BCH 202 FOR NURSING

1. BLOOD, URINE AND SWEAT TESTS

What is a blood test?
Regular blood testing is one of the most important ways to keep track of
your overall physical well-being. Getting tested at routine intervals can
allow you to see the way your body changes over time and empower you to
make informed decisions about your health.
What does a blood test show?
Some blood tests can help your doctor determine how different organs in
your body are working. Examples of organs whose malfunctions can be
visible in a blood test include Trusted Source your thyroid, liver, or kidneys.
Your doctor can also use blood tests to search for markers of diseases and
health conditions such as:
 diabetes
 HIV
 anemia
 cancer
 coronary heart disease
Even if a person does not have heart disease, a blood test can show whether
they may be at risk of developing the condition.
Other blood tests can indicate whether the medications you’re taking are
working properly, or assess how well your blood is clotting.
10 important blood tests
Let’s take a closer look at some common blood tests.
1. Complete blood count
A routine complete blood count (CBC) checks for levels of 10 different
components of every major cell in your blood: white blood cells, red blood
cells, and platelets.
Important components this test measures include red blood cell count,
hemoglobin, and hematocrit.
Here’s the typicalTrusted Source range of results, although every
laboratory may have its own range that varies slightly:
Component Normal range
red blood cells (cells responsible for male: 4.3–5.9 million/mm3;
carrying oxygen throughout the body) female: 3.5–5.5 million/mm3
white blood cells (immune system cells in
4,500–11,000/mm3
the blood)
platelets (the substances that control the
150,000–400,000/mm3
clotting of the blood)
hemoglobin (protein within the red blood
cells that carries oxygen to organs and male: 13.5–17.5 grams/deciliter
tissues, and carbon dioxide back to the (g/dL); female: 12.0–16.0 g/dL
lungs)
hematocrit (percentage of blood made of
male: 41–53%; female: 36–46%
red blood cells)
Abnormal levels of these components may indicate:Trusted Source
 nutritional deficiencies, such as vitamin B6 or B12
 anemia (iron deficiency)
 clotting problems
 blood cancer
 infection
 immune system disorders
Based on your results, your doctor will order follow-up tests to confirm
abnormal levels and a possible diagnosis.
2. Basic metabolic panel
A basic metabolic panel (BMP) usually checks for levels of eight compounds
in the blood:
 calcium
 glucose
 sodium
 potassium
 bicarbonate
 chloride
 blood urea nitrogen (BUN)
 creatinine
This test may require you to fast for at least 8 hours before your blood is
drawn, depending on the instructions of your doctor and what the test is
measuring.
See our chart for normal results.
Abnormal results may indicate:
 kidney disease
 diabetes
 hormone imbalances
Your doctor will perform follow-up tests to confirm a diagnosis.
3. Comprehensive metabolic panel
A comprehensive metabolic panel (CMP) includes all the measurements of a
BMP as well as additional proteins and substances related to liver function,
such as:
 albumin
 total protein
 alkaline phosphatase (ALP), an enzyme mostly found in the bones and
liver that’s involved in several bodily processes
 alanine aminotransferase (ALT), an enzyme found in the liver
 aspartate aminotransferase (AST), an enzyme found in the liver and
other tissues within the body
 bilirubin, which is waste resulting from the breakdown of red blood
cells that the liver filters out
The same conclusions can be drawn from a CMP as from a BMP for the
same substances that a BMP covers. Other abnormal levels can also indicate
underlying conditions, such as:
High levels Low levels
•bile duct blockage
•cirrhosis
• bone metabolism disorders
• gallbladder
• heart surgery
ALP inflammation
• malnourishment
•gallstones
• zinc deficiency
•hepatitis
• Paget’s disease
•cirrhosis
•hepatitis
ALT considered normal
•liver cancer
• liver damage
• cirrhosis
• heart conditions
AST • hepatitis considered normal
• mononucleosis
• (mono)pancreatitis
• abnormal red blood cell
bilirubin destruction (hemolysis) not a concern
• adverse medication reactions
 • bile duct blockage
• Gilbert’s syndrome
• hepatitis
4. Lipid panel
This test checks levels of two typesTrusted Source of cholesterol:
 high-density lipoprotein (HDL), or “good” cholesterol
 low-density lipoprotein (LDL), or “bad” cholesterol
HDL is “good” because it removes harmful substances from your blood and
helps the liver break them down into waste. LDL is “bad” because it can
cause plaque to develop in your arteries, increasing your risk of heart
disease.
You may need to fast for at least 8 hours before this test.
Here are the rangesTrusted Source for each type:
High Low/Optimal
male: <40 mg/dL;
HDL >60 mg/dL female: <50 mg/dL
(low)
LDL >160 mg/dL <100 mg/dL (optimal)
Normal levels can also vary by age.
5. Thyroid panel
A thyroid panel, or thyroid function test, checks how well your thyroid is
producing and reacting to certain hormones, such as:
 Triiodothyronine (T3). Along with T4, this regulates your heart rate
and body temperature.
 Thyroxine (T4). Along with T3, this regulates your metabolism and
how you grow.
 Thyroid-stimulating hormone (TSH). This helps regulate the levels of
hormones your thyroid releases.
Your thyroid is a tiny gland in your neck. It helps regulate bodily functions
like your mood, energy level, and overall metabolism.
Here are normal results:
 T3: 80–180 nanograms per deciliter of blood (ng/dL)
 T4: 0.8–1.8 ng/dL in adults.
 TSH: 0.5–4 milli-international units per liter of blood (mIU/L)
Abnormal levels of these hormones can indicate numerous conditions, such
as:
 low protein levels
  thyroid growth disorders
 abnormal levels of testosterone or estrogen
6. Cardiac biomarkers
Enzymes are proteins that help your body accomplish certain chemical
processes, such as breaking down food and clotting blood. They’re used
throughout your body for many vital functions.
Abnormal enzyme levels can indicate many conditions.
Common enzymes tested include:
 Creatine kinase (CK). This is an enzyme primarily located in the
brain, heart, and skeletal muscle. When muscle damage happens, CK
seeps into the blood in growing amounts.
 Creatine kinase-MB (CK-MB). These enzymes are found in your
heart. They often increase in your blood after a heart attack or other
heart injury.
 Troponin. This is a heart enzyme that can leak into your blood and
results from heart injury.
Here are the normal ranges for the enzyme listed above:
 CK: 30–200 U/L
 CK-MB: 0–12 IU/L
 troponin: <1 ng/mL
7. Sexually transmitted infection tests
Many sexually transmitted infections (STIs) can be diagnosed using a blood
sample. These tests are often combined with urine samples or swabs of
infected tissue for more accurate diagnoses.
The following STIs can be diagnosed with blood tests:
 chlamydia
 gonorrhea
 herpes
 HIV
 syphilis
Blood tests aren’t always accurate right after contracting an infection. For
an HIV infection, for example, you may need to wait at least a month before
a blood test can detect the virus.
8. Coagulation panel
Coagulation tests measure how well your blood clots and how long it takes
for your blood to clot. Examples include the prothrombin time (PT) test and
fibrinogen activity test.
Clotting is a crucial process that helps you stop bleeding after a cut or
wound. But a clot in a vein or artery can be deadly since it can block blood
flow to your brain, heart, or lungs. This can cause a heart attack or stroke.
Coagulation test results vary based on your health and any underlying
conditions that may affect clotting.
Results from this test can be used to diagnose:
 leukemia
 excessive bleeding (hemophilia)
 thrombosis
 liver conditions
 vitamin K deficiency
9. DHEA-sulfate serum test
The dehydroepiandrosterone (DHEA) hormone comes from your adrenal
glands. This test measures whether it’s too high or too low.
In men, DHEA helps develop traits like body hair growth, so low levels are
considered abnormal. In women, high levels can cause typically male traits,
like excess body hair, to develop, so low levels are normal.
Low levels may be caused by:
 Addison’s disease
 adrenal dysfunction
 hypopituitarism
High levels in men or women can result from:
 congenital adrenal hyperplasia
 benign or malignant tumor on the adrenal gland
 polycystic ovary syndrome (PCOS)
 ovarian tumor
10. C-reactive protein test
C-reactive protein (CRP) is made by your liver when tissues in your body
are inflamed. High CRP levels indicate inflammation from a variety of
causes, including:
 bacterial or viral infection
 autoimmune diseases, such Lupus or rheumatoid arthritis
 inflammation related to diabetes
 inflammation related to physical trauma or from habits like smoking
 cancer
The higherTrusted Source the level, the higher the risk of heart disease:
 <0.3 mg/dL: normal
  0.3 to 1.0 mg/dL: minor elevation can be associated with a person’s
sex, body mass index (BMI), or with conditions like depression or
insomnia
 1.0 to 10.0 mg/dL: moderate elevation usually caused by systemic
inflammation, such as from an autoimmune disease, bronchitis, heart
attack, or cancer
 >10.0 mg/dL: marked elevation typically caused by a serious bacterial
or viral infection, major trauma, or systemic vasculitis
 >50.0 mg/dL: severe elevation usually caused by an acute bacterial
infection

Urinalysis (Urine Test)

What Is Urinalysis?
Urinalysis is a series of tests on your urine, or pee. Doctors use it to check
for signs of common conditions or diseases. Other names for it are urine test,
urine analysis, and UA.
Why Is Urinalysis Done?
You may have a urinalysis as part of a routine check of your overall health,
like during your yearly physical. Urinalysis is one way to find certain
illnesses in their earlier stages. They include:
 Kidney disease
 Liver disease
 Diabetes
Your doctor may want to test your urine if you’re getting ready to have
surgery or are about to be admitted to the hospital. Urinalysis can be part of
a pregnancy checkup, too.
If you have symptoms of a kidney or urinary tract problem, you may have
the tests to help find out what the problem is.
You might also have this test regularly if you have a condition such as a
kidney disease that needs to be watched over time.
How Does a Urinalysis Work?
There are three ways to analyze urine, and your test might use all of them.
- One is a visual exam, which checks the color and clarity. If your pee has
blood in it, it might be red or dark brown. Foam can be a sign of kidney
disease, while cloudy urine may mean you have an infection.
- A microscopic exam checks for things too small to be seen otherwise.
Some of the things that shouldn’t be in your urine that a microscope can
find include:
 Red blood cells
 White blood cells
 Bacteria
 Crystals (clumps of minerals, a possible sign of kidney stones)
- The third part of urinalysis is the dipstick test, which uses a thin plastic
strip treated with chemicals. It’s dipped into your urine, and the chemicals
on the stick react and change color if levels are above normal. Things the
dipstick test can check for include:
 Acidity, or pH. If the acid is abnormal, you could have kidney stones,
a urinary tract infection (UTI), or another condition.
 Protein. This can be a sign your kidneys aren’t working right.
Kidneys filter waste products out of your blood.
 Glucose. A high sugar content is a marker for diabetes.
 White blood cells. These are a sign of infection or inflammation, either
in the kidneys or anywhere else along your urinary tract.
 Nitrites. This means that there is an infection with certain kinds of
bacteria.
 Bilirubin. If this waste product, which is normally eliminated by your
liver, shows up, it may mean your liver isn’t working properly.
 Blood in your urine. Sometimes this is a sign of infections or certain
illnesses.

How Do I Prepare for a Urinalysis?

If urinalysis is the only test you’re having, you should be able to eat and
drink normally before the procedure. Beets and food dyes can discolor your
urine, so you may want to watch what you eat beforehand.
Be sure to let your doctor know about all the medicines you take, including
over-the-counter drugs, vitamins, and supplements. If you’re having your
period, let the doctor know before the test.
You’ll either be asked to collect a urine sample at home and bring it with
you, or you’ll make it at your doctor’s office. The office will give you a
container for the sample.
The best results come from using what’s known as the “clean catch” method.
Here are the steps:
1. Wash the area around the urinary opening.
2. Start to pee into the toilet.
3. Stop midstream.
4. Let 1-2 ounces flow into the container.
5. Finish peeing in the toilet.
6. Follow your doctor’s directions for handing over the sample.
For babies and other people unable to provide a sample this way, a doctor
may have to insert a soft, narrow tube called a catheter through the urinary
opening and into the bladder.
What Do the Urinalysis Results Mean?
A urinalysis is just one piece of information about what’s going on in your
body. The test can show warning signs but can’t tell your doctor for sure
that anything is wrong with you. The results may be a clue that you need
more tests and follow-up. The next steps depend on why you had the test in
the first place.
For example, if your results are only slightly abnormal and you don’t have
any other symptoms of an illness, your doctor may not do other tests. If you
already have a kidney issue or urinary tract infection, your doctor may
want to change your treatment plan.

Sweat Test
If you show symptoms of cystic fibrosis or your baby has a positive newborn
screen for CF, a sweat test at a CF Foundation-accredited care center can
help provide a CF diagnosis by measuring the concentration of salt in your
or your baby's sweat. The test is painless and is the most reliable way to
diagnose CF.
Summary
 The sweat test measures the amount of chloride (a component of salt)
in the sweat. There are no needles involved in this test.
 Sweat testing is painless and lasts less than an hour.
 Sweat testing is the most reliable test for cystic fibrosis.
The Most Reliable Test
The sweat test is considered the most reliable for diagnosing cystic fibrosis.
Sweat tests should be done at a CF Foundation-accredited care center,
where guidelines are used to help ensure accurate results. The sweat test is
performed by a trained technician and the results are evaluated in an
experienced and reliable laboratory.
The sweat test can be done for anyone older than 48 hours. However, some
infants may not make enough sweat to do the test. If an infant does not
produce enough sweat the first time, the test should be repeated.
If your baby had a positive NBS or you received a positive prenatal genetic
test, it’s important to schedule a sweat test once your newborn is 48 hours
old. At the latest, babies with a positive NBS or prenatal genetic test should
have a sweat test performed by the age of 4 weeks to ensure that any health
issues or changes can be found early and treated quickly.
What to Expect During a Sweat Test
The sweat test measures the amount of chloride (a component of salt) in the
sweat. There are no needles involved in this test. In the first part of the test,
a colorless, odorless chemical (pilocarpine) and a little electrical stimulation
is applied to a small area of the arm or leg to encourage the sweat glands to
produce sweat. A person may feel tingling in the area, or a feeling of
warmth. This part of the test lasts about five minutes.
The sweat is then collected on a piece of filter paper or gauze or in a plastic
coil. This step lasts for 30 minutes. The collected sweat is then sent to a
hospital laboratory to measure how much chloride is in the sweat — usually
later the same day. The sweat test usually takes about an hour, but it may
take longer. When you schedule the test, ask how long it will take and when
you can expect to learn the results
Preparing for a Sweat Test
There is no activity limit or special diet needed before the sweat test.
However, you should not apply creams or lotions to the skin 24 hours before
the test. You can continue all regular medications. These will have no effect
on the test results.
Babies should be fed their usual amount at their usual times.
Read the CF Foundation's guidelines for sweat testing.

Understanding Sweat Test Results

People with CF have more chloride in their sweat than people who do not
have CF.
For a child who has CF, the sweat chloride test results will confirm the
diagnosis by showing a high chloride level. A baby has to sweat enough to
do the test. Full-term babies usually produce enough sweat by 2 weeks of
age. The test should be done as soon as possible between 10 days and, at the
latest, 4 weeks of age for babies who have had a positive NBS or prenatal
genetic test.
Typically, sweat chloride values do not change from positive to negative or
negative to positive, as a person grows older. Sweat test results also do not
vary when a person has a cold or other brief illness. If a sweat test is done
correctly, then results that are positive will show a high chloride level.
To understand what the sweat test results mean, a chloride level of:
 Less than or equal to 29 mmol/L = CF is unlikely regardless of age*.
 Between 30 - 59 mmol/L = CF is possible and additional testing is
needed.
 Greater than or equal to 60 mmol/L = CF is likely.
*Although a sweat test result of less than 29 mmol/L makes CF unlikely,
there are CFTR mutations associated with sweat test results of less than 29
mmol/L.
Some conditions can and factors are associated with a false positive result. A
clinician who specializes in CF can meet with you to interpret your child’s
results, discuss what they mean, and explain next steps.
When sweat chloride test results fall between the range of 30-59 mmol/L,
the sweat test is usually repeated.
If your child had a positive NBS and has a sweat test of 30-59, you should
consult with an CF clinician who can explain the results and recommend
further testing. Further testing may be recommended for those whose sweat
test results fall into the intermediate range and whose genetic analysis
determines unknown mutations or that their CFTR genotype is undefined.
If further testing is unavailable or found to be inconclusive, the diagnosis
cannot be resolved, and they may be considered to have CFTR-related
metabolic syndrome. A positive NBS is not required for this classification.
When the Sweat Test Confirms a CF Diagnosis
First of all, remember that you are not alone. There is a strong community
of people with CF, other parents and families, and multidisciplinary teams
of health care professionals who make up the CF Foundation’s care center
network to combine clinical research with medical care best practices to
help you and your baby. Thanks to this network — and to aggressive
research and new therapies — people with CF are living longer and
healthier lives.
There are also new medications called cystic fibrosis transmembrane
conductance regulator (CFTR) modulators designed to treat the underlying
cause of CF in people with certain CF gene mutations, and similar therapies
are in development for more people living with CF.
Thanks to the community of people living with CF and their families who
participate in CF Foundation-supported research and work with care teams
at CF Foundation-accredited care centers across the country, there are
more options available to treat CF than ever before. These include drugs to
help clear CF mucus out of the airways, reduce inflammation, fight germs,
and help your child grow.
2. Antigen-Antibody Interaction
The interactions between antigens and antibodies are known as
antigen-antibody reactions. The reactions are highly specific, and an
antigen reacts only with antibodies produced by itself or with closely
related antigens. Antibodies recognize molecular shapes (epitopes) on
antigens. Generally, the better the fit of the epitope (in terms of
geometry and chemical character) to the antibody combining site, the
more favorable the interactions that will be formed between the
antibody and antigen and the higher the affinity of the antibody for
antigen. The affinity of the antibody for the antigen is one of the most
important factors in determining antibody efficacy in vivo.
The antigen- antibody interaction is bimolecular irreversible
association between antigen and antibody. The association between
antigen and antibody includes various non-covalent interactions
between epitope (antigenic determinant) and variable region (VH/VL)
domain of antibody.
Chemical Bonds Responsible for the Antigen-Antibody Reaction
The interaction between the Ab-binding site and the epitope involves
exclusively non-covalent bonds, in a similar manner to that in which
proteins bind to their cellular receptors, or enzymes bind to their
substrates. The binding is reversible and can be
prevented or dissociated by high ionic strength or extreme pH. The
following intermolecular forces are involved in Ag–Ab binding:
1. Electrostatic bonds: This result from the attraction between
oppositely charged ionic groups of two protein side chains; for example, an
ionized amino group (NH4+) on a lysine in the Ab, and an ionized carboxyl
group (COO_) on an aspartate residue in the Ag.
2. Hydrogen bonding: When the Ag and Ab are in very close proximity,
relatively weak hydrogen bonds can be formed between hydrophilic groups
(e.g., OH and C=O, NH and C=O, and NH and OH groups).
3. Hydrophobic interactions: Hydrophobic groups, such as the side
chains of valine, leucine, and phenylalanine, tend to associate due to Van
der Waals bonding and coalesce in an aqueous environment, excluding
water molecules from their surroundings. As a consequence, the distance
between them decreases, enhancing the energies of attraction involved. This
type of interaction is estimated to contribute up to 50% of the total strength
of the Ag–Ab bond.
4. Van der Waals bonds: These forces depend upon interactions between
the “electron clouds” that surround the Ag and Ab molecules. The
interaction has been compared to that which might exist between
alternating dipoles in two molecules, alternating in such a way that, at any
given moment, oppositely oriented dipoles will be present in closely apposed
areas of the Ag and Ab molecules.
Each of these non-covalent interactions operates over very short distance
(generally about 1 Å) so, Ag-Ab interactions depends on very close fit
between antigen and antibody.
Strength of Ag-Ab interaction:
1. Affinity:
Affinity measures the strength of interaction between an epitope and an
antibody’s antigen binding site. It is defined by the same basic
thermodynamic principles that govern any reversible biomolecular
interaction:

o KA = affinity constant
o [Ab] = molar concentration of unoccupied binding sites on the
antibody
o [Ag] = molar concentration of unoccupied binding sites on the antigen
o [Ab-Ag] = molar concentration of the antibody-antigen complex
In other words, KA describes how much antibody-antigen complex exists at
the point when equilibrium is reached. The time taken for this to occur
depends on rate of diffusion and is similar for every antibody. However,
high-affinity antibodies will bind a greater amount of antigen in a shorter
period of time than low-affinity antibodies. KA can therefore vary widely
for antibodies from below 105 mol-1 to above 1012 mol-1, and can be
influenced by factors including pH, temperature and buffer composition.
Combined strength of total non-covalent interactions between single Ag-
binding site of Ab and single epitope is affinity of Ab for that epitope.
Low affinity Ab: Bind Ag weakly and dissociates readily.
High affinity Ab: Bind Ag tightly and remain bound longer.
2. Avidity:
Antibodies and antigens are multivalent, meaning they possess more than
one binding site. The measure of the total binding strength of an antibody at
every binding site is termed avidity. Avidity is also known as the functional
affinity.
Avidity is determined by three factors.
The binding affinity: The strength of the relationship at a singular binding
site.
The valency: The total number of binding sites involved.
The structural arrangement: The structure of the antigen and
antibody involved. All antibodies are multivalent e.g. IgGs are
bivalent and and IgMs are decavalent. The greater an
immunoglobulin’s valency (number of antigen binding sites), the
greater the amount of antigen it can bind. Similarly, antigens can
 demonstrate multivalency because they can bind to more than one
antibody. Multimeric interactions between an antibody and an
antigen help their stabilization.
A favorable structural arrangement of antibody and antigen can also lead to
a more stable antibody-antigen complex
Strength of multiple interactions between multivalent Ab and Ag is avidity.
Avidity is better measure of binding capacity of antibody than affinity. High
avidity can compensate low affinity.

3. Cross reactivity:
Antibody elicited by one Ag can cross react with unrelated Ag if they
share identical epitope or have similar chemical properties.
Types of Ag-Ab reactions:
1. Agglutination
2. Precipitation
3. Complement Fixation
4. Enzyme linked Immunosorbent Assay
5. RadioImmuno Assay
6. Western Blotting
Agglutination
results in visible clumping called agglutination. Antibodies that produce
such reactions are called agglutinins. Better agglutination takes place with
IgM antibody than with IgG antibodies. Excess of an antibody also inhibits
agglutination reaction; this inhibition is called prozone phenomenon.
1. Agglutination is more sensitive than precipitation for the detection of
antibodies.
2. Agglutination occurs optimally when antigens and antibodies react in
equivalent proportions.
The prozone phenomenon may be seen when either an antibody or an
antigen is in excess. Incomplete or monovalent antibodies do not cause
agglutination, though they combine with the antigen. They may act as
blocking antibodies, inhibiting agglutination by the complete antibody
added subsequently.
Types of agglutination
1. Slide agglutination: Serotyping.
2. Tube agglutination: e.g. Widal test.
3. Indirect (passive agglutination): where soluble antigens are coated on
vehicle particle e.g. latex particle, RBCs.

Application of Agglutination reaction:

1. Cross-matching and grouping of blood.
Identification of Bacteria. E.g. Serotyping of Vibrio cholera,
2. Serotyping
of Salmonella Typhi and Paratyphi.
3. Serological diagnosis of various diseases. E.g Rapid plasma regains
(RPR) test for Syphilis, Antistreptolysin O (ASO) test for rheumatic fever.
4. Detection of unknown antigen in various clinical specimens. E.g.
detection of Vi antigen of Salmonella Typhi in the urine.
Precipitation
It is a type of antigen-antibody reaction, in which the antigen occurs in a
soluble form. When a soluble antigen reacts with its specific antibody, at an
optimum temperature and PH in the presence of electrolyte antigen-
antibody complex forms insoluble precipitate. This reaction is called a
precipitation reaction. A lattice is formed between the antigens and
antibodies; in certain cases, it is visible as an insoluble precipitate.
Antibodies that aggregate soluble antigens are called precipitins.

The interaction of antibody with soluble antigen may cause the formation of
insoluble lattice that will precipitate out of solution. Formation of an
antigen-antibody lattice depends on the valency of both the antibody and
antigen. The antibody must be bivalent; a precipitate will not form with
monovalent Fab fragments. The antigen must be bivalent or polyvalent;
that is it must have at least two copies of same epitope or different epitopes
that react with different antibodies present in polyclonal sera. Antigen and
antibody must be in an appropriate concentration relative to each other.
1. Antigen access: Too much antigen prevents efficient
crosslinking/lattice formation.
2. Antibody access: Too much antibody prevents efficient
crosslinking/lattice formation.
3. Equivalent Antigen and Antibody: Maximum amount of lattice
(Precipitate) is formed.
Application of Precipitation reaction:
1. Detection of unknown antibody to diagnose infection e.g. VDRL test
for syphilis.
2. Standardization of toxins and antitoxins.
3. Identification of Bacteria e.g. Lancified grouping of streptococci.
4. Identification of bacterial component e.g Ascoli’s thermoprecipitin
test for Bacillus anthracis.
 Complement Fixation
Complement fixation is a method that demonstrates antibody presence
in patient serum. Complement fixation is a classic method for
demonstrating the presence of antibody in patient serum. The
complement fixation test consists of two components.
The first component is an indicator
system that uses combination of sheep
red blood cells, complement-fixing
antibody such as immunoglobulin G
produced against the sheep red blood
cells and an exogenous source of
complement usually guinea pig serum.
When these elements are mixed in
optimum conditions, the anti-sheep
antibody binds on the surface of red
blood cells. Complement subsequently
binds to this antigen -antibody
complex formed and will cause the red
blood cells to lyse.
The complement pathway:
Complement
The second component is a knownbinds to antigen-antibody complex
antigen and patient serum added to a
suspension of sheep red blood cells in
addition to complement. These two
components of the complement fixation
method are tested in sequence.
Patient serum is first added to the
known
antigen, and complement is added to
the solution.
If the serum contains antibody to the
antigen,
the resulting antigen-antibody
complexes will bind all of the complement. Sheep red blood cells and the
anti-sheep antibody are then added. If complement has not been bound by
an antigen-antibody complex formed from the patient serum and known
antigens, it is available to bind to the indicator system of sheep cells and
anti-sheep antibody. Lysis of the indicator sheep red blood cells signifies
both a lack of antibody in patient serum and a negative complement
fixation test. If the patient’s serum does contain a complement-fixing
antibody, a positive result will be indicated by the lack of red blood cell lysis.

What are some routine tests and others I should ask about?
If you are showing concerning symptoms of any illness or long-term
condition, visit your doctor for a checkup. They will conduct a physical
examination and let you know what kinds of blood tests you’ll need to
undergo.
If you want to request a routine blood test, the most common ones to
consider are:
 complete blood count (CBC)
 basic metabolic panel
 thyroid panel
 nutrient tests for levels of vital nutrients, such as iron or B vitamins
Some other tests you may want include:
 enzyme markers if you’re at risk of cancer or other conditions like
cirrhosis, stroke, or celiac disease
 sexually transmitted infection (STI) tests if you recently had sex
without a barrier method or had sex with a new partner
How often should I get routine blood work?
How often you should get a physical exam may depend on your age,
according to guidelines from a variety of clinical organizations:
 ages 18 to 39: at least every 5 years
 ages 40 to 49: every 2 to 3 years
  ages 50 and older: every 1 to 2 years
Your doctor will decide whether you need any blood tests during your
physical exam.
In general, recommendations callTrusted Source for at minimum a lipid
test starting at age 20 and every 5 years after that for people with a low risk
of heart disease.
For people at a higher risk of heart disease, more frequent lipid testing may
be necessary.
In addition, you should get a glucose blood test if your blood pressure is
continuously above 135/80. People over age 50 should get a fecal occult
blood test to screen for colorectal cancer annually.
But some doctors may still suggest routine blood work during your yearly
physical exam, and in some cases, you may want to get additional testing.
For example, when:
 You’re experiencing unusual, persistent symptoms. These could
include anything from fatigue and abnormal weight gain to new pain.
 You want to optimize your health. Knowing levels of various blood
components, such as HDL and LDL cholesterol, can allow you to
tweak your diet or fitness plan to maximize healthy habits.
 You want to reduce your risk of disease or complications. Regular
blood tests can catch the warning signs of almost any disease early.
Many heart, lung, and kidney conditions can be diagnosed using
blood tests.
Talk with your doctor first if you want to get certain tests done, or have
them done more often than once a year.
Who orders my blood tests?
Your doctor typically orders blood tests for you during a physical, checkup,
or an appointment intended to screen for a specific condition.
It’s possible to order your own blood tests without a doctor through
laboratories like LabCorp and Quest Diagnostics, but health insurance may
not cover these tests.
While such blood tests may more accessible and convenient, it may be
harder to interpret the results without a medical professional.
Some blood testing facilities may also not give you accurate results.
One infamous case of this is Theranos. The California biotechnology firm
shut down in 2018 when an investigation uncovered lies and fraud around
the accuracy of its private blood-testing technology.
Currently, litigation is underway against the founder and chief executive of
the company, Elizabeth Holmes.
Where can I get blood work done?
There are different locations that offer laboratory services that include
blood work. Most hospitals contain a laboratory that you can visit to get
tests done. Some laboratories will have walk-in options. Others may require
an appointment.
Additional locations for blood testing may include:
 Private laboratories. Hospitals may use private labs to offload some
testing from their own laboratories, or in cases when a specialized test
is needed. Often, health insurance plans will require you to use a
specific laboratory that is in their network for the test to be covered.
 Point-of care. This describes situations when you may need to get a
blood test wherever you are receiving medical care. In routine
scenarios, this typically includesTrusted Source your doctor’s office
during an appointment. It can also include tests done inside an
ambulance during transport, or at a cruise ship or military clinic, for
example.
 Direct access testing. Also known as direct to consumer, it allows you
to order your own test without a doctor’s referral. You get the test
done at a laboratory specially set up for this purpose.
 Home testing. You can getTrusted Source some tests at a pharmacy
and then do them at home. You may need a prescription for some
tests, while others may be available over the counter. This can include
things like blood glucose monitoring for people with diabetes, or the
fecal occult blood test that screens for colorectal cancer. The Food
and Drug Administration (FDA) must approve all home tests before
they’re available for purchase.
Why do some blood tests require fasting?
Everything you eat and drink contains vitamins, proteins, and other
nutrients that can cause the related levels in your blood to temporarily
spike or drop.
Fasting for 8 to 12 hours helps ensure that blood test results are free from
these variables, making your test results as accurate as possible.
Some common tests that may require fasting include:
 cholesterol tests
 blood sugar tests
 liver function tests
 kidney function tests
 basic metabolic panel
 glucose tests
How long does it take to get results?
Results may take anywhere from a few hours to a few days to become
available. Here’s an overview of how long some common tests may take:
 complete blood count (CBC): 24 hours
 basic metabolic panel: 24 hours
 complete metabolic panel: 24 to 72 hours
 lipid panel: 24 hours
Timing can depend on the specific lab where you get tested, and how many
tests you get done at once. If you order multiple tests, you may not get the
complete results until all of the tests are completed.
Sometimes a lab will only release results to your doctor, who reviews them
and then releases them to you.
How to read blood test results
While every laboratory or test-providing company may structure their
result reports differently, they all must include the same components as
mandated by federal legislation.
Some of that may be administrative content, such as the name of the person
who did the blood test, the date the test was done, and the name of the
doctor who ordered the test.
When it comes to understanding the results, you can look for the
followingTrusted Source:
 Quantitative test result. Results will be typically written out
numerically in cases when the test measured the quantity of
something. For example, if the test measured the amount of
cholesterol in your blood.
  Abnormal markers. Often, a laboratory report will include some kind
of marker to let you know if a result is outside the normal interval,
and therefore abnormal. For example, you may see the letter H to
indicate high, the letter L to indicate low, or the acronym WNL for
“within normal limits.” You may see an asterisk and some additional
comments in text if your results come out as highly abnormal. In this
case, you’ll typically get a call from your doctor.
 Reference range. Every laboratory will have its own reference range
for each type of test. Typically, this reference range will be written in
your laboratory report next to the numerical value of your result so
you are able to see where your result falls in the range.
What’s the typical blood work procedure?
A nurse or technician usually performs a blood test at a laboratory or in a
doctor’s office. The procedure takes just a few minutes.
To performTrusted Source a blood test, the nurse or technician:
1. Cleans the area on your arm where they’ll draw the blood from.
2. Ties a rubber band to your upper arm to help make your veins more
visible, and asks you to make a fist.
3. Puts a needle attached to a tube gently into a vein to draw blood.
4. Removes the needle from the skin and takes the rubber band off your
arm when the collection is complete.
5. Covers the drawing site with a bandage or clean cotton and medical
tape.
The risks of routine blood tests are very low but can include:
 slight pain or discomfort when the needle goes in
 fainting from blood loss
 vein puncture
Takeaway
Blood tests can offer a good snapshot of your overall health.
They’re also a good way to catch illness or disease early, and to see how well
your body responds to treatments for various conditions.
Many people get routine blood tests done at least once a year. Talk with
your doctor to learn whether there are any other tests you may need to
ensure your optimal health.
HEALTHLINE RESOURCE
Simplify your search for at-home testing kits
With evidence-based reviews and brand comparisons, we provide
informative product recommendations so you can explore ways to manage
your health at home.
Last medically reviewed on November 16, 2021
How we reviewed this article:
Share this article
Medically reviewed by Lauren Castiello, MS, AGNP-C — By Tim Jewell
and Alina Sharon — Updated on November 16, 2021

For a Longer Life and Happier Gut, Eat More Fiber

Top 6 Benefits of Taking Collagen Supplements

6 Ways to Boost Your Coffee with Vitamins and Antioxidants

The 3-Day Fix for Energy

Was this article helpful?

YesNo
Everything You Need to Know About Fasting Before a Blood Test
 How long
 Coffee
 Alcohol
 Water
 Children
 During pregnancy
 Q&A
How do you prepare for a blood test?
Some blood tests will require you to fast beforehand. In these cases, your
doctor will instruct you not to eat or drink anything, except water, in the
hours leading up to the test.
Fasting before certain blood tests is important to help make sure that your
test results are accurate. The vitamins, minerals, fats, carbohydrates, and
proteins that make up all food and beverages can impact blood-level
readings, clouding the results of your test.
Not all blood tests will require you to fast beforehand. Blood tests that you
will likely need to fast for include:
 blood glucose test
 liver function test
 cholesterol test
 triglyceride level test
 high-density lipoprotein (HDL) level test
 low-density lipoprotein (LDL) level test
 basic metabolic panel
 renal function panel
 lipoprotein panel
If your doctor has prescribed a new blood test for you, or doesn’t mention
whether or not you should fast or for how long, ask them if fasting is
required. Some tests, such as a fecal occult blood test, don’t require fasting
but do limit certain foods. Red meats, broccoli, and even some medications
may cause a false positive test. Always follow your doctor’s advice when
preparing for a test.
How long should you fast before a blood test?
The amount of time you need to fast for will vary depending on the test. For
most tests, you will be told not to consume anything but water for eight
hours leading up to the test. For a few tests, a 12-hour fast may be needed.
Tip
1. Schedule your test as early in the day as possible. The hours you
spend sleeping are considered part of the fasting period, as long as
you don’t break your fast with coffee or food once you’re awake.
Can you drink coffee if you’re fasting before a blood test?
Even if you drink it black, coffee can interfere with blood test results.
That’s because it contains caffeine and soluble plant matter, which might
skew your test results.
Coffee is also a diuretic, which means that it will increase how much you
pee. This can have a dehydrating effect. The less hydrated you are, the
harder it can be for the nurse or other medical professional who’s doing
your blood test to find a vein. This can make the blood test harder or more
stressful for you.
Can you drink alcohol if you’re fasting before a blood test?
Some blood tests, such as those that assess liver health or triglyceride levels,
may require you to not drink any alcohol for a full 24 hours. Trace amounts
of alcohol can remain in your bloodstream for several days. If you have any
concerns about alcohol consumption, discuss this with your doctor when
you schedule your test.
Also ask your doctor if you can smoke cigarettes before the test, or if you
should refrain from smoking during your fast.
Is it OK to drink water before a blood test?
It’s fine to drink water before a blood test, unless you’re instructed
otherwise by your doctor. This is different from some surgical procedures,
which may require you to have a totally empty stomach.
Tap or bottled water are both OK, but leave the squeeze of lemon for
another time. Seltzer and club soda are off-limits. Carbonated beverages,
flavored or otherwise, shouldn’t be consumed during a fast, and neither
should any type of tea.
Tip
1. Water hydrates your body and makes your veins plumper and more
visible. Stay hydrated in the two days before your test. Also try
drinking several glasses of water right before the blood draw to make
it easier for the nurse or other medical professional to find a vein.
What if your child needs to fast before a blood test?
Just like adults, children may need blood tests that require them to fast
beforehand. If so, your child’s pediatrician will let you know how long your
child should abstain from eating and drinking.
Tips
 Schedule your child’s blood test as early in the day as possible.
 Distract, distract, distract: The hours leading up to the test may be
the time to give in and let them watch a nonstop hour of goofy
cartoons on TV or play with your iPad.
 Pack a snack for them to devour as soon as the test is done.
  If they manage to sneak a snack when you’re not looking, it’s better
to reschedule than to get inaccurate readings.
What about fasting for a blood test during pregnancy?
There are several blood tests you may need if you’re pregnant. These are
designed to assess any potential health concerns that you or your baby
might experience during pregnancy or after you give birth. Some of these
tests will require you to fast beforehand. Your doctor will advise you how to
prepare for each test.
Fasting is usually safe if you’re pregnant, provided you’re in good health
and aren’t having a high-risk pregnancy. For your overall comfort, your
doctor may advise you to drink extra water or to remain indoors, especially
if the weather is very hot or humid.
Fasting may increase heartburn in some pregnant women. If you
experience uncomfortable or concerning symptoms of any kind while
you’re waiting to have your blood drawn, let your doctor know immediately.
If you’re seeing a doctor other than your obstetrician-gynecologist, make
sure they are made aware of your pregnancy before your blood test.
Q&A: What happens if you don’t fast before a blood test?
Q:
What happens if you don’t fast before a blood test? Should you still do the
test?
Anonymous patient
A:
If you don’t fast before a test that requires it, the results may not be
accurate. If you forget and eat or drink something, call your provider and
ask if the test can still be done. Some tests can be analyzed with a notation
that it isn’t fasting and results may vary. The main thing is to be honest. If
you had a snack, a cup of coffee, or even a full breakfast, tell the technician
when you have your blood drawn. They should make a note so that the
results are reviewed with the food intake as a variable. And if fasting is an
absolute must for meaningful results, they should stop and reschedule your
blood draw.
Deborah Weatherspoon, PhD, RN, CRNAAnswers represent the opinions of
our medical experts. All content is strictly informational and should not be
considered medical advice.
HEALTHLINE RESOURCE
Simplify your search for at-home testing kits
With evidence-based reviews and brand comparisons, we provide
informative product recommendations so you can explore ways to manage
your health at home.
Last medically reviewed on March 22, 2017
How we reviewed this article:
Share this article
Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Corey
Whelan — Updated on September 17, 2018

For a Longer Life and Happier Gut, Eat More Fiber

Top 6 Benefits of Taking Collagen Supplements

6 Ways to Boost Your Coffee with Vitamins and Antioxidants

Was this article helpful?

YesNo
How Long Does It Take to Get Blood Test Results?
 Procedure
 Timing for blood test results
 Blood testing and location
 Getting faster results
 Takeaway
Overview
From cholesterol levels to blood counts, there are many blood tests
available. Sometimes, results are available within minutes of performing
the test. In other instances, it can take days or weeks to obtain blood test
results.
How soon you can learn your levels really depends on the test itself and a
number of other factors.
How does the procedure work?
A blood draw is also known as a venipuncture. The procedure involves
taking blood from a vein. Medical personnel known as phlebotomists most
commonly perform blood draws. To take your blood, they’ll:
 Wash their hands with soap and water or hand sanitizer and apply
gloves.
 Place a tourniquet (usually a stretchy, rubber band) around a
location, usually on your arm.
 Identify a vein and clean the area off with an alcohol wipe.
 Insert a small, hollow needle into the vein. You should see blood
coming through the needle and into a collection tube or syringe.
 Remove the tourniquet and hold gentle pressure on the venipuncture
site. Sometimes, they’ll place a bandage over the site.
The blood draw process can be very quick if you have veins that are easily
visualized and accessed. The process usually takes 5 to 10 minutes.
However, sometimes it may take more time to identify a vein. Factors such
as dehydration, the experience of the phlebotomist, and the size of your
veins can impact how quickly a blood draw can be done.
Common blood tests and how long it takes to get results
Some of the more common blood tests a doctor may order include:
 Complete blood count (CBC). This test measures the presence of 10
cell types in the white blood cells, red blood cells, and platelets.
Examples of these results include hematocrit, hemoglobin, red blood
cell count, and white blood cell count. CBC results are usually
available to your doctor within 24 hours.
 Basic metabolic panel. This test measures common electrolytes in the
blood as well as other compounds. Examples include calcium, glucose,
sodium, potassium, carbon dioxide, chloride, blood urea nitrogen,
and creatinine. You may be asked to fast for a certain period of time
before having your blood drawn. These results are also typically sent
to your doctor within 24 hours.
 Complete metabolic panel. This blood test measures all the factors
mentioned in the test above as well as two protein tests, albumin and
total protein, as well as four tests of liver function. These include ALP,
ALT, AST, and bilirubin. A doctor may order this more
comprehensive testing if they wish to understand more about your
 liver or kidney function. They’ll usually receive your results within
one to three days.
 Lipid panel. Lipid panels measure the amount of cholesterol in the
body. This includes high-density lipoprotein (HDL) and low-density
lipoprotein (LDL). Your doctor should receive results from the lab
within 24 hours.
Often a laboratory’s personnel will call or transmit results directly to a
doctor’s office for their review. Depending on your doctor’s schedule, you
may learn your results via a phone call or online portal shortly after the
doctor’s office receives them. However, you should be prepared to allow
more time.
Some labs will release results directly to you via a secure online portal
without your doctor’s review. In this case, the lab can tell you when to
expect results.
Your results may be delayed if the sample is inadequate (not enough blood),
contaminated, or if the blood cells were destroyed for some reason before
reaching the lab.
Pregnancy blood test
Pregnancy blood tests are typically quantitative or qualitative. A qualitative
blood test delivers a “yes” or “no” result to a pregnancy. A quantitiative
blood test can answer how much human chorionic gonadotropin (hCG) is
present in the body. This hormone is produced during pregnancy.
The time it takes for these tests to result can vary. If a doctor has an in-
house laboratory, you may receive your result in a few hours. If not, it
could take two to three days. Both tests take longer than a pregnancy urine
test. That test typically gives results in minutes, but is less precise.
Thyroid tests
A thyroid panel tests for the presence of thyroid hormone, such as thyroid-
stimulating hormone (TSH), in the blood.
Other measurements include T3 uptake, thyroxine (T4), and free-T4 index,
also known as T7. A doctor would order this test to determine if a person
has a medical condition affecting their thyroid, such as hyperthyroidism or
hypothyroidism.
These results should be sent to your doctor within one to two days, so you
can usually expect to learn your levels within a week.
Cancer tests
Doctors may use several different blood test types to detect for the possible
presence of cancers. The blood tests recommended depend on the type of
cancer your doctor is looking for. Some of these tests can be rarer, as is the
case for certain types of immunoglobulins and tumor markers.
These tests can take days to a week or more before results are available.
Sexually transmitted infection (STI) tests
Rapid testing is available for HIV tests, often at community health centers
and clinics. According to Columbia University, these tests most commonly
provide results in 10 to 20 minutes. Doctors also use blood tests to test for
the presence of conditions such as herpes, hepatitis, and syphilis. These
results may take up to one to two weeks.
Be aware that swabs (of either the genital area or inside the mouth) and
urine tests may be the preferred method for some STI testing. Results can
also take longer if cultures need to be grown.
Some STIs don’t show up immediately after they’re transmitted, so your
doctor may order a follow-up test a certain period of time after a negative
result.
Anemia tests
A doctor could order a CBC to test for anemia or order fewer tests by
requesting a hemoglobin and hematocrit (H and H) test. Rapid testing for
these results is available, with levels sometimes reported in 10 minutes or
less. However, other laboratory tests may take hours to result.
Inpatient vs. outpatient blood testing
Location can play a factor into how fast you’ll get your results back. For
example, going to a place where there’s an on-site laboratory (such as a
hospital) may get you results more quickly than if your blood has to be sent
to another laboratory. Specialty tests for rare conditions often need to be
sent to specific laboratories.
According to Regional Medical Laboratory, most in-hospital results can be
obtained within three to six hours after taking the blood. Sometimes blood
drawn at other, non-hospital facilities can take several days to get results.
Tips for getting results faster
If you’re hoping to receive blood test results as quickly as possible, some
tips to do this can include:
  Ask to have blood drawn at a location where there’s an on-site
laboratory.
 Ask if there are “quick test” options for a particular test, such as an
H and H for anemia.
 Ask if the results can be sent to you via a web portal.
 Ask if you can wait at the medical facility until results are available.
Sometimes, how quickly the blood tests take depends on how common the
blood test is. Blood tests performed more often, such as a CBC or metabolic
panel, are usually available more quickly than tests for rare conditions.
Fewer laboratories may have the testing available for these conditions,
which could slow results.
The takeaway
With innovations in quick testing, many more laboratory tests are available
sooner than ever before. However, it’s often important that your doctor do
a careful review before passing along the results. Asking a doctor or
laboratory technicians about how long average tests will take can help you
to establish a realistic time frame for getting results.
The AACC provides comprehensive information on blood tests in their
guide.
HEALTHLINE RESOURCE
Simplify your search for at-home testing kits
With evidence-based reviews and brand comparisons, we provide
informative product recommendations so you can explore ways to manage
your health at home.
Last medically reviewed on March 9, 2018
How we reviewed this article:
Share this article
Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP —
By Rachel Nall, MSN, CRNA — Updated on August 1, 2019

For a Longer Life and Happier Gut, Eat More Fiber

Top 6 Benefits of Taking Collagen Supplements

6 Ways to Boost Your Coffee with Vitamins and Antioxidants

Was this article helpful?

YesNo
How Is Blood Drawn? What to Expect
 Before the draw
 The procedure
 How to stay calm
 Side effects
 Aftercare
 Takeaway
It’s likely that at some point in your life, you’ll have blood drawn for either
a medical test or for donating blood. The process for either procedure is
similar and usually much less painful than most people think.
Read on to find out how to prepare for your next blood draw. If you’re a
medical professional, we’ll provide a few tips for enhancing blood drawing
techniques.
Before the draw
Before you have a blood draw, it’s important to know if you need to follow
special instructions before your test.
For example, some tests require that you fast (don’t eat or drink anything)
for a certain amount of time. Others don’t require you to fast at all.
If you don’t have any special instructions other than an arrival time, there
are still some steps you can take to try to make this process easier:
 Drink plenty of water before your appointment. When you’re
hydrated, your blood volume goes up, and your veins are plumper
and easier to access.
 Eat a healthy meal before you go. Choosing one with plenty of protein
and whole-grain carbohydrates may prevent you from feeling light-
headed after giving blood.
 Wear a short-sleeved shirt or layers. This makes accessing your veins
easier.
 Stopping taking aspirin at least two days before your blood draw if
you’re donating platelets.
You may wish to mention if you have a preferred arm for a person to draw
blood from. This could be your nondominant arm or an area where you
know a person taking your blood has had success before.
The procedure
The time it takes for a blood draw usually depends upon the amount of
blood needed.
For example, donating blood can take about 10 minutes, while obtaining a
small amount of blood for a sample may take just a few minutes.
While the process may vary depending on who is drawing the blood and for
what purpose, the person performing the blood draw will follow this
general procedure:
 Ask you to expose one arm, and then place a tight elastic band known
as a tourniquet around that limb. This makes the veins back up with
blood and be easier to identify.
 Identify a vein that appears easy to access, specifically a large, visible
vein. They may feel a vein to assess the borders and how large it may
be.
 Clean the targeted vein with an alcohol pad or other cleansing
method. It’s possible they may have difficulty accessing the vein when
they insert the needle. If this is the case, they may need to try another
vein.
 Insert a needle successfully into the skin to access the vein. The needle
is usually connected to special tubing or a syringe to collect blood.
 Release the tourniquet and remove the needle from the arm, applying
gentle pressure with a gauze or bandage to prevent further bleeding.
The person drawing blood will likely cover the puncture site with a
bandage.
Some blood product types may take longer to donate. This is true for a
special type of blood donation known as apheresis. A person donating via
this method is providing blood that can be separated into further
components, such as platelets or plasma.
How to stay calm
While drawing blood is ideally a fast and minimally painful experience, it’s
possible that some people will feel very nervous about getting stuck with a
needle or seeing their own blood.
Here are some ways to minimize these reactions and stay calm:
 Focus on taking deep, full breaths before getting a blood draw. By
focusing on your breathing, you can relieve mental tension and
naturally relax your body.
 Take your headphones and listen to music before and during the
draw. This allows you to block out an environment that might
otherwise make you feel nervous.
 Have the person taking your blood tell you to look away before they
bring a needle near your arm.
 Ask if there are devices or methods the person drawing blood can use
to minimize discomfort. For example, some facilities will use numbing
creams or small lidocaine injections (a local anesthetic) before
inserting a needle into the vein. This can help minimize discomfort.
 Use a device like Buzzy, a small vibrating tool that can be placed
nearby that helps reduce the discomfort of needle insertion.
The person drawing your blood has likely seen nervous individuals about to
have their blood drawn before. Explain your concerns, and they can help
walk you through what to expect.
Side effects
Most blood draws cause minimal side effects. However, it’s possible you
could experience some of the following:
 bleeding
 bruising
 lightheadedness (especially after donating blood)
 rash
 skin irritation from tape or adhesive from an applied bandage
 soreness
Most of these will subside with time. If you still experience bleeding from a
puncture site, try holding pressure with a clean, dry gauze for at least five
minutes. If the site continues to bleed and soak bandages, see a doctor.
You should also see a doctor if you experience a large blood bruise known
as a hematoma at the puncture site. A large hematoma can block blood flow
to the tissues. However, smaller (less than dime-sized) hematomas will often
go away on their own with time.
After the blood draw
Even if you’ve had a small amount of blood drawn, there are still steps you
can follow to enhance how you feel afterward:
 Keep your bandage on for the recommended amount of time (unless
you experience skin irritation at the puncture site). This is usually at
least four to six hours after your blood draw. You may need to leave
it on longer if you take blood-thinning medications.
 Refrain from doing any vigorous exercise, which could stimulate
blood flow and may cause bleeding from the site.
 Eat foods rich in iron, such as leafy green vegetables or iron-fortified
cereals. These can help replenish lost iron stores to build your blood
supply back up.
 Apply a cloth-covered ice pack to your arm or hand if you have
soreness or bruising at the puncture site.
 Snack on energy-boosting foods, such as cheese and crackers and a
handful of nuts, or half of a turkey sandwich.
If you do experience any symptoms that you’re worried are out of the
ordinary, call your doctor or the location that did your blood draw.
For providers: What makes a better blood draw?
 Ask the person getting blood drawn how their nerves are best soothed.
For example, some people benefit from knowing each step, while
others find they’re only more nervous. Finding out the best way to
communicate with an individual can help.
 Always check for any allergies before performing the draw. A person
can be allergic to latex in a tourniquet or bandage as well as the
components of some soaps used to cleanse the area. This helps to
minimize discomfort.
 Learn more about the typical anatomy of the arm and hand when it
comes to veins. For example, many people who perform blood draws
will do so in the antecubital area of the arm (inner part of the
forearm) where there are several large veins.
 Examine the arm before applying a tourniquet to see if any veins are
already clearly visible. Look for the veins that are appear to be the
straightest to reduces the risk for hematoma.
  Apply a tourniquet at least 3 to 4 inches above the site for puncture.
Try not to leave the tourniquet on for longer than two minutes as this
can cause numbness and tingling in the arm.
 Hold the skin taut around the vein. This helps to keep the vein from
rolling or redirecting as you insert the needle.
 Ask the person to make a fist. This can make the veins more visible.
However, pumping the fist is ineffective because there isn’t blood flow
to the area when you’ve applied the tourniquet.
The bottom line
Blood draws and blood donations should be a minimally painless process
that has few side effects.
If you’re interested in donating blood, consider contacting your local
hospital or the American Red Cross, which can direct you to a blood
donation site.
If you do have concerns about side effects or the process itself, share these
with the person taking your blood. There are many ways to soothe nerves
and make the process smoother overall.
HEALTHLINE NEWSLETTER
The latest in alternative medicine, delivered
Get innovative health and wellness tips delivered to your inbox with our
Healthline Natural newsletter.
Your privacy is important to us
Last medically reviewed on February 25, 2019
How we reviewed this article:
Share this article
Medically reviewed by Gerhard Whitworth, R.N. — By Rachel Nall, MSN,
CRNA on February 25, 2019

For a Longer Life and Happier Gut, Eat More Fiber

Top 6 Benefits of Taking Collagen Supplements

6 Ways to Boost Your Coffee with Vitamins and Antioxidants

Was this article helpful?
YesNo
How to Find Out Your Blood Type
 Blood typing
 Blood testing
 At-home blood typing
 Free blood typing
 No-stick blood typing
 Takeaway
We include products we think are useful for our readers. If you buy
through links on this page, we may earn a small commission. Here’s our
process.
Finding out your blood type is relatively simple. You can:
 have your doctor order a test
 get the information when donating blood
 take an at-home blood test
How do you determine your blood type?
Your blood type is comprised of two blood groups: ABO and Rh.
Blood types are based on antigens on the surface of your red blood cells. An
antigen is a substance that triggers an immune response by your body
against that substance.
The presence of specific antigens designates ABO blood types:
 Type A has the A antigen
 Type B has the B antigen
 Type AB has both the A and B antigen
 Type O has neither the A nor B antigen
Once your ABO blood type has been determined, it can be further defined
by identifying the Rhesus (Rh) factor:
 Rh-positive. If you have Rh antigens on the surface of your red blood
cells, you have Rh-positive blood.
 Rh-negative. If you don’t have Rh antigens on the surface of your red
blood cells, you have Rh-negative blood.
By including the Rh factor, the 8 most prevalent blood types can be
identified: A+ or A-, B+ or B-, AB+ or AB-, and O+ or O-.
How is blood testing typically done?
A phlebotomist (someone trained to draw blood) will use a needle to draw
blood from your arm or hand at your doctor’s office, a clinical laboratory,
or a hospital
The typical method for typing blood involves two steps:
 forward typing
 reverse typing
Forward typing
The first step is called “forward typing.” Your blood cells are mixed with
antibodies against type A and B blood, and the sample is checked to see
whether the blood cells stick together (agglutinate).
If blood cells stick together, it means your blood cells reacted with one of
the antibodies.
For example, if your blood cells agglutinate when mixed with antibodies
against type B blood (“anti-B antibodies”), you have type B blood.
Reverse typing
The second step is called “back typing” or “reverse typing.” The liquid part
of your blood without red blood cells (serum) is mixed with blood cells that
are known to be type A and type B.
People with type A blood have antibodies against Type B blood (“anti-B
antibodies”) in their serum, and those with type B blood have antibodies
against Type A blood (“anti-A antibodies”) in their serum.
Type O blood contains both anti-A and anti-B antibodies.
So, for example, if agglutination occurs when your serum is mixed with type
B blood cells, you have type A blood.
Summary and Rh typing
ABO testing should include both forward and reverse typing. The result
from forward typing is the patient’s blood type. Reverse typing is a cross-
check for forward typing and provides confirmation of results.
Next, your blood will be mixed with an anti-Rh serum. If your blood cells
respond by clumping together, you have Rh-positive blood.
How can I find out my blood type at home?
In at-home blood typing tests, they typically ask that you prick your finger
with a lancet and put drops of your blood on a special card.
After putting the blood on the card, you can observe the areas where blood
clumps or spreads out, and then match those reactions to an included guide.
Some home testing kits have vials of fluid for your blood, as opposed to a
card.
Purchase an at-home blood typing kit here.
How to find out your blood type for free
One way to find out your blood type is to donate blood.
If you donate to community blood supplies, ask the staff if they’ll be able to
tell you your blood type. Many donation centers are able to provide that
information.
Typically, you won’t get your blood type immediately and may have to wait
a few weeks, as blood isn’t commonly tested right away.
Can blood type be determined without drawing blood?
About 80 percent Trusted Sourceof people secrete blood group antigens in
other bodily fluids, such as saliva, mucus, and sweat. This group of people is
referred to as secretors.
Secretors can have their blood type determined by a saliva or other body
fluid test.
Blood typing kits using saliva are available online, but they’re typically
more expensive.
Using one of the kits, you’ll first learn whether you’re a secretor. If you are,
then you’ll be able to determine you ABO blood type.
Takeaway
There are a number of ways you can determine your blood type, including:
 visiting your doctor
 going to a hospital or clinical laboratory that tests blood
 donating blood
 getting a home testing kit
If you’re in the category of people who secrete blood-group antigens in
other body fluids, you may be able to find out your blood type without
having blood drawn.