CLINICAL LAB SCIENEC

348
ESSENTIALS OF CLINICAL LABORATORY SCIENCE
In the Lab
Procedure #4 Report Form: Manual Hemoglobin Determination by Spectrophotometer
Patient Name: _____________________ Pt. ID _______________ Date: _____________
Age: _______ Gender (Circle One) M F Physician: ____________________________
Time Requested: ___________ Time Performed: ___________ Time Reported: __________
Examination Requested:
Hemoglobin Other
Procedure Results
Test Results Normal Range Quality Control Values/Acceptable Range
Comments (unusual findings) _____________________________________________________
Performed by: ______________________ Date Reported _________________________
HEMATOLOGY AND COAGULATION PROCEDURE #5
Red Blood Cell Morphology
Principles
Red blood cells are constantly being produced in the bone marrow. Even under
normal circumstances, cells at various stages of development may be released into
the vascular system slightly earlier than the majority of RBCs. In serious diseases of
the bone marrow, RBCs may be released as primitive cells and may appear similar
to early forms of white blood cells. In this early form, some cells may still have a
nucleus, which is usually lost prior to the cells entering the blood vessels. Clues as to
the morphology of RBCs may be found in the results of the hemoglobin and the hematocrit
when a complete blood count is performed prior to a microscopic evaluation.
Red cells are evaluated relative to color, shape, and size. These characteristics
are invaluable in discovering various types of anemia. Some changes in the morphology
and appearance of RBCs may be due to dietary deficiencies; others occur secondary
to medications, infections, or illness; and still others are hereditary (e.g., sickle
cell anemia). Most of the cells available to the laboratory student are normal in morphology.
The ability to recognize normal cells is critical, for it is the pattern of normal
cells against which all other cells are measured (Figure 13-12).
Although the evaluation of red blood cell morphology is one of the most important
facets of hematology, it is important as well to concurrently examine the WBCs. RBC
size should be approximately the size of the nucleus of a lymphocyte, a white blood
cell, when the RBC is normal in size. In addition, some disease conditions (e.g., megaloblastic
anemia) affect both the RBCs and WBCs.
Equipment and Supplies
1. Gloves, disposable paper towels, and disinfectant or other cleaning solution
2. Report form for Procedure #5
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