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Objectives Define Hematology & Hemostasis Describe the
Composition of Blood Define Management of the Hematology department
List Hematology tests & Reference Ranges Describe Safety Issues
Identify Quality Assurance Describe Specimen Collection
Slide 3
Introduction to Hematology Class participation What is the
meaning of Hematology & Hemostasis terms? What is hematology
and what do you expect to study?
Slide 4
Whether near or far.. Med lab Students at Malumghat, Bangladesh
Med lab Students at Umm Al-Qura University
Reference Ranges Concentration of blood components varies with
gender, age, race, geographic location and others Ranges for this
class will be found in Tables A-K on the inside covers of the
textbook
Slide 9
High power magnification: What do you see?
Slide 10
Management of the Hematology department What does the Health
system want? Who handles personnel issues? What will this class
help you with? Who is responsible for inventory control?
Slide 11
Hematologic Diagnosis & Treatment fill in the blanks 1.
Maintaining Wellness 2. RBC abnormalities _____________ 3. WBC
abnormalities _______________ 4. Platelet
abnormalities______________ 5. Invasive organisms
_______________
Slide 12
Examples of patients questions My hematocrit was 16 and I had
to have an infusion, but I am still suffering with headaches. Is it
normal to have headaches with a low hematocrit? My WBC is 3.2 and
the range is 4.0 10.0. The doctor told me my lab tests were fine,
but on my copy there is an H next to the MPV of 10.7.
Slide 13
Oil immersion view of red and white blood cells in the bone
marrow
Slide 14
Safety Issues Handling of potentially harmful material
(Universal Precautions) Safety Agreement Forms Sharps containers/
Yellow Bags Student Lab Surface Cleaning Safety Manual/ MSDS/
Incident Reports
Slide 15
Clinical Microscopy Care of the microscope____________
Component parts and functions_____ Hematology uses
_____________?
Slide 16
Quality Assurance program n What are the Basic components? n
Give examples of items found under the three components n What is
proficiency testing? n What is competency testing?
Slide 17
Critical features of a Quality Assurance Program Compliance
with legislation and accreditation standards (CBAHI, JCI, &
CAP) Minimize risk of producing unreliable results Accuracy:
ability to determine true value Precision: ability to obtain nearly
identical result with repetition Alert the operator when the
analytic system begins to fail Document the offices preventive
stand, problem identification and preventive actions. Savings in
time and money- tests are not repeated
Slide 18
Quality Control Three levels of control material are run on
each instrument daily (each shift) Low Normal High Plot on
Levey-Jennings chart to spot shift or trend Should be within 2
standard deviations Instrument delta checks
Slide 19
Factors Contributing to Imprecise or Inaccurate Results Give
examples related to: Testing environment Pre-analytic factors
Analytic system Post-analytic factors
Slide 20
Specimen Collection
Slide 21
HAEMATOLOGY LABORATORY COLLECTION & HANDLING OF SAMPLES
Precautions: * Gloves * Avoid injury * Sharp objects disposal *
Samples must be sent in closed plastic bags * Proper & safe
disposal of waste products Samples: * Venous blood * Capillary
blood # * Serum * Heel blood # * Plasma # Results are slightly
higher than that of the venous samples Anticoagulants: * Ethylene
diamine tetra-acetic acid (EDTA) * Trisodium citrate * Heparin
Slide 22
Role of the Phlebotomist Represents laboratory to patients
Assures quality of specimen
Slide 23
Types of Collection Venipuncture Routine Special Capillary
Puncture Fingerstick Heelstick Arterial Blood Collection
Slide 24
Blood Vessels Veins Thinner walls, Less pressure, Valves
Arteries Thicker walls, more pressure Capillaries Tiny vessels
Step by Step Procedure All supplies within easy reach, Assemble
needle and holder Put on Gloves Apply tourniquet Select site and
cleanse with alcohol Remove needle cover Pull down skin to anchor
vein Penetrate skin with bevel of needle up Push on tubes, release
tourniquet, apply gauze and pressure Apply bandaid, label
tubes
Slide 27
Sequence of Tube Draw Sterile for blood culture Plain tubes, No
additive Anticoagulant tubes blue (sodium citrate) green ( heparin)
lavender (EDTA) gray (sodium fluoride)
Slide 28
Site selection of difficult patients Hematoma: avoid areas
where bruising is present Edema: difficult to palpate, tissue fluid
contamination IV lines: draw below or shut off for 3 min. Scarring,
burns: painful, susceptible to infection Dialysis: never draw from
a fistula
Slide 29
Alternate Sites and Methods Applying warm towel to hand, arm,
heel Dangle arm for a few minutes Dorsal surface of hands and
wrists Ankle or foot - last resort
Slide 30
Sources of Sampling Errors Wrong order of tube draw Prolonged
tourniquet application Delay in processing Inadequate volume
Hemolysis Unlabeled specimens Clotted anticoagulant specimen
Slide 31
Special Venipuncture Collection Timed specimens post-prandial,
fasting Therapeutic drug monitoring trough (immediately before
dose) peak (1/2 to 1 hour after dose) Blood cultures specific
cleansing techniques using betadine Pediatric and infant draws
Slide 32
Problem Patient Reactions Fainting Nausea Vomiting Excessive
bleeding Convulsions
Slide 33
What you can do to learn the process Practice on the artificial
arms Practice with a classmate under the supervision of lab
technician or instructor. You Are READY!!