1. Over View of Blood.ppt

8/17/2019 1. Over View of Blood.ppt

1/42

CURRICULUM VITAEDr. Noormartany, dr., SpPK, MSi

Konsultan Imunologi

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2/42

Over View of Over View of BloodBlood

4-INI4A- PAT7-(Y DEPARTEMENT

"A4#-TY " MEDI4INE PAD/AD/ARAN #NI>ERSITY

Dr. Noormartany, dr., Sp PK., M Si

Konsultan Immunology


3/42

"un;tions o *lood

7!art pumps 1 to $' pints o ?lood t0roug0 mor!

t0an &+,+++ mil!s o =!ins, art!ri!s, and ;apillari!s. 7!matology 9 t0! study o ?lood 7!matologists 9 study its un;tion and ;omposition

3

*lood 0as many un;tions, all o @0i;0 ar!important to o=!rall 0!alt0 o t0! ?ody.


4/42

"un;tions o *lood ;ont.<*lood do!s all t0! ollo@ing:*lood do!s all t0! ollo@ing:

• Distri?ut!s oByg!n, nutri!nts, and0ormon!s to ?ody ;!lls

•

Eliminat!s @ast! produ;ts• Maintains a;id2?as! ?alan;!

• R!gulat!s ?ody t!mp!ratur!

• Atta;s in!;ting pat0og!ns

• Prot!;tion against or!ign su?stan;!s

• R!gulatory mol!;ul!s

• R!gulation o p7 and osmosis

• 4lot ormation

4


5/42

4omposition o *lood PlasmaPlasma

liquid in which other components are suspended

R!d ?lood ;!lls !ryt0ro;yt!s


6/42

Composition of Blood


7/42

!lasma

-iCuid part o ?lood Pal! y!llo@ mad! up o %$ @at!r, % ot0!r

4ontain:

•

Al?umin : Important in r!gulation o @at!rmo=!m!nt ?!t@!!n tissu!s and ?lood

• (lo?ulins : Immun! syst!m or transport mol!;ul!s

• "i?rinog!n : R!sponsi?l! or ormation o ?lood ;lots

•!t;

"


8/42

#ormed $lements

• R!d ?lood ;!lls !ryt0ro;yt!s<• W0it! ?lood ;!lls l!uo;yt!s<(ranulo;yt!s #TS<

• N!utrop0ils

• Eosinop0ils

• *asop0ils

Agranulo;yt!s

• -ymp0o;yt!s• Mono;yt!s

• Plat!l!ts t0rom?o;yt!s<

%


9/42

!roduction of #ormed $lements

• 7!matopoi!sis or 0!mopoi!sis&!rocess of blood cell production

• St!m ;!lls& 'll formed elements derived from

single population !roerythroblasts & (evelop into red blood cells

)yeloblasts & (evelop into basophils*

neutrophils* eosinophils

+ymphoblasts & (evelop into lymphocytes

)onoblasts & (evelop into monocytes

)ega,aryoblasts & (evelop into platelets

-


10/42

.ematopoiesis

/0


11/42

$rythrocytes

• 1tructure Biconcave* anucleate

• Components .emoglobin

+ipids* '2!* carbonic

anhydrase

• #unction

2ransport oygen fromlungs to tissues and

carbon dioide from

tissues to lungs

//


12/42

/

.emoglobin

• Consists of&

4 globin molecules& 2ransport carbon dioide 6carbonic

anhydrase involved7* nitric oide

4 heme molecules& 2ransport oygen

• 8ron is required for oygen transport


13/42

$rythropoiesis

• !roduction of red blood cells 1tem cells proerythroblasts early erythroblasts

intermediate late reticulocytes

• $rythropoietin& .ormone to stimulate 9BC

production /3


14/42

.emoglobin Brea,down

/4


15/42

+eu,ocytes

• Prot!;t ?ody against mi;roorganisms

and r!mo=! d!ad ;!lls and d!?ris

•Mo=!m!nts• Am!?oid

• Diap!d!sis

• 40!motaBis

• Passi=! Immunity

• A;ti=! Immunity

• Antig!n 9 Anti?ody

/5


16/42

2ypes of +eu,ocytes

N!utrop0ils : Most ;ommon p0ago;yti; ;!lls d!stroy ?a;t!ria #

Eosinop0ils : D!toBiy ;0!mi;als r!du;! inlammation

*asop0ils : Al!rgi; r!a;tions R!l!as! 0istamin!, 0!parin

-ymp0o;yt!s : * ) T 4!l typ!s

Mono;yt!s : *!;om! ma;rop0ag!s

/


17/42

/"


18/42

2hrombocytes: !latelet

• Cell fragments pinched

off from mega,aryocytes

in red bone marrow

• 8mportant in preventing blood loss !latelet plugs

!romoting formation and

contraction of clots

/-;/%


19/42

4oll!;ting, Pro;!ssing and

T!sting *lood Sp!;im!ns

/-


20/42

• EBamination o ?lood ;an

pro=id! !Bt!nsi=! inormation

a?out a pati!ntFs ;ondition.

• *asi; und!rstanding o t0!anatomy and p0ysiology o t0!

;ir;ulatory syst!m @ill 0!lp you

p!rorm t0!s! tass.

0


21/42

4oll!;ting *lood Sp!;im!ns

R!ading and int!rpr!ting t0! t!st ord!r

Ass!m?ling t0! !Cuipm!nt and suppli!s

Pr!paring t0! pati!nt

(r!!ting and id!ntiying t0! pati!nt:

4onirming pr!t!st pr!parations

EBplaining t0! pro;!dur! and sa!typr!;autions

Esta?lis0ing ;0ain o ;ustody

7andling !Bposur! in;id!nt/


22/42

Id!ntiying t0! Pati!nt

's, patient to state their full name<

Be sure you hear both the first and last namescorrectly<

Verify that the name the patient gives is the name onthe order<

1ome places* the phlebotomist may as, for social

security* patient 8(* or chart number to furtheridentify the patient<


23/42

3

Dra@ing *lood Som! stat!s p!rmit m!di;al

assistants to o?tain ?loodsampl!s.

Your oi;! @ill ;lariyyour duti!s

>!nipun;tur! 9 pun;tur!o a =!in

P0l!?otomy 9 pun;turing a

=!in @it0 a n!!dl! to ;oll!;t?lood into a n!!dl! or tu?!


24/42

>!nipun;tur! ECuipm!nt

E=a;uation syst!m >A4#TAINERA4#TAINER


25/42

>A4#TAINER

5

The VACUTAINER system uses interchangeable

collection tubes that allow you to raw se!eral bloo

s"ecimens #rom the same !eni"uncture site$


26/42

4apillary Pun;tur!

Sup!ri;ial pun;tur! o sin @it0 s0arp point todra@ small amount o ?lood.

4oll!;t!d in small, ;ali?rat!d glass tu?!s, slid!s, orr!ag!nt strips.


27/42

Pati!nt N!!ds

All!=iat! pati!nts !ars or ;on;!rnsPro=id! mor! inormation a?out:

• Pain• *ruis!s or s;ars

• S!rious diagnosis

•

4ontra;ting a dis!as! rom pro;!dur!

"


28/42

Sp!;ial 4onsid!rations

40ildr!n: Tal @it0 pati!nt or ;ar!gi=!rs ?!or! @oring

@it0 ;0ild Addr!ss t0!m dir!;tly Sp!a ;almly in soot0ing =oi;! EBplain t0! pro;!dur! ?ri!ly in t!rms t0!y ;an

und!rstand K!!p ;0ild inorm!d o status o pro;!dur!

%


29/42

Sp!;ial 4onsid!rations ;ont.<

Eld!rly Pati!nts:• 40ang!s in sin ;onditions ma! !ld!rly pati!nts

pron! to ?ruising• D!;r!as!d ;ir;ulation ma!s it dii;ult to ;oll!;t

!noug0 ?lood

• Sp!a in ;l!ar, lo@2pit;0!d ton!

•

(i=! t0! pati!nt tim! to r!spond to Cu!stions

-


30/42


Pati!nts at ris o un;ontroll!d ?l!!ding su;0

as 0!mop0ilia or taing ?lood2t0inning drugs

*! ;ar!ul and al!rt

7old ;otton ?all o=!r t0! pun;tur! sit! or at

l!ast 8 minut!s

Notiy p0ysi;ian i ?l!!ding is un;ontrolla?l!

30


31/42

Sp!;ial 4onsid!rations;ont.<

Dii;ult =!nipun;tur!:

• Try a s!;ond tim! and t0!n gi=! t0! pati!nt

a r!st

"ainting pati!nt:

• Position ?!or! =!nipun;tur! so no in6ury

@ill o;;ur

3/


32/42


Angry or =iol!nt pati!nts:Angry or =iol!nt pati!nts:

En;ourag! pati!nt to su?mit to t!st and t0!ntal @it0 do;tor

Do not or;! t0! issu!

Pati!nt 0as t0! rig0t to r!us! 3


33/42

33

7old ;otton ?all o=!r t0! pun;tur! sit! or at l!ast

8 minut!s

*! ;ar!ul and al!rt

Notiy p0ysi;ian i ?l!!ding is un;ontrolla?l!

W0at is on! pr!;aution you ;an ta!@0!n dra@ing ?lood rom a pati!nt @0o

0ad 0!mop0iliaG


34/42

34

P!rorming 4ommon

*lood T!stsR!sults ;an aid in t0! diagnosis o sp!;ii;

;onditions, dis!as!, and disord!rs

40!mi;als in la?:40!mi;als in la?:

• Anti;oagulants

• S!rum s!parators• Stains


35/42

7aHardous Wast!

7aHardous @ast! produ;ts in;lud!:• *lood and ?lood produ;ts

• *ody luids and tissu!

• 4ultur!s• >a;;in!s

• S0arps

• (lo=!s

•

Sp!;ula• Ino;ulating loops

• Pap!r produ;t ;ontaminat!d @it0 ?ody luids

35


36/42

7!matologi; T!sts P!rorm!d on =!nous or ;apillary ?lood sp!;im!ns

*lood ;ountsts

• 9ed blood cells

• =hite blood cells

• !latelets

• .ematocrit

• .emoglobin

34!ntriug!d 4apillary Sampl!


37/42

7!matologi; T!sts ;ont.<

Eryt0ro;yt! s!dim!ntation rat! ESR


38/42

40!mistry T!sts

7ig0ly d!tail!d t!sts ar! not

p!rorm!d in P- la?s ?!;aus!

o !Bp!nsi=!, sop0isti;at!d!Cuipm!nt and t!;0niCu!s.

Som! t!sts su;0 as ?lood glu;os!

monitoring ar! ot!n p!rorm!d

?y m!di;al assistant.

3%


39/42

S!rologi; T!sts

D!t!;t pr!s!n;! o sp!;ii; su?stan;!s in

?lood sampl!s.

R!!r to t0! introdu;tion o an antig!n oranti?ody into t0! sp!;im!n and to d!t!;t

sp!;ii; r!a;tion to t0! antig!n or

anti?ody.

#s!d to d!t!;t dis!as! anti?odi!s, drugs,

0ormon!s and =itamins.

3-


40/42

Immunoassays

EnHym!2lin!d immunosor?!nt assay E-ISA< W!st!rn ?lot

Radio2immunoassay RIA< !t;

40

S!rologi;al t!sts us! t0! introdu;tion o anantig!n or anti?ody into t0! sp!;im!n to

d!t!;t sp!;ii; r!a;tions to t0! antig!n or

anti?ody.


41/42

4/

Summary

Su;;!ssul p0l!?otomy pro;!dur!s r!Cuir! not

only sup!rior t!;0ni;al sills ?ut also !B;!ll!nt

int!rp!rsonal ;ommuni;ation sills

You may ?! ;all!d on to ;ompl!t! ;!rtain t!stingpro;!dur!s or to !Bplain t0! purpos! o t!sts to

pati!nts


42/42

1. Over View of Blood.ppt

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