Exercise 29: Hematology



Hematology

Purpose: This exercise is designed to familiarize the student with several simple blood tests and the safety measures required to do them safely.

Performance Objectives: At the end of the exercise the student should be able to:

1. Perform each test in this lab exercise safely.

2. Define hematocrit.

3. Perform blood glucose and cholesterol test if available.

4. Describe the techniques used in making a hematocrit, hemoglobin test and blood typing test.

5. Identify and describe the 5 types of white blood cells.

Safety Precautions

Note: If you fail to observe the safety precautions for this lab, you may be required to leave the lab!

1. Work alone

2. Collect and test only your own blood

3. Spray table with disinfectant before and after lab

4. Wear nitrile gloves on both hands except while you are doing finger punctures

5. Do not recap or reuse lancets

6. Safely dispose of all disposable and reusable supplies and equipment that you have used on your own blood. See the handout “safety precautions for the blood lab” for specific disposal instructions for each item that you will use

7. Wash the lab bench area that you have been using with disinfectant solution before you leave.

Activity: Determining the Hematocrit using a heparinized tube

1. Puncture your finger with a lancet. The blood must be free flowing for the tube to fill properly.

2. Fill the tube by holding it horizontally to the drop of blood seal the heparinized capillary tube by pressing it into the tray of clay.

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3. Leave the capillary tube in the tray of clay until the instructor is ready to help you place them in the centrifuge.

4. After the capillary tube is removed from the centrifuge tube this is what results:

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5. Determine the hematocrit values using the plastic card (Hematocrit Reader) at your lab table or from the picture below.

a. Place the centrifuge tube with the interface of sealant and packed cells intersecting the “0%” or bottom line.

b. Slide the hematocrit tube across the reader until the top layer intersects the top or “100%” line.

c. Read the percentage height of the red cells from the scale.

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6. A metric ruler can also be used to determine hematocrit. The instructor will provide the instructions.

7. Record the hematocrit on your data sheet

Disposal:

Dispose of lancet in plastic sharps container immediately

Dispose of alcohol swabs, cotton balls, and other paper supplies in the biohazard bag.

Put the Seal-Ease in the bleach tray

Dispose of capillary tube in the sharps container

Activity: Determining Hemoglobin Concentration

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The Tallquist method simply involves comparing the color of a drop of blood on white blotting paper to the color chart provided in the booklet

1. Place a drop of blood on a piece of Tallquist paper.

2. Wait about 15 seconds, then place the paper with the blood behind the color chart.

3. Find the color that matches your blood hue and record the grams of hemoglobin in the data table.

Disposal:

Dispose of blotting paper in biohazard bag

Place the Tallquist scale by placing in bleach tray on counter

Activity: Typing for ABO and RH Blood Groups

We will use “Eldon Cards” to determine blood types. This test will detect the common blood grouping system A, B, O, AB and Rh (D).

1. Open the foil pouch containing the test card. Place the card on a table or flat surface.

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2. Obtain 4 applicators (Eldon Sticks) and place them in a convenient location ready for use.

3. Add a drop of tap water to each of the colored reagent spots on the Eldon Card.

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4. Twist off the little protective cap from the lancet. Place the lancet upon a table.

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Wipe a fingertip with the alcohol wipe provided and allow it to dry.

Place the lancet against the end of the finger and press against your finger to release the needle.

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Massage the finger from the bottom to the top to increase blood flow. Press the blood towards fingertip. Repeat pressing until a drop with a 3 to 4 mm (1/8 inch) diameter is seen.

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Transfer the blood to an Eldon Stick, by approaching from below the finger. Don’t spread the blood over the skin.

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Place the Eldon Stick with the drop of blood into the first circle. The blood should touch the water already present. Gently press the side of the Eldon Stick head against the card and stir in the water and blood mixture until the colored dry material has dissolved.

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Repeat this procedure for the other 3 circles, making sure you use a new Eldon Stick for each circle. NEVER transfer liquid from one circle to another.

Once all 4 circles are complete gently tilt the whole card vertically on its bottom edge and keep this position for 10 seconds. You will see the blood flowing slowly to the bottom of the circle. Repeat this procedure tilting the card on the 3 other sides.

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As soon as you have finished tilting read and record the results immediately. See the table below for how the results are interpreted.

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Disposal:

Dispose of Eldon Cards, sticks and paper towels in biohazard bag

Summary Table

Fill in the summary table on your data sheet with your own values from this lab period and the “normal” values for your gender and race (when appropriate) that you found from your text or lab manual.

Activity: Identifying Different Types of White Blood Cells

1. Obtain a prepared human blood smear.

2. Using the chart or the pictures provided identify the 5 types of white blood cells

Activity: Determining Cholesterol level in blood

|[pic] |[pic] |

4. Place your data in the summary chart in the Lab Report Section.

Activity: Determing blood Glucose level

1. Get a blood sample. Use your lancing device and a new lancet to get a drop of blood from your fingertip.

2. Wait until the blood droplet symbol appears then apply the blood droplet to the test strip. The blood should touch the top edge of the test strip.

|[pic] |[pic] |

3. Read the result. Your meter will count down and display the result of your blood glucose level.

4. Place your data in the summary chart in the Lab Report Section

Lab Report

Hematology and Blood Analysis

Data Sheet

Activity: Examining the Formed Elements of Blood Microscopically

Use the internet or other sources to find a color picture of each type of White Blood Cell and paste here:

| |

Activity: Determining the Hematocrit

|Hematocrit |

| |Test Values |

|hematocrit (%PCV): | |

| |

|% WBC’s | |

|% plasma | |

Activity: Determining Hemoglobin Concentration

|Method |Hemoglobin (g/100ml) |

|Tallquist | |

|Scale | |

Activity: Typing for ABO and RH Blood Groups

If you know your blood type report it here: ___________

Your Blood Type from this lab test: ___________

Based on the results of this test what are the:

What blood antigens are present in your blood? ___________

What blood antibodies are present in your blood? ___________

Summary: Transfer your data to the table below then add the “normal” values or ranges for each component tested, when appropriate, use gender specific values for the normal ranges.

|Blood Characteristic |Your Values |Normal values or ranges* |Explain any discrepancies |

|Hematocrit (%PCV) | | | |

|Hemoglobin (g/100ml) | | | |

|Blood | | | |

|Type | | | |

|Cholesterol | | | |

|Blood Glucose | | | |

*Use gender specific values when they exist

Review Questions:

1. Distinguish between blood, plasma, serum and formed elements

2. In what medical conditions would you find a(n):

a. increase in the proportion of lymphocytes in a differential count?

b. increase in the proportion of eosinophils in a differential count?

c. decrease in total white blood cell count?

3. What specifically is the clinical value of determining the hematocrit and the hemoglobin content of blood; why do you need to know both?

4. a. What was your blood type according to today’s test ________

b. Based on your blood type above (ABO & Rh), what blood types can you receive?

c. What recipients can you donate to?

|Summary of Cleanup and Disposal Instructions |

|Plastic Sharps Container: |

|lancets |

|capillary tubes |

|Biohazard Bag: |

|cotton balls |

|alcohol swabs |

|contaminated paper towels |

|Eldon cards & sticks |

|contaminated gloves |

|Bleach Container: |

|glass slides and coverslips with blood on them |

|clay trays, Tallquist Reader Cards |

|Regular Trash: |

|uncontaminated paper towels and gloves |

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