No special patient preparations are necessary.

Specimen must be labeled with patient name, hospital number, date & time collected and name of person who collected specimen.

Tube type:
Lavender (K2 EDTA) Whole Blood

One 5.0 mL K2 EDTA (Lavender) tube or
One 3.0 mL K2 EDTA (Lavender) tube or
One 2.0 mL K2 EDTA (Lavender) tube

Volume Requirement:

5.0 mL tube must have 1.5 mL of blood
3.0 mL tube must have 0.75 mL of blood
2.0 mL tube must have 0.5 mL of blood

Microtainer tube must have 0.50 mL of blood (to the 500 mark on tube)

Venipuncture tube must be at least 1/4 full; Microtainer must be at least 1/2 full.

Tube must be mixed immediately after filling with blood.

IF ordering a citrated platelet for platelet clumping, a 3.2%sodium citrate whole blood sample is required. Tube must be completely filled and a PLTCIT and should be ordered to rule out platelet clumping.  Citrate sample must be drawn with an order having a platelet count, additionally. Call laboratory to inform them both samples will be sent to check for platelet clumping.  Extension 9-9113

Frozen, clotted, or grossly hemolyzed samples.

Storage:

   Room temperature for 24 hours

   Refrigerator temperature for 48 hours

Specimen should be tested within 24 hours of draw if being transported at room temperature.

Hematology.
Daily, routine and STAT.

A manual white blood cell differential may be performed based on the following criteria:
WBC <2000 uL or >25,000
Neutrophils <500 uL or > 23,000
Lymphocytes >5000 uL
Monocytes >20%
Eosinophils >15% or >2000uL
Basophils >4% or >500uL
Immature Granulocytes >5%
Bands: Detected

Main Lab:  If platelet is < 40 K and no previous results within 30 days, an IPF will be reflexed.
 

MCV measures the size of RBC's and is the most important index for classification of anemias into "macrocytic" with higher than normal MCV and "microcytic" with low MCV.

MCV (Mean Cell Volume) =    Hematocrit x 10    

                                       RBC in millions/cmm

MCHC is calculated and provides a measure of the concentration of Hgb in the cells.

MCHC (Mean Corpuscular Hemoglobin Concentration) =  Hemoglobin in gm/dL x 100 

                                                                                            Hematocrit

RDW is calculated to provide a measure of the anisocytosis, or variation in size of the RBC's.
Red Cell Distribution Width (RDW) = standard deviation of MCV

Hematology.
Daily, routine and STAT.

Main Lab: Sysmex XN 9100

Clarkson West/Village Pointe Labs: Coulter LH500

Results same day.

STAT results within 1 hour.

Routine results within 2 hours.

With report. Reference ranges are age and sex dependent.

Interferences:

• Clots and fibrin strands.
• Marked changes in plasma constituents (e.g. low sodium, extremely elevated glucose) may cause cells to swell or shrink. The blood to anticoagulant ratio is important.
• Red cell fragments, microcytic RBC's or white cell cytoplasmic fragments may interfere with automated platelet counts.
• Cold agglutinins produce spurious macrocytosis, elevated MCHC's, falsely decreased RBC counts and HCT's.
• Rare warm agglutinins produce the same spurious results as cold agglutinins.
• Extremely elevated WBC's may cause turbidity and falsely increase the hemoglobin.
• Severely hemolyzed samples (in vitro) falsely decrease RBC and HCT.
• Giant platelets and clumped platelets may falsely elevate the WBC count and falsely decrease the platelet count.
• Abnormal paraproteins found in Multiple Myeloma patients can falsely increase the HGB and on rare occasions the WBC and PLT parameters can be affected.
• Lipemia and severe icterus falsely elevates the HGB and MCHC.
• Megakaryocytes may falsely increase WBC counts.
• Cold agglutinin, diagnostic intravenous fluorescent dyes (e.g. fluorescein) and malaria may interfere with the determination of retic% and absolutes.