethemoglobin method, Oxyhemoglobin method, Alkali Hematin
method.
 Gasometric Method
Vanslyke Apparatus (1 gm Hb = 1.34 mlof O2)
 Chemical Method:
Iron content of hemoglobin is measured.
 Specific Gravity Method
Copper sulphate solution with Sp. Gravity 1.054
Sahlis acid hematin method
Principle- Hb is converted into acid
hematin by 0.1 N HCl and brown
color is matched against a brown
glass standard in a comparator.
Disadvantages:
-complete conversion of Hb into
acid hematin takes 1 hr . This delay
being impracticable , readings are
taken at end of 10 mins with only
95% conversion of acid hematin
Sahlis acid hematin method
Equipments:
1.Sahlis hemoglobinemeter.
2.Sahlis pipette(marked at 20 microlitre)
3.Stirrer.
4.N/10 HCL.
5.Dropping pipettes.
6.Reagents.
7.Distill water.
Sahlis acid hematin method
Disadvantages- Color
developed is not stable and
starts fading immediately
Carboxy,meth,sulf Hb cannot be
converted into acid hematin
Advantages Disadvantages
Cheap Chances of technical error
Portable/Bedside Sample collection
Technically simple Mixing of blood.
Easy to handle/perform All Hbs not converted
(cyanmeth,meth and
sulfhemoglobin)
Not wiping tip
Not waiting for 10 min
Manufacturer error
Fading of comparator
CyanmethHaemoglobin method
Principle-

When blood is mixed with a solution


containing potassium cyanide &
fericyanide soln (Drabkin’s solution),
all types of haemoglobins except
sulphaemoglobin are converted into
cyanmethHb which is measured in
photoelectric calorimeter at 540 nm.
Portable Hemoglobinometer
Hemocue system.

Pre-caliberated Spectrophotometer.

Can be used in Blood donation camps.


Autoanalyzer
Principle: Electrical Impedance
Blood diluted with reagent diluent.
Add sodium lauryl sulfate(SLS)Hb
reagent.
Surfactant which lyses RBC’s
releases HB.
Absorbance is measured at 555nm
to determine Hb.
HEMOGLOBIN Cont.
Normal Hemoglobin levels
 Adult Male 13 - 18 gm/dL
 Adult Female 12 - 15 gm/dL
 Infant cord blood 13 - 19 gm/dL

Normal Hemoglobin Types


 HbA (α2 β2)
 HbA2(α2δ2)
 HbF (α2γ2)

Abnormal Hemoglobin
 HbS, HbC, HbE, HbD, etc.
 Measured by electrophoresis
Packed cell volume
Definition: It is a ratio of volume of
erythrocyte to that of whole blood.
It is expressed as %.
Methods of measurement
Direct – By centrifugation
-macromethod- Wintrobe tube
-micromethod-Microhematocrit
method.
Indirect – As a product of MCV and
RBC
Uses of PCV
Detection of anaemia and Polcythemia.
Use of Red cell indices.
To see accuracy of Hemoglobin value.
Macromethod:

Wintrobe tube
Centrifuged (3000rpm x30 min.)

Height of red cell


Column recorded in %
Advantages
1. Colour of plasma – Jaundice,
Haemolysis
2.Thickness of buffy coat – Leukocytosis
3.Smears prepared from buffy coat –
-LE cell
-microfilaria
Micromethod
Capillary hematocrit tube

Sp. Centrifuged (12000rpm x 5 min)

Results are read on chart

Advantages
Quicker and less cumbersome
Normal values
 Male: 41-51 %
 Female: 36-45 %

 Rule of 3 and 9

PCV is approximately 3 times that of Hb .


RBC count (mill/cmm)x9=PCV
Interpretation
Low value
 Anemia

 Pregnancy

 Excessive administration of fluids

High value
 Polycythemia

 Shock associated surgery, Trauma, Burn


Eryrothycte Sedimentation Rate
(ESR)
It measures the rate of settling(sedimentation)
of erythrocytes in anticoagulated whole blood.

Methods of ESR

Westergreen Method.
Wintrobe Method.
Zeta Sedimantation Ratio.
Micro-ESR.(small children).
Automated method.
Equipments and Reagents for ESR
Westergreen Tube.
Westergreen Stand.
Wintrobe tube.
Zeta Sedimantation Ratio.
Micro-ESR.(small children)

Specimen:
Venous blood is collected in Trisodium citrate
bulb(Blue top) in 4:1 ratio.
Wintrobe tube
It is used for estimation of ESR and PCV.
After obtaining ESR tubes are centrifuged to
get PCV.
More reliable when ESR is low.
Increase ESR Decrease ESR
Infection:Tuberculosis, Polcythemia.
Pyogenic arthrits,Bacterial CCF,Dehydration.
endocarditis,Rheumatic Hereditary spherocytosis.
fever.
Hypofibrinogenemia.
Inflammatory Disease-
Rheumatoid
arthritis,SLE,Arteritis,Polym
algia Rheumatica.
Paraproteinemia:
Multiple myeloma,
Waldenstroms
macroglobuniemia.
Technical problem like Inc
temp,tilted tube.
Interpretation Of ESR by
Westergren Method
ESR value By Wintrobe method
Males :0-9 mm in 1 hr
Females:0-20 mm in 1 hr.
Children:0-13 mm in 1 hr
Theory Marks Distribution
Multiple choice question 20 marks
SAQ-AETCOM Module(2.8) 7x1 7 marks
Short answer question (any 3 out of 4) 7x3 21 marks
Long answer question(structured) 12x1 12 marks
Short answer question (any 4 out of 5) 7x4 28 marks
Long answer question(structured) 12x1 12 marks

Total marks: 100


Practical Marks Distribution
PRACTICAL
OSPE 15 marks
Peripheral smear 5 marks
CBC report interpretation 5 marks
Histopathology slide 5 marks

VIVA
 Gross specimen and General Pathology viva 7 marks
 Hematology viva 8 marks
Log book 5 marks
TOTAL(Practical& Oral & Viva) 50 marks
Practical Skill Exercise
Competency no :PA 16.6
Exercise :Preparation of peripheral smear.
Certification: By respective Batch Teacher

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