HEMA311 WEEK 2 1

Hematology
Blood Composition
Unit Content
• Introduction to Hematology
• Basic Hematology Terms
• Blood Characteristics and Functions
• Basic Hematologic Examination
• Anticoagulants Used in Hematology
• Quality Assessment and Quality Control in
Hematology Laboratory
Hematology
• Haemas: blood • if non anti-coagulated blood the yellow part is called
• logos: study serum
• Study of the cellular elements of the blood • Blood is compose of 55% liquid & 45% solid
• deals with the cellular elements of our blood (RBC, • the plasma component of our blood are most likely
WBC & platelets 95% water and 5% chemical constituent of blood
History • in a centrifuge blood the bu y coat is where all other
๏ 1657: describe worms in the blood by Athanasius cells aside from RBC, then platelets, monocyte,
Kircher lymphocyte, granulocytes, reticulocytes & etc.
๏ 1658: discovery of erythrocytes by Swammerdam • Fibrinogen is the protein that di ers plasma from
๏ 1674: human erythrocytes described by Van platelets
Leuwenhoek General Characteristics of Blood
๏ 1842: platelets were described ๏ Blood Volume: 5-6 L (5-6L for men and 4-5 for
๏ 1846: PMN distinguished from other leukocytes women), 250-350 mL for newborn
by Wharton Jones • Hypovolemia can happen when you are
๏ 1879: rst complete classi cation of leukocytes by dehydrated, large injury, burns and etc.
Ehrlich • Hypervolemia can happen when their is
๏ 1902: development of Wright’s stain by James excessive transfusion of blood
Homer Wright ๏ Viscosity: 3.5-4.5x thicker as compared with the
๏ 1920: hematology was considered a separate blood
science from clinical pathology ๏ Color: bright red = oxygenated, dark red = de-
Basic Hematology Terms oxygenated
๏ a – without ๏ In vivo and in vitro appearance: vivo: liquid
๏ blast – youngest / nucleated/ can be immature cell state, vitro: if there is no anti coagulant in the
๏ chomic – color tube where you put it, it will be solid.
๏ cyte – cell ๏ pH: 7.35-7.45
• lungs and kidney are responsible for balancing
๏ Dys – abnormal our pH
๏ aemia – in the blood
๏ Speci c gravity: WB = 1.045-1.066, Serum
๏ Ferro/ferric – iron 1.024-1.028, Plasma 1.025-1.029
๏ Hyper - increased Functions of Blood
๏ Hypo – decreased ๏ RESPIRATORY
๏ Iso - equal ๏ NUTRITIONAL
๏ Macro - large ๏ EXCRETORY
๏ Micro - small ๏ BUFFERING ACTION
๏ Myelo – marrow ๏ M A I N T E N A N C E O F C O N S TA N T B O D Y
๏ Normo – normal TEMPERATURE
๏ Oid - like ๏ TRANSPORTATION OF HORMONES AND
Common Abbreviations O T H E R E N D O C R I N E S E C R E T I O N T H AT
๏ FBC – Full Blood Count REGULATES CELL FUNCTION
๏ fL- Femtoliter ๏ BODY DEFENSE MECHANISM
๏ Hb/hgb – Hemoglobin Concentration Basic Hematological Methods of Examination
๏ Hct - Hematocrit A. Complete Blood Count
• RBC count
๏ MCH – Mean Cell Hemoglobin
• WBC count
๏ MCV – Mean Cell Volume/ size • Platelet count
๏ MCHC – Mean Cell Hemoglobin Concentration • Di erential count
๏ CBC - COMPLETE BLOOD COUNT • Hemoglobin
๏ pg - picogram
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• Hematocrit
• Blood Indices QA Programs
B. Reticulocyte Count
• to check your bone marrow
C. Erythrocyte Sedimentation Rate
• to know if a patient has in ammation or not
Common Anticoagulants Used in Hematology
A. EDTA (purple)
• Action: prevents food from clotting using
calcium
• Forms: liquid
• Optimum Concentration: depends on the
tube
• Use: primarily use in hema lab because it
preserves best of cell Non-analytical Factors in Quality Assessment
• Disodium Salt or Tripotassium Salt
B. Citrate (blue/black)
• Action: further inhibits your calcium
• Use: Black is mainly use for ESR testing
• Blue is for coagulation test
• Blood ration of blue 9:1 & black 4:1
C. Heparin (green)
• Action: inhibits thrombin
• Optimum Concentration: need 10-20u/mL
• Use: never use in blood smears
D. Oxalate
• Action: inhibits calcium Quality Control
• Optimum Concentration: 1-2 mg/mL
• A system of ensuring accuracy and precision in
• Use: ESR the laboratory
Quality Assessment in Hematology Laboratory • Involves process of monitoring the characteristics
• Pre-analytical of the analytical processes and detects analytical
- before the actual laboratory test errors during the test
• Analytical Basic Terminologies
- actual performance of the test • Sensitivity: being able to measure the smallest
• Post analytical concentration of the analyte of the interest
- how to relay or interpret the results • Speci city: able to speci cally test for the
Major Activities analyte of interest
• Preventive – activities done in prior to the • Accuracy: being able to hit the target value
examination of the specimen or sample that is • Precision: able to give/ hit the similar result
intended to establish system conducive to Kinds of Quality Control
accuracy testing. • Intralab – involves the analyses of control
• Assessment – activities done during testing to samples together with the patient specimen.
determine whether the test systems are • Interlab – for maintaining long-term accuracy of
performing correctly. the analytical methods
• Corrective – done when error is detected to QC Material
correct the system.
• Recalibration of the instrument/machine.
• Resembles human sample
• Inexpensive
• No communicable disease
• No matrix e ect
• Known analyte concentration
• Convenient packaging
Tools of Quality Assurance and Quality Control
• Standard Solution - known characteristics and
values, 100% pure
• Control Solution - not totally 100% pure
• Blank - solution without specimen
CBC Quality Control
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• Commercial Controls:
• 3 levels (low, normal, high)
• Values stored in instrument computer
• Levey-Jennings graph generated and stored
for each parameter
• Mode to Mode QC:
• Most automated hematology instruments
have a primary and secondary mode of
sample aspiration.
‣ Primary=Automated or Closed
‣ Secondary=Manual or Open
• Delta Checks
• When the Laboratory Information System (LIS)
and the instrument are interfaced (connected)
delta checks are conducted by the LIS on
select parameters.
Functions of Quality Control Program