Preparation of a peripheral blood film this protocol describes how to prepare a slide film of peripheral blood for microscopic examination. A well prepared blood smear is necessary for microscopic examination of blood. In some ways it is becoming a lost art but it often provides rapid, reliable access to information about a variety of hematologic disorders. It consists of a number of cells suspended in a fluid medium known as plasma. 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. Examination of giemsastained peripheral blood smear is the standard test for the diagnosis of malarial infection.
The examination of a peripheral blood smear is one of the most informative exercises a physician can perform. State the appropriate sample used for preparing a peripheral blood smear. Pdf purpose and criteria for blood smear scan, blood. The three main blood cells that the test focuses on are. Pdf purpose and criteria for blood smear scan, blood smear. The red cells are decreased in number and are normochromic and macrocytic. It is useful in establishing the diagnosis of malaria, identifying the plasmodium spp as well as determining the degree of parasitaemia. Blood smears are used to determine leukocyte differentials, to evaluate erythrocyte, platelet and leukocyte morphology, and, if necessary, to estimate platelet and leukocyte counts. The peripheral blood film remains a very useful tool in hematological assessment.
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. Describe the appearance of a well prepared blood smear. Peripheral blood smear clinical methods ncbi bookshelf. 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. 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. Manual scanning for platelet clumps is recommended. It is useful to ask the laboratory to generate a wrightsstained peripheral blood smear and examine it. 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. Plasmodium falciparum centers for disease control and. Pdf the peripheral blood film pbf is a laboratory workup that.
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. 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. The smear is greater than 25 mm long and the feathered edge stops approximately 10 mm from the end of the slide. As basic as it is, pbf is invaluable in the characterization of various. No morphologic abnormalities in granulocytes, red cells and platelets. The examination of the 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. 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. It is then treated with a special stain and studied under a microscope to examine the blood cells. Introduction to peripheral blood smear examination. Slides should not be left uncovered on top of the counter. 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 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. 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.
Scroll left and right to see various peripheral blood components. May 01, 2015 peripheral blood smear examination macroscopic view. It works by precipitating proteins and carbohydrates. Trainees and practicing pathologists may benefit from this system, which is freely available on the internet. The examination of blood films stained with wrights stain frequently provides important clues in the diagnosis of anemias and various disorders of. Many hematological diagnoses depend upon this procedure and often a definitive diagnosis can be established from the careful examination of the blood film. Blood lab first week this is a self propelled powerpoint study atlas of blood cells encountered in examination of the peripheral blood smear. Stained peripheral blood smear is examined carefully using 40 x to 100 x objective usually oil. Peripheral blood test your knowledge below is a slide at high magnification under an oil immersion lens. The smear is stained with wrights stain and performed after the complete blood count is run. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification purposes. Essential knowledge and tools for working in todays lab, conference presentations, basic hematology. Making the blood smear before any stained smear can be used for a diagnosis. The wedge blood smear will be discussed in this lab.
Acute lymphocytic leukemia early detection, diagnosis, and. The test request form must be completed with patient history, including pertinent clinical information and physicians name and telephone number. 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. 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.
Blood smears are needed for microscopic examination of the blood. Synoptic reporting system for peripheral blood smear. The mechanism of action of wrights stain is also discussed. Hematopathology consultation, peripheral smear labcorp.
The white blood cells are decreased in number and consist mostly of. The slide is stained with leishmans, and examined under a microscope. Blood smear examinationmanual differential leukocyte count with complete blood count cbc. It is found to reduce typing errors, enhance completeness, and improve reporting turnaround time. Laboratory diagnosis of malaria making thick and thin blood smears. Dec 17, 2010 for medical lab technology mlt course at portland community college. Preparing a peripheral blood smear the laboratory report series is written for those who collect patient specimens. If the blood has been refrigerated, allow it to return. Blood provides a mechanism by which nutrients, gases, and wastes can be transported throughout the body. A complete blood count cbc and peripheral blood film is. Proper preparation of a peripheral blood smear slide staining with wrights stain a.
An unconventional way to make peripheral blood smears duration. This lesson also includes some general descriptions of conditions indicated by. Utmedical school at houston, pathology last revision on. A case report of mayhegglin anomaly in a 33yearold white woman with an update on the molecular findings of myh9related disease.
The central pale area of each red blood cell is due to. Detection of platelet clumps on peripheral blood smears by. A variety of methods are available for preparing and staining blood smears, the most common of which are discussed in this atlas. 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. Wewilluseadropletof blood tomakeathin% smear,dryit,fixandstainitand observe under a microscope. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Icsh recommendations for the standardization of nomenclature. Red blood cells have a characteristic pink appearance due to their high content of hemoglobin. Changes in the numbers and the appearance of the cells often help diagnose leukemia. 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. A blood smear is a blood test used to look for abnormalities in blood cells. The smear offers a window into the functional status of the bone marrow, the factory. More recently, automated digital systems have become available to help analyze blood. The peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide.
Making a quality blood smear although there are several techniques described for making blood smears, most people use the wedge or push technique. Making and staining a blood smear university of vermont. This synoptic reporting system for peripheral blood smears helps users to draft a complete, accurate, and concise report. A peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. The white blood cells are decreased in number and consist mostly of blasts 41% as reported on the differential. A blood smear reveals information about the number and shape of blood cells in the body. Lymphoblasts and prolymphocytes are not usually seen in the normal peripheral blood. A synoptic reporting system for peripheral blood smear interpretation.
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. Microscopic examination of the peripheral blood is used to supplement the information provided. Wewilluseadropletofbloodtomakeathin%smear,dryit,fixandstainitand observe under a microscope. A peripheral blood smear is a glass microscope slide coated on one side with a thin layer of venous blood. Whenever possible, use separate slides for thick and thin smears.
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. The peripheral blood film pbf is a laboratory workup that involves cytology of. 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. Peripheral blood smear test purpose, procedure, results. Peripheral blood smear examination macroscopic view. Changes in the numbers and the appearance of the cells often help diagnose. A blood smear is a sample of blood thats tested on a specially treated slide. Peripheral blood smear procedure and interpretation. The test provides information on the number and shape of these. Peripheral blood smear, preparation, examination, interpretation, reporting, blood cells morphology. 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. A properly prepared blood smear is essential to accurate assessment of cellular morphology. Complete blood cell count and peripheral blood film, its.
It is good practice to prepare two slides for each sample. Most commonly blood smears are used for the differential leukocyte count dlc. Peripheral blood smear test about, preparation, test. A synoptic reporting system for peripheral blood smear. Erythrocytes, or red blood cells, are by far the predominant cell type in the blood smear. For best results, send five 5 thin blood smears unstained, unfixed and five 5 thick smears unstained, unfixed in addition to whole blood. 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. Microcytes right panel are smaller than normal red blood cells cell diam eter peripheral blood smear is an important basic hematological procedure.
These guidelines provide information on how to reliably and consistently report abnormal red blood cells, white blood cells and platelets using manual microscopy. 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. Examination of the peripheral blood smear is an inexpensive but powerful diagnostic tool in both children and adults. It is hoped that this paper will provide an aid to those who wish to employ the blood smear as a diagnostic tool. Traditionally, trained laboratorians have examined blood smears manually using a microscope. Lymphocytes seen in the peripheral blood are predominantly small 1012. With the advent of hematological automated machines, complete and highly accurate hematological data and parameters can be obtained within a few minutes. Proper preparation of a peripheral blood smear objectives at the completion of this laboratory, you will be able to. Essential knowledge and tools for working in todays lab, conference presentations, basic hematology created date. Examination of the blood smear is an important part of the hematologic evaluation. 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. Thin and thick blood smears should be prepared immediately or within 1 hour after collection. The technique of making a peripheral blood wedge slide or push slide was developed by maxwell wintrobe1.
Jul 15, 2019 a peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. Moderate anisopoikilocytosis occasional oval macrocytes, dacrocytes, and elliptoid cells is seen. These tests are often the first ones done on patients with a suspected blood problem. Small lymphocytes are usually round in outline, and the nucleus is round with coarse, densely staining chromatin. 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. By providing this educational background on medical tests, it is intended that fewer errors in specimen collection will be made. Introduction to peripheral blood smear examination clinical. Preparation and staining of blood smears flashcards.