Sources for blood collection

Transcription

1 Blood Collection

2 Purpose Hematological investigations Biochemical investigations Serological investigations For culture For transfusion Therapeutic measure in polycythemia

3 Sources for blood collection Capillary blood Arterial blood Venous blood

4 Capillary Blood Sites : Adults - free margin of ear lobe palmer surface of tip of finger Infants - plantar surface of great toe planter surface of heel

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6 Procedure Choose site Clean with spirit swab and let it dry Puncture rapidly with lancet or needle Do not squeeze the finger tip, only moderate pressure required

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8 Lancets

9 Indications Total RBC count Retic count Blood grouping and Hb by manual method Total WBC count Differential count and Peripheral smear PS for Malarial Parasite Micro ESR and ZSR

10 PS from fresh blood

11 Venous Blood Sites : Antecubital vein Median cubital, cephalic or basilic vein Superficial vein of dorsum of hand Ext. Jugular vein / Femoral vein in child Anterior fontanelle in infants IVC in autopsy

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14 Syringes are available in 2 ml, 5 ml and 10 ml size. Various numbers (bore gauge no.) needles are available and their uses are : No 26 : For subcutaneous injections. No 24 :For intramuscular injections No 23 : --do-- No 22 : For collection of blood. No 18 : For blood transfusion in patient. No 16 : For collection of blood from donor in blood bank.

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17 Procedure Explain Keep the required bulb or vacuette ready Select the vein and make it prominent Apply tourniquet of blood pressure cuff Clean with spirit swab and let it dry Push the needle with single puncture and withdraw blood Release tourniquet and open fist Remove needle, keep swab until bleeding stops

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19 Complications LOCAL Immediate Hematoma Syncope Continued bleeding Late Thrombosis of vein Thrombophlebitis

20 GENERAL Blood transmitted diseases like AIDS, Hepatitis B, Syphillis.

21 Arterial Blood Sites : Radial artery Femoral artery Brachial artery at antecubital fossa Scalp arteries in infants

22 Indications To measure arterial po2, pco2 and ph in Respiratory distress Acid base balance disorders cardiovascular patients Patients undergoing cardiac or lung surgeries

23 Evacuated Blood collection tubes New method for blood collection which is safer, minimizes hemolysis and assures accurate blood to anticoagulant ratio Specialized collection for infants and pediatric age group Costly

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26 Biochemical Ix Blood sugar Renal function tests Serum electrolytes Cardiac profile Lipid profile Drug assay Liver function tests Tumour markers Vitamins

27 Serological Ix ASO Titre RA test VDRL HIV HbsAg HCV Indirect Coomb s test

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29 Bulb with beads Hemolytic anemia Serum required urgently LE cell preparation

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31 EDTA Ethylene diamine tetra-acetic acid MOA - Chelation of Ca into unionized soluble complex EDTA salts Tripotassium Dipotassium Disodium Dilithium

32 Concentration EDTA solution EDTA 4 gm Distilled water 100 ml EDTA bulb 0.2 ml EDTA solution (= 8 mg EDTA) to each bulb for 3-4 ml blood

33 Uses Blood Bank Blood grouping Direct Coomb s test Weak D test Cross matching Screening of donors for MP

34 Laboratory CBC Platelet count PS for CM and PS for MP AEC ESR by Wintrobe s method Retic count Sickling test Hb Electrophoresis

35 Disadvantages Not suitable for Coagulation studies If EDTA excess RBC - Shrinks, PCV decreases, MCHC increases WBC - Shrink and degenerate Platelet - Swell, disintegrate causing high platelet count

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37 Trisodium Citrate MOA - Reversible chelation of Ca into unionized soluble complex Concentration Trisodium citrate solution Tri sodium citrate3.8 gm Distilled water 100 ml

38 Uses ESR by Westergren method Ratio of Blood to Anticoagulant 1:4 0.4 ml of 3.8 gm TCS ml whole blood Coagulation studies (PT, APTT, Fibrinogen) Ratio of Blood to Anticoagulant 1: ml of 3.8 gm TCS ml whole blood Blood Banking Blood grouping with blood in any of the above ratio to anticoagulant

39 Blood Bank In CPDA bags 14 ml TCS In CPDA bags 49 ml TCS In CPDA bags 63 ml TCS 100 ml blood bags 350 ml blood bags 450 ml blood bags

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41 Single Oxalate MOA - Chelation of Ca ions Concentration Potassium oxalate solution Potassium oxalate 2 gm Distilled water 100 ml Bulb ml of Potassium Oxalate solution (=8 mg of anticoagulant) for 3-4 ml blood

42 Uses Blood Urea Blood ph

43 Double Oxalate (Wintrobe s) MOA - Chelation of Ca ions Concentration Double oxalate solution Ammonium Ox and Potassium Ox in ratio 3:2 Ammonium oxalate 2.4 gms Potassium oxalate 1.6 gms Distilled water 100 ml Double oxalate bulb 0.2 ml double oxalate solution (=8 mg of anticoagulant) for 3-4 ml blood

44 Uses Laboratory CBC Blood indices ESR by Wintrobe s method

45 Disadvantages WBC morphology is poorly preserved so not preferred for hematological Ix Calcium oxalate precipitates are harmful so not used as preservative in blood bags

46 Fluoride MOA - EDTA / Oxalate are added as anticoagulant & Sodium fluoride prevents glycolysis Concentration Flouride Oxalate solution (1:3) Sodium fluoride 1.0 gm Potassium oxalate 3.0 gm Distilled water 100 ml

47 Concentration Flouride EDTA solution (2:1) Sodium flouride 4 gm EDTA 2 gm Distilled water 100 ml Flouride bulb ml fluoride solution (=8 mg of anticoagulant) for 3-4 ml blood

48 Uses Glucose estimation of blood and other body fluids e.g CSF, Ascitic etc

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50 Heparin MOA - Antithrombin action Concentration mg/ml of blood Uses Osmotic fragility Serum electrolytes Disadvantages Causes clumping of WBC, platelets and gives blue background to PS Expensive

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