The Complete Blood Count
Post on 16-Mar-2016
DESCRIPTIONThe Complete Blood Count. Clinical Pathology K. Canga, RVT. Reading and Assignments. Read pp: 32 38 (Start at CBC, end before histograms) You MUST register at IDEXXLearningCenter.com and complete the course titled: The VetTest Certificate Course RACE #106-11660 - PowerPoint PPT Presentation
The Complete Blood CountClinical PathologyK. Canga, RVT
Reading and AssignmentsRead pp: 32 38 (Start at CBC, end before histograms)You MUST register at IDEXXLearningCenter.com and complete the course titled: The VetTest Certificate Course RACE #106-11660This is FREE, and will count as 3 hours of CE to use after you become licensed.The course will take ~ 3 hours and you need to turn in a certificate of completion prior to using the IDEXX machines at school.Certificates are due by Monday, May 5. PLEASE print a hard copy. No Engrade or e-mail message will be accepted. (Yes, this is for points)
Composition of the CBCTotal RBC countPCVPlasma Protein ConcentrationTotal WBC countBlood film evaluation (differential WBC count, RBC and WBC morphological evaluation, platelet estimation)Reticulocyte countHb ConcentrationErythrocyte indices (Theyre baaack)
RBC CountShould be in the millionsUsually done by machineCan be done manually with Unopette and HemacytometerIs outdated and difficult to obtain diluents
PCVPacked Cell VolumeIndicates the percent of packed red cells in a patients blood.Done with hematocrit tube that has been centrifugedTakes VERY little time and can be quick diagnostic toolNormal ranges?
Plasma Protein ConcentrationUtilize the already centrifuged PCV tubeRead using a refractometerHelps to determine abnormal amounts of protein in bloodProtein present may be from fat, or other sources.Normal Ranges?
Total WBC countUsually done by machineCan be done manually with unopette and hemacytometer method. (Again, outdated and difficult to obtain diluents)Critical in determining absolute number of WBCs. This is the number with diagnostic value.
Blood Film AnalysisUsed to calculate the relative WBC percentagesUsed to evaluate RBC and WBC morphologiesUsed to perform reticulocyte count if patient is anemicUsed to Perform platelet estimation.REVIEW retic. and platelet calculations. I am not going to re-teach these.
Calculating the Absolute WBC countYou must have done a relative percentage from a blood film. (Written as a %)You must have a total WBC countYou will then take each relative percentage and multiply each by the total WBC count from your CBC analyzed blood.
Calculating the Absolute WBC valuesYour relative percentages were as follows:Neutrophils: 52%Lymphocytes: 38%Monocytes: 7%Eosinophils: 3%Basophils: 0%Take each cells percentage and multiply by the total WBC numbers from the machine readout. Lets say that your total was 38,000.
Your WBC total was 38,000 38,000 x 52% = 19,760 total neutrophils38,000 x 38% = 14,440 total lymphocytes38,000 x 7% = 2,660 total monocytes38,000 x 3% = 1,140 total eosinophils38,000 x 0% = 0 total basophilsThe % is VERY important in your calculation. Simply hit the % key after you punch in the number you are multiplying the total by.NOTICE that your numbers add up to 38,000!
Hemoglobin concentrationUsually done by machineDifferent machines use different techniques to estimate Hb concentrationLysing solutionsPhotometricsAre only as accurate as machine is. Calibration is important.
Erythrocyte IndicesMCV: Average volume within RBCMCHC: Average Hb concentration within RBCMCH: Average weight of Hb within RBCReview these calculations please!
Performing the CBC and Clinical Chemistry Tests on the IDEXX MachinesBlood MUST be drawn in both Lithium-Heparin micro tube AND large purple top tube. (These are tubes designed for the IDEXX machines)You can use a serum separator tube in place of the lithium heparin tube. REMEMBER: DO NOT remove the stopper from the large purple top tube.DO NOT fill tube past bottom of label (0.5 1.5 cc)You WILL need to remove the top from the micro-tube.
IDEXX CBC and ChemistryCentrifuge the microtube or serum separator tube for ~7 minutes.Transfer plasma or serum off and place in serum cup. (Barbie shot glass)Place purple top tube and grey top tube obtained from Ms. Kenner in CBC machine.Bar codes on purple and grey tubes MUST MATCH in order for your tests to be valid. (If purple tubes do not have a bar code, this is OK, as long as theyre the large tubes!)
IDEXX MachinesTo run the chemistry portion of the test, you will obtain test slides from Ms. KennerOn the Monitor of the VetLab Station, use the stylet to enter the following information:Click Analyze SampleEnter Client: VTIEnter P. Name: Patient id # is fineSelect next and then select reason: Routine SX/WellnessAt the bottom of the screen, you will need to tap the test icons desired. (CBC and Chemistry) and THENSTOP
Running your TestsIf you havent already loaded the large purple top and grey top tubes in to the CBC machine, do so now. Then hit RUNLook at the LED screen on the body of the Vet Test Machine.Follow prompts on the LED screen. This is where you will add the slides ONE AT A TIME. (DO NOT OPEN the foil until you are ready to load the slide in to the machine.)DO NOT touch the center of the slides. You will need to handle the slides by the edges and make sure the bar code is UP
Running your TestsOnce you have placed all the slides in the machine, follow the prompts on the LED screen.Place pipette tip securely on the pipettor of machine.Press E on LED keyboard to continue the analysis.lower pipette into plasma and press button. Machine will beep 1 time. (Release button)2 beeps: Remove pipette3 beeps: wipe pipette tip and replace in machine within 20 seconds. You will hear one more beep after pipette is replaced.
Test is RunningThe machine will automatically pipette the appropriate amount of plasma on each slide to run the tests.Total run time is ~6 minutesWhen test is complete, press ERemove pipette tip, empty used slide drawer Machine should start printing results. If not, press E and wait. If results are still not printing, try selecting option 2: print results.
PrintersThe internal printer on the IDEXX machine is disabled on our machine.We have an external printer connected to print results. PAPER MUST BE LOADED before you start running tests.