1. Hematology and Coagulation Procedures
Chapter 42
Hematology and Coagulation Procedures

3. Learning Objectives List the components and functions of blood
List tests included in complete blood count (CBC)
Describe the different cellular elements and their roles
Describe the components of hemoglobin and hematocrit and their functions

4. Learning Objectives
Describe the different leukocytes and their functions
State the normal range for the different hematological tests
State the importance of a differential cell count

5. Learning Objectives
List the tests associated with coagulation determination
Describe the importance of knowing the patient’s International Normalized Ratio (INR) in reference to prothrombin time

6. Hematology and Coagulation
Hematology—the study of the formed cellular elements of blood
Hematology testing includes the morphologic appearance and function of blood cells
Coagulation—evaluates the overall process of hemostasis

7. Blood
Transports nutrients, gases, medications, wastes, and other substances throughout the body
Average adult has 5–6 liters of blood
Blood samples can be whole blood, plasma, and serum
Whole blood sample—anticoagulant in tube

8. Plasma Liquid portion of blood Clear, straw-yellow
90% water, 10% solutes
55% total body volume
Not allowed to clot

9. Substances Found in Plasma
Hormones
Nutrients
Plasma proteins
Blood cells

10. Serum Clear, yellow fluid Blood has been allowed to clot
Substances include nutrients, hormones, and antibodies

11. Blood Cells
Erythrocytes
Leukocytes
Thrombocytes

12. Erythrocytes Live about 120 days Are old RBCs destroyed by macrophages
Are formed in bone marrow
Carry oxygen and nutrients to tissues
Carry carbon dioxide and waste away from tissues

13. Leukocytes Five different types Formed in bone marrow
Help to fight off infection
Phagocytosis
Granulocytes and agranulocytes

14. Neutrophils 40–60% Phagocytosis Many-lobed nucleus
Increase numbers in bacterial infections

15. Eosinophils 0–4% Assist inflammatory response
Increase numbers in allergic reactions, skin infections, and parasitic infections
Phagocytosis

16. Basophils
0–1%
Assist in inflammatory response by releasing substances such as histamine and heparin
Phagocytosis

17. Lymphocytes 20–40% Produce antibodies
Increase numbers in viral infections and infectious mononucleosis
B cells, T cells

18. Monocytes 3–8% Phagocytosis Effective against chronic infection
Leaves bloodstream and travels to tissues

19. Platelets Small, irregular-shaped cell fragments Life span 9–12 days
Necessary for blood-clotting process

20. Hematology Tests Platelet Red blood cell count (RBC)
Hemoglobin (hgb)
Hematocrit (hct)
White blood cell count (WBC)
Differential—100 wbc differential count
Platelet
Erythrocyte sedimentation rate (ESR)
Protime (PT)
Prothrombin time (PTT)
INR
Bleeding time

21. Complete Blood Count (CBC)
Red blood cell count
White blood cell count
Hemoglobin
Hematocrit
Blood cell indices
Platelets
Differential

22. CLIA Waived Tests
Medical assistants may perform
Hemoglobin
Hematocrit

23. Erythrocyte Sedimentation Rate
ESR
Shows rate of erythrocyte settling
Used to determine nonspecific inflammation
Screening test

24. Reticulocyte Count Retic count
Evaluates ability of bone marrow to produce and release RBCs into bloodstream
Increased count may indicate hemolytic anemia or problem with bone marrow

25. Hematologic Disorders
Anemia
Leukemia
Polycythemia
Thrombocytopenia
Leukopenia
Leukocytosis

26. Coagulation Tests Prothrombin time INR
Activated partial thromboplastin time
Bleeding time
Thrombin time
Fibrin degradation product
D-dimer
Fibrinogen

27. Therapeutic Ranges Anticoagulant therapy
Prevention of thrombosis in atrial fibrillation and myocardial infarction
INR 2.0–3.0
Mechanical prosthetic heart valve and recurrent systemic embolism
INR 2.5–3.5

28. Diseases Associated With Coagulation Disorders
Disseminated intravasular coagulation (DIC)—coagulation abnormalities that are systematic instead of local
Thrombophilic disorder is an inherited disorder, person is at risk for developing blood clots

29. Diseases Associated With Coagulation Disorders
Hemophilia—hereditary disorder characterized by abnormal clotting, affects more males than females

30. Discussion Name the five types of white blood cells
Identify white blood cells capable of phagocytosis
Identify white blood cells known as a macrophage
Explain the abnormality that may indicate an elevated ESR

31. Credits