Although advances in automated technology have made the examination of a peripheral blood smear by a physician seem less important, the technology is not a completely. Introduction to peripheral blood smear examination clinical. The examination of the peripheral blood smear is an important basic hematological procedure. Blood smear examinationmanual differential leukocyte count with complete blood count cbc. Examination of the blood smear is an important part of the hematologic evaluation. The smear is stained with wrights stain and performed after the complete blood count is run. Peripheral blood smear, preparation, examination, interpretation, reporting, blood cells morphology. The results of the peripheral smear are considered abnormal when there is an abnormality in the shape, size or number of cells in the blood sample. This lesson also includes some general descriptions of conditions indicated by. As basic as it is, pbf is invaluable in the characterization of various. A peripheral blood smear pbs or blood film is required to be made from capillary blood or from a drop of blood from an edta anticoagulated blood sample. Whenever possible, use separate slides for thick and thin smears. Learn indepth information on giemsa blood smear test, on why the laboratory test is performed, specimen collected, the significance of the results, and its use in diagnosing medical conditions.
No morphologic abnormalities in granulocytes, red cells and platelets. A properly prepared blood smear is essential to accurate assessment of cellular morphology. Manual scanning for platelet clumps is recommended. An unconventional way to make peripheral blood smears duration. These tests are often the first ones done on patients with a suspected blood problem. Red blood cells have a characteristic pink appearance due to their high content of hemoglobin. A peripheral blood smear is a glass microscope slide coated on one side with a thin layer of venous blood. The blood film occupies the central portion of the slide and has definite margins on all sides that are accessible to examination by oil immersion.
Pdf purpose and criteria for blood smear scan, blood smear. Preparation and staining of blood smears flashcards. A complete blood count cbc and peripheral blood film is. The central pale area of each red blood cell is due to.
Detection of platelet clumps on peripheral blood smears by. Peripheral blood smear examination under microscope. Making a quality blood smear although there are several techniques described for making blood smears, most people use the wedge or push technique. For the peripheral blood smear sometimes just called a smear, a drop of blood is smeared across a slide and then looked at under a microscope to see how the cells look. Neel, dvm, dacvp clinical associate professor, clinical pathology nc state college of veterinary medicine raleigh, nc, 27607 introduction although tremendous advances have been made in the field of pointofcare hematology analyzers, examination of a well prepared, well stained blood smear remains the cornerstone of veterinary.
The examination of blood films stained with wrights stain frequently provides important clues in the diagnosis of anemias and various disorders of. The wedge blood smear will be discussed in this lab. Many hematological diagnoses depend upon this procedure and often a definitive diagnosis can be established from the careful examination of the blood film. By providing this educational background on medical tests, it is intended that fewer errors in specimen collection will be made.
Making and staining a blood smear university of vermont. Attention to detail in slide preparation, staining and standard criteria for cell estimates, morphology and differential reporting enhance the value of results provided to the physician. Changes in the numbers and the appearance of the cells often help diagnose leukemia. The white blood cells are decreased in number and consist mostly of. Essential knowledge and tools for working in todays lab, conference presentations, basic hematology. A synoptic reporting system for peripheral blood smear interpretation. Peripheral blood smear test purpose, procedure, results.
Peripheral blood film or peripheral blood smear or peripheral smear examination forms an important and basic lab investigation for diagnosing a number of hematological blood disorders. Thin and thick blood smears should be prepared immediately or within 1 hour after collection. It is found to reduce typing errors, enhance completeness, and improve reporting turnaround time. Dec 17, 2010 for medical lab technology mlt course at portland community college. Essential knowledge and tools for working in todays lab, conference presentations, basic hematology created date.
Icsh recommendations for the standardization of nomenclature. The white blood cells are decreased in number and consist mostly of blasts 41% as reported on the differential. The extra time and care taken during the field season will be rewarded later when the smears must be scanned, and parasites identified and counted. Lymphocytes seen in the peripheral blood are predominantly small 1012. It is hoped that this paper will provide an aid to those who wish to employ the blood smear as a diagnostic tool. Most commonly blood smears are used for the differential leukocyte count dlc. A blood smear is a blood test used to look for abnormalities in blood cells. It is useful to ask the laboratory to generate a wrightsstained peripheral blood smear and examine it.
A blood smear is a drop of blood spread thinly onto a glass slide that is then treated with a special stain and the blood cells on the slide are examined and evaluated. Laboratory diagnosis of malaria making thick and thin blood smears. The red cells are decreased in number and are normochromic and macrocytic. A blood smear reveals information about the number and shape of blood cells in the body. Small lymphocytes are usually round in outline, and the nucleus is round with coarse, densely staining chromatin. A blood smear is a sample of blood thats tested on a specially treated slide. It consists of a number of cells suspended in a fluid medium known as plasma. It is useful in establishing the diagnosis of malaria, identifying the plasmodium spp as well as determining the degree of parasitaemia. Pdf purpose and criteria for blood smear scan, blood. Trainees and practicing pathologists may benefit from this system, which is freely available on the internet. Preparation of a peripheral blood film this protocol describes how to prepare a slide film of peripheral blood for microscopic examination. Cell fixationis done by placing the slide in methanol ch3oh.
The peripheral blood film pbf is a laboratory workup that involves cytology of. Wewilluseadropletof blood tomakeathin% smear,dryit,fixandstainitand observe under a microscope. Examination of giemsastained peripheral blood smear is the standard test for the diagnosis of malarial infection. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This way, each slide may be used to spread the film of the other, and duplicate slides will be of value if something happens to one of them in the. With the advent of hematological automated machines, complete and highly accurate hematological data and parameters can be obtained within a few minutes. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification purposes. Proper preparation of a peripheral blood smear slide staining with wrights stain a.
Peripheral blood smear clinical methods ncbi bookshelf. Peripheral blood smear examination macroscopic view. Learn to count cells, observe and identify different blood cells in a smear, quantify their proportions and count rbcs per l mm3 using a haemocytometer. For best results, send five 5 thin blood smears unstained, unfixed and five 5 thick smears unstained, unfixed in addition to whole blood. Jul 15, 2019 a peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. Peripheral blood smear procedure and interpretation. Slides should not be left uncovered on top of the counter.
In some ways it is becoming a lost art but it often provides rapid, reliable access to information about a variety of hematologic disorders. Erythrocytes, or red blood cells, are by far the predominant cell type in the blood smear. Peripheral blood smear test is ordered as part of a general health exam to help diagnose many illnesses it helps diagnose if red blood cells, white blood cells and platelets are normal in appearance and number. The peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide. Peripheral blood morphology for hematological disorders remains a very important diagnostic tool give vital clues for further work up essential in situations where automated cell counter fails due to interferences peripheral blood smear examination a reflex test. Microcytes right panel are smaller than normal red blood cells cell diam eter peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide. The three main blood cells that the test focuses on are. A peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. It works by precipitating proteins and carbohydrates.
If the blood has been refrigerated, allow it to return. Traditionally, trained laboratorians have examined blood smears manually using a microscope. Blood smears are used to determine leukocyte differentials, to evaluate erythrocyte, platelet and leukocyte morphology, and, if necessary, to estimate platelet and leukocyte counts. Synoptic reporting system for peripheral blood smear.
Pdf the peripheral blood film pbf is a laboratory workup that. A blood smear test is said to be normal when the sample of blood contains an optimum number of cells and the cells have a normal appearance. A case report of mayhegglin anomaly in a 33yearold white woman with an update on the molecular findings of myh9related disease. Changes in the numbers and the appearance of the cells often help diagnose. They appear as biconcave discs of uniform shape and size 7. Moderate anisopoikilocytosis occasional oval macrocytes, dacrocytes, and elliptoid cells is seen. The test provides information on the number and shape of these. Making the blood smear before any stained smear can be used for a diagnosis. The mechanism of action of wrights stain is also discussed. Hematopathology consultation, peripheral smear labcorp. More recently, automated digital systems have become available to help analyze blood.
Introduction to peripheral blood smear examination. Acute lymphocytic leukemia early detection, diagnosis, and. Blood provides a mechanism by which nutrients, gases, and wastes can be transported throughout the body. The test request form must be completed with patient history, including pertinent clinical information and physicians name and telephone number. In the ncsu clinical pathology laboratory, we correct the total wbc count whenever 4 or more nrbcs are identified during the manual differential cell count. Proper preparation of a peripheral blood smear objectives at the completion of this laboratory, you will be able to. It is good practice to prepare two slides for each sample. Wewilluseadropletofbloodtomakeathin%smear,dryit,fixandstainitand observe under a microscope.
The smear is greater than 25 mm long and the feathered edge stops approximately 10 mm from the end of the slide. The technique of making a peripheral blood wedge slide or push slide was developed by maxwell wintrobe1. Stained peripheral blood smear is examined carefully using 40 x to 100 x objective usually oil. For a blood smear test, a laboratory professional examines the slide under a microscope and looks at the size, shape, and number of different types of blood cells. Always start with room temperature, wellmixed, clot free, edta anticoagulated blood heparin is used for some exotic species. The smear offers a window into the functional status of the bone marrow, the factory. Peripheral blood smear test about, preparation, test.
The slide is stained with leishmans, and examined under a microscope. Scroll left and right to see various peripheral blood components. A variety of methods are available for preparing and staining blood smears, the most common of which are discussed in this atlas. It is then treated with a special stain and studied under a microscope to examine the blood cells. Examination of the peripheral blood smear is an inexpensive but powerful diagnostic tool in both children and adults. Microcytes right panel are smaller than normal red blood cells cell diam eter peripheral blood smear is an important basic hematological procedure. For a blood smear, the lab professional looks for blood cell problems that may not be seen on a computer analysis. Making and staining a blood smear a wellmade blood smear is a beauty to behold, and likely to yield interesting and significant information for a research project. Preparing a peripheral blood smear the laboratory report series is written for those who collect patient specimens. These guidelines provide information on how to reliably and consistently report abnormal red blood cells, white blood cells and platelets using manual microscopy.
A number of different stains can be used, but it is important to remember that not all stains allow detection of some of the characteristic features of malaria eg, schuffner dots. A well prepared blood smear is necessary for microscopic examination of blood. Plasmodium falciparum centers for disease control and. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. This synoptic reporting system for peripheral blood smears helps users to draft a complete, accurate, and concise report. Blood smears are needed for microscopic examination of the blood. May 01, 2015 peripheral blood smear examination macroscopic view. Blood lab first week this is a self propelled powerpoint study atlas of blood cells encountered in examination of the peripheral blood smear. Lymphoblasts and prolymphocytes are not usually seen in the normal peripheral blood. Icsh recommendations for the standardization of nomenclature and grading of peripheral blood cell morphological features.
Utmedical school at houston, pathology last revision on. The peripheral blood film remains a very useful tool in hematological assessment. Identify the component cells of a typical blood smear. Microscopic examination of the peripheral blood is used to supplement the information provided. A blood filmor peripheral blood smear is a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically.
Describe the appearance of a well prepared blood smear. Peripheral blood test your knowledge below is a slide at high magnification under an oil immersion lens. The examination of a peripheral blood smear is one of the most informative exercises a physician can perform. Blood films are examined in the investigation of hematological blood disorders and are routinely employed to look for blood parasites, such as those of malaria and filariasis. A synoptic reporting system for peripheral blood smear. Preparation of blood smears in order to reduce the number of unacceptable smears received, marshfield labs recommends the following procedure to be used in preparation of blood smears. State the appropriate sample used for preparing a peripheral blood smear.