Introduction to

Clinical
Laboratories
Introduction to Clinical Laboratories

 When a person is ill, diagnosis begins

with physical examination by a doctor.
It may not possible to diagnose a
disease only on the basis of physical
examination.
 There are various diagnostic tests to
confirm a suspected diagnosis. The
clinical/pathological laboratory tests
are extremely useful to find out the
causes of disease.
The functional components of the
clinical U laboratory are:
 Clinical pathology
 Hematology
 Clinical biochemistry
 Clinical microbiology
 Serology
 Blood bank
 Histology and cytology
 Clinical Biochemistry is the division of
laboratory medicine that deals with the
measurement of chemicals (both natural and
Clinical unnatural) in blood, urine and other body
fluids.
Biochemistry
These test results are useful for detecting
health problems, determining prognosis and
guiding the therapy of a patient.
 Uses of biochemical tests
• The science of biochemistry is fundamental to Clinical Medicine.
• Biochemical investigations are involved in varying degrees, in
every branch of clinical medicine.
• The results of biochemical tests may be of use to the clinician in
diagnosis and monitoring of treatment.
• Biochemical tests may also be of value in screening for disease
or in assessing the prognosis, once a diagnosis is made.
• The biochemical tests are also used in research and in clinical
trials.
• A biochemical result on its own is of no value. It requires
interpretation and proper interpretation requires that the reason
for its being requested is properly understood.
Blood analysis steps
Phlebotomy equipments: The
phlebotomist, the technician who
collects blood, should be trained to:

 1) Disposable syringes or vacutainer

systems
 2) Disposable lancets
 3) Gauze pads or adsorbent cotton 4)
Tourniquet
 5) Alcohol swap
 6) Waste container
 Blood collection

Selecting vein site:

For most venipuncture procedure on
adults vein located in the arm are used.
The median cubital vein is the one used
for the patient.
If the venipuncture of this vein is
unsuccessful, one of cephalic or basilic
veins may be used. The blood however
usually flows more slowly from these
veins.

For the determination of blood pH,

PCo2, PO2 and bicarbonate,
arterial blood is used. It is usually
performed by physicians.
 Basic incorrect blood tube.

Samples without the appropriate preservative

Samples that are received ambient, when a frozen sample is required.

Hemolysis of blood:

Criteria of
Samples in incorrect containers (e.g. cervical cytology must be a ThinPrep
U

vial; urine cytology must be in a uricyte container).

blood sample Insufficient sample received.

rejection Labelling or form issues (mislabelled/unlabelled/no forms/no clinical

information).

Clotted/haemolysed/lipaemic samples.

Sample is broken or has leaked in transit.

Stability time has been exceeded. Stability time is test-dependent, and also
refers to tests that can only be carried out on certain days of the week.
Hemolysis of blood:
 Hemolysis means liberation of
hemoglobin from RBCs. Due to hemolysis,
plasma or serum assumes pink to red color.
It is important to avoid hemolysis during
sampling, transporting and storage (too hot
or too cold)because hemolysis causes
changes in measurement of a number of
analysis such as:
 Serum K
 Serum in.org P.
 SGOT
 Acid phosphatase
 Hemolysis of blood
 Hemolysis is the breaking down of red
blood cells due to the mishandling of blood
samples during routine blood collection
and transport.
 Due to hemolysis, plasma or serum
assumes pink to red color.
 Serum from heavily hemolyzed blood
specimens can interfere with the antigen-
antibody reaction and color measurement
in immunoassays such as ELISAs. Trace
Mineral, Serum testing is also affected by
hemolysis resulting in increased iron,
magnesium, and potassium concentrations,
while possibly decreasing those of sodium.
 Blood collection
tubes
Most blood collection tubes contain an
additive that either accelerates clotting
of the blood (clot activator) or prevents
the blood from clotting (anticoagulant).
A tube that contains a clot activator will
produce a serum sample
when the blood is separated by
centrifugation and a tube that contains
an anticoagulant will produce a plasma
sample after centrifugation.
Some tests require the use of serum,
some require plasma, and other tests
require anticoagulated whole blood.
 Plasma Separating
Tubes(PST)

LAVENDER top tube:

This tube is used to for
Hematology (CBC, e.g.) and
certain Chemistry and Blood
Bank testing.
The tube contains EDTA as an
anticoagulant.
Samples collected in lavender
tubes may not be used for
coagulation tests.
 Light Blue Top Tube:

 This tube is used for coagulation testing.

 The tube contains buffered sodium
citrate as an anticoagulant. It is critical
to test accuracy that the tube be filled
completely.
 Inadequate amounts of blood in the tube
can yield erroneous test results.
 must be inverted immediately after
filling
 Green Top Tube:
 This tube contains sodium or lithium heparin
as an anticoagulant, and is used for certain
hematology, chemistry and virology tests and
for tests requiring whole blood or plasma
such as ammonia

Black Top Tube (Vac-Tec):

 This tube is used for sedimentation rates
(ESR).
 The tube contains sodium citrate as the
anticoagulant.
Grey Top Tube:
This tube is primary used for glucose testing.
It contains potassium oxalate with sodium fluoride as the
anticoagulant.

Royal blue Top Tube:

this tube contains heparin or Na EDTA anticoagulants
Tube is designed to contain no contaminating metals -Trace element and
toxicology studies

Yellow Top Tube:

This tube is used for certain reference tests requiring whole
blood.
It contains ACD (acid-citrate-dextrose) as the anticoagulant.
It is also used for blood cultures.
Serum Separating Tubes(SST)
Red top tube (Plain tube)
 contains no additives.
 Tests for antibodies and drugs often require these.
Gold Top Tube
 These contain particles that cause blood to clot quickly, as
well as a gel to separate blood cells from serum.
 Blood
Blood is a liquid tissue, Suspended in
the watery plasma are seven types of
cells and cell fragments.

 Red blood cells(RBCs)

 White blood cells(WBCs)
 Platelets
 Five kinds of Leukocytes (lymphocytes,
monocytes,neutrophils,eosinophils,baso
phils)
 After centrifugation of blood, the blood
separate into three layers
 Blood plasma
 Plasma is the liquid component of blood.
 It is mainly composed of water, blood proteins
and inorganic electrolytes.
 Roughly 92% water, mixed with organic and
inorganic-substances.
 The most abundant plasma solute is the plasma
protein, of which there are three groups:
albumin, globulins, and fibrinogen.
 Blood clot

 When a blood sample is left standing without

anticoagulant, it forms a coagulum or blood clot.
 One of the normal components of plasma is a soluble
plasma protein called fibrinogen.
 On standing, this protein will be converted to insoluble
substance called fibrin >>>> this occurrence is referred
to as blood coagulation or clotting.
 The clot contains coagulation proteins, platelets, and
entrapped red and white blood cells.
 Procedure of Plasma Preparation:

 Draw blood from patient.

Select vacutainer with an
appropriate anticoagulant.
 Mix well with anticoagulant.
 Allow to stand for 10min.
 Centrifuge the sample to
speed separation and affect a
greater packing of cells.
 The supernatant is the plasma
which can be now collected
for testing purposes or stored
(-20C to -80C) for subsequent
analysis or use.
Thank you