BLEEDING TIME

AND
CLOTTING TIME
 Bleeding time

AIM :
To determine the bleeding time of the given blood
sample.
 Bleeding time
• The time taken from the skin puncture to the
stoppage of bleeding
• It shows the effectiveness of the plug formation &
vasoconstriction.
• Normal value is 1 to 5 mins.
• It is determined by Duke’s method .
 DUKE’S METHOD :
Principle:
• Bleeding Time (BT) is the time interval between the skin puncture and
spontaneous, unassisted (i.e.without pressure) stoppage of bleeding.

• The BT test is an in vitro test of platelet function.

• A deep skin prick is made & the length of time required for bleeding
to stop is recorded .

• It determines the function of the platelets & integrity of the

capillaries.
 APPARATUS :
Equipment required for the sterile finger prick:

• Whattman‘s filter paper

• Stopwatch

• lancet
 PROCEDURE:
• Clean the finger with spirit & allow it to dry.

• Make a deep skin prick with lancet / sterile needle.

• Immediately start stop watch.

• Blot the blood drop on filter paper for every 15 seconds.

• Place the subsequent drop a little further on the side of filter paper.
• Number the blood spots from 1 onwards .

• Do not allow the finger to press on the filter paper.

• Touch the finger on the filter paper.

• Stop the stop watch as soon as the bleeding ceases &

note the time.

• Count the number of blood drops on the filter paper.

Duke’s method
 OBSERVATION

• If the number of drops are N then

The Bleeding time is (N ) × 15 Seconds.
 RESULT

The bleeding time of the given blood sample is

________ mins .
 PRECAUTIONS :
• Don’t rub the finger tip as it increases the blood flow & alter the
BT.

• Don’t squeeze the finger.

• If bleeding continues after 10 mins, stop the test & apply pressure
on the site of wound.

• Don’t allow the filter paper to press on the bleeding spot as it

may interfere with bleeding.
Conditions in which BT increased:

1) Thrombocytopenia ( platelet count < 50,000/mm3 )

2) Thrombasthenia ( platelet function abnormality)

3) Von Willebrand disease ( factor VIII deficiency +

Platelet defect)
 CLOTTING TIME
• Clotting time is time interval between skin puncture
and formation of fibrin thread.
• It is the test for clot mechanism.
• Normal clotting time : 2 to 8 mins
• It is determined by CAPILLARY GLASS TUBE METHOD
 CAPILLARY GLASS TUBE METHOD :

Principle:
• A deep skin prick is made & blood is taken into the
capillary glass tube.

• The time taken for blood to clot as detected by the

appearance of fibrin string is reported as clotting time.
APPARATUS:
• lancet
• Stopwatch
• Capillary glass tube ,10-12 cm long,about 1-2mm
uniform bore diameter.
PROCEDURE:
• Make a sterile finger prick of 3 mm in depth.

• Start stop watch immediately after finger prick.

• Allow the blood to flow into the capillary tube.

• Hold the tube with blood between palms so as to

maintain the body temperature.
• After 2 mins, break off the capillary tube 1 to 2 cms from
one end for every 30 seconds & look for the appearance of
fibrin string.

• When a thin fibrin string span a gap of 5mm is seen between

two ends of broken capillary tube it indicates clotting time.

• Stop the watch & record the time.

• Normal CT by capillary tube method is 2- 8 mins.

 OBSERVATION & RESULT
Observation :
• Note the time at which fibrin string is formed.

Result :
• The given blood sample has clotting time _____ mins
 PRECAUTIONS
• Prick should be deep & blood should flow
spontaneously.
• Immediately after filling the capillary tube, should
be held between palms to maintain body
temperature.
• With each break of capillary tube fibrin string
should be looked.
QUESTIONS:
1)What are other methods for determination of bleeding
time & clotting time?

• For bleeding time : Ivy method

capillary fragility test of Hess.

• For clotting time : Lee white ( venipuncture ) method.

Drop method
2)What is the clinical significance of BT & CT ?

BT & CT is done in individual :

• Who have frequent/persistent bleeding from injuries .
• Before every minor & major surgery.
• Family history of bleeding disorders.
• Before & during anticoagulant therapy
• Also done before for taking biopsy from BM, liver &
kidney or in patients with liver disease like hepatitis,
Cirrhosis.
3)Why CT is longer than BT in normal individuals?

• BT is the time taken for the formation of temporary

hemostatic plug .

• Whereas, CT is the time taken for the formation of

definite hemostatic plug which involves complex
cascade of reactions.
4) Name the condition in which BT is prolonged & CT is
normal?

• Thrombocytopenia
• Thrombasthenia
• Von willebrand disease
• Vessel wall defect , allergic purpura
• Drugs : aspirin , penicillin ,corticosteroids
• Other diseases : uremia, cirrhosis ,leukemia.
5) Name the conditions in which CT is prolonged , but
BT is normal ?

• Hemophilia
• Christmas disease
• Any bleeding disorder in which clotting factors are
deficient.
6) Name the conditions in which clotting time
increases ?
• Hereditary coagulation disorder :
- Hemophilia
- Deficiency of factor XIII
• Acquired coagulation disorder :
- vit K deficiency
-liver diseases
-Anticoagulant therapy
7)What is the mechanism of clotting in the glass capillary
tube in your experiment?

• When blood comes in contact with the glass surface of

capillary tube, it initiates intrinsic coagulation mechanisms.

• Activation of platelets causes release of phospholipids

• The phospholipids along with high molecular wt

kininogens & kallikerin convert factor XII to XIIa , that
facilitates the intrinsic mechanism of clotting.
8)What is purpura?

• Purpura is a condition characterized by capillary

abnormality resulting in hemorrhages into skin,
mucous membrane, internal organs & other tissues.
9)What are the other tests to determine hemorrhagic
disorders?
• Prothrombin time
• Activated partial thromboplastin time
• Thrombin time
• Platelet count
• Clot retraction time.
10)What happens to the BT & CT in following
conditions?
• Hemophilia – CT prolonged
• Purpura – BT prolonged
• Liver diseases – BT & CT prolonged.
11 ) Name the clotting factors ?
12) What are the mechanisms of coagulation of blood ?
THANK YOU