REPORT

“Return Time (bleeding Time), IVY Method”

BY:
NAME : AHMAD AMRAN
NIM : E.18.03.044
CLASS : TLM B LEVEL 2

STIKES PANRITA HUSADA BULUKUMBA

DEPARTEMEN OF MEDICAL LABORATORY TECHNOLOGY

FY 2019/2020
A. OBJECTIVE
To find out the time needed for artificial bleeding until the bleeding stops
(Method IVY)
B. BASIC OF THEORY
Bleeding is a complication that often occurs after a surgical procedure.
The bleeding time is the time interval from the first blood drop until the blood
stops dripping. Bleeding time is one of the parameters of blood clotting
measurement to determine the vasoconstriction process in the vascular vase
and the formation of a hemostatic plug while on platelet vase in the hemostatic
process. Hemostatic physiology is a process that is very controlled and
balanced and limited only to damage to the walls of blood vessels, should not
expand systemically. (Regina, 2013)
Vasoconstriction can occur due to local autoloid namely serotonin and
platelet-derived growth factor (PDGH) released from platelets that attach to
the walls of damaged blood vessels. This vasoconstriction will slow blood
flow, so that bleeding will decrease. Changes in blood vessel diameter will
cause changes in the ability of blood vessels to deliver blood flow. Increased
blood flow is proportional to the fourth power of blood vessels. Blood flow to
the capillaries will also decrease during rest. (Regina, 2013)
Homeostasis states all the mechanisms used by the body to protect
themselves against the possibility of bleeding or blood loss. One of the
screening tests to see abnormalities in the homeostasis process is the bleeding
period. The period of bleeding is the occurrence of bleeding gaps after
controlled superficial trauma. The duration of bleeding extends to
thrombocytopenia, Von Willebrand's disease, Glanzmann's thrombastenia,
Bernard-Soulier's disease, most of the platelet function abnormalities and after
taking aspirin. The results of several studies identified an increase in platelets
of 18-80% immediately after doing treadmill exercises, the large number of
platelet additions with momentary exercise was influenced by the weight of
the exercise. Increased platelet counts are associated with the release of
platelets from the bone marrow, spleen veins and intravascular pulmonary
circulation. (Sri, 2017)
 Homeostasis is a mechanism to protect and maintain the composition and
fluidity of blood in blood vessels. Death can occur due to the inability to stop
bleeding. To determine the location of homeostatic abnormalities, a good and
careful history is needed, examination and evaluation of clinical
manifestations of careful bleeding and appropriate laboratory examinations.
Homeostatic examination is important to do with the aim of helping clinicians
diagnose and monitor homeostatic abnormalities. Homeostatic disorders with
abnormal bleeding can occur due to vascular abnormalities, thrombocytopenia
or impaired platelet function and blood clotting disorders. (Wahdaniah, 2017)
The normal homeostatic response to vascular damage depends on the
closely related interactions between the walls of the blood vessels, circulating
platelets, and platelet clotting factors. Platelets play an important role in the
homeostatic process by forming platelet plugs in vascular lesions and forming
an effective primary hemostatic mechanism. Disorders of platelet counts can
cause abnormal bleeding. (Wahdaniah, 2017)
C. PRINCIPLE
The standard is made on the volar surface with the bottom, the length of
the bleeding until it stops being painted.
D. METHOD
Performed using IVY
E. TOOLS AND MATERIALS
1. Tools
 Tensimeter
 Stopwatch
2. Material
 Sterile disposable lancets
 Round filter paper
 An alcohol swab
F. WORK PROCEDURES
1. Place the tensimeter cuff on the upper arm and pump tens to 40 mmHg and
maintain it during the examination. Clean the voalr surface of the forearm
 with 70% alcoholic cotton. Select the area of the skin where there is no
supervicial vein, about 3 fingers from the elbow fold.
2. Extend the skin and wound 2 mm wide by 3 mm deep.
3. Right when there is a change, run the stopwatch.
4. Every 30 seconds the blood comes out, smeared with round filter paper but
don't touch the wound.
5. When the bleeding stops (diameter <1 mm), stop the stopwatch and release
the cuff. Record the time with 0.5 minutes rounding.
G. RESULTS

N Patient Name Age Gender Date Of

O Examination
1. A. Alfahrul 20 years old male 22 April 2020

The results obtained by examining the ivy method with patients

named A. Alfahrul are: 4:17 seconds.

Reference value: 1-7 minutes.

H. DISCUSSION
Bleeding time (bleeding time) ivy method is a routine examination
performed to determine the time needed for artificial bleeding until the
cessation of bleeding. To do the examination with ivy method, it is prepared
tools and materials used, which include stopwatches, tensimeter, 70%
alcoholic cotton, sterile tissue and lanceolate and at the time of the
examination are required to use personal protective equipment such as
laboratory coats, masks and handscoens. If the tools and materials have been
 prepared by laboratory staff also have used personal protective equipment
should be examined in patients.
The patient was asked for his identity, after that the patient to show his
arm to be examined, namely touching and asked to clench the patient's hand so
that the vein was clearer. So that stabbing will be avoided in the area of the
vein, because if the vein is stabbed, the blood will not stop flowing, so that
only the outer part of the skin and there is no vein taken by blood sampling.
After doing the touching technique, then put the blood pressure cuff
placed on the upper arm and pumped up to 40 mmHg and maintain it during
the examination, then clean the area to be stabbed with 70% alcohol cotton,
alcohol must be left on the skin long enough to kill the wounded area, because
can affect test results and inhibit clotting, and wait for it to dry. After that,
wrap the wound with a sterile disposable lanceolate 2 mm into 3 mm, if the
blood starts to come out, the stopwatch is turned on by blood drops that must
be rubbed every 30 seconds by using a tissue, not to touch the wound after the
tissue stops and if the tissue cannot be sucked , stop the stopwatch and release
the tensimeter on the patient's arm, after that check the check time.
The results obtained by examining the bleeding period with the ivy
method of the patient named A. Alfahrul, 20 years old, produced (4:17
seconds), compared to the normal time limit of 1-7 minutes, the results of
bleeding tests in patients were still within normal limits. This means there are
no abnormalities in platelet dysfunction in patients.
I. CONCLUSIONS AND SUGGESTIONS
1. Conclusion

Bleeding time (BT) assesses the ability of blood to clot after injury
or trauma, where platelets interact with the walls of blood vessels to form
clots. The results obtained in patients are 4:17 seconds

2. Suggestions
In the next lab to be careful again in taking samples and hope to
use personal protective equipment (PPE).
J. BIBLIOGRAPHY
Tedjasulaksana, Regina.2013. Ethyl Acetate Extract and Ethanol Betel Leaves
(piper betle L.) Can Shorten the Bleeding Time of Mice (Mus
Musculus). Journal of Dental health, 1(1)
Tumpuk, Sri, Dkk.2017. Effects of Short Distance Running Physical Exercise
on Bleeding Time IVY Method. Journal of Equatorial Laboratory,1(1)
Wahdaniah, Ddk. 2017. Relationship of Platelet Amount With Prothrombin
Time and Activated Paertial Thromboplastin Time in Patients Preparing
for Caesarean Surgery. Journal of Equatorial Laboratory,1(1)