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
