However, blood smear examination is relatively insensitive and should not be relied upon solely to diagnose anaplasmosis. Most commonly blood smears are used for the differential leukocyte count dlc. Edta cause the various storage artefacts encountered on peripheral blood smear examination when smear prepared from prolong stored sterile edta containing blood sample tube at room temperature. Examination of the peripheral blood film and correlation with the complete blood count. Synoptic reporting system for peripheral blood smear.
Introduction to peripheral blood smear examination clinical. Part 1 preparation of peripheral blood smear pbs youtube. The slide is stained with leishmans, and examined under a microscope. Microcytes right panel are smaller than normal red blood cells cell diam eter 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. Microscopic examination of the peripheral blood is used to supplement the information provided. Typically true poikilocytosis involves comparatively smaller numbers of cells throughout the peripheral blood film. To compare the estimation of platelet count done by peripheral smear method and by automated cell counter.
A synoptic reporting system for peripheral blood smear. Microscopically, the rbcs should appear orange to salmon pink, and wbc nuclei should be purple to blue. The examination of the peripheral blood smear is an important basic hematological procedure. In some ways it is becoming a lost art but it often provides rapid, reliable access to information about a variety of hematologic disorders. The examination of a peripheral blood smear is one of the most informative exercises a physician can perform. The lateral edges are where large cells such as monocytes, immunoblasts, immature cells, and blasts are often deposited.
Many disorders such as malaria, anemia, leukemia, thrombocytopenia, sickle cell anemia etc. Scroll left and right to see various peripheral blood components. Kahwash1,2 1department of pathology and laboratory medicine, nationwide childrens hospital, columbus, ohio, united states of america, and 2department of pathology, ohio state university college of. 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. Peripheral blood smear are usually examined to investigate hematological problems and occasionally, to look for parasites within the blood. Examination of the peripheral blood film and correlation. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification purposes. Failure to keep the entire edge of the spreader slide against the slide while making the smear. Macroscopically, a wellstained blood film should be pink to purple. Examination of the peripheral blood smear is an inexpensive but powerful diagnostic tool in both children and adults. Blood smears are made by placing a well mixed drop of blood 1 to 2 mm in diameter 14 inch from the frosted edge of the slide. This test focuses on the red blood cells, white blood cells and platelets.
Peripheral blood smear examination macroscopic view. The test provides information on the number and shape of these. Time effect storage artifacts of anticoagulant edta on. Following low power examination of a peripheral blood smear, the 50x or 100x objective of the microscope is selected 500x or x total magnification when using a 10x ocular and the area of morphology is examined in a consistent scanning pattern fig 3 to avoid counting the same cells twice. The blood smear test is often done to diagnose conditions that are causing. The organisms appeared purple in the wrightstained preparation, but. Teaching the clinical interpretation of peripheral blood smears to a. A blood smear, also referred to as a peripheral smear for morphology, is an important test for evaluating blood related problems, such as those in red blood cells, white blood cells, or platelets. Labcorp test details for hematopathology consultation, peripheral smear. Preparation of a peripheral blood film this protocol describes how to prepare a slide film of peripheral blood for microscopic examination. Purpose and criteria for blood smear scan, blood smear. Figure e174 figure e177iron deficiency anemia next to normal red blood cells. Pdf purpose and criteria for blood smear scan, blood smear.
Peripheral smears study was done with field a and b stain and leishman stain. Peripheral blood smear analysis is a common practice to evaluate health status of a person. Properly staining a peripheral blood film is just as important as making a good film. Whole blood and peripheral blood films made at the time of collection. It might be used to help identify andor keep an eye on numerous conditions that impact blood cell populations.
Peripheral blood smear procedure and interpretation. Find a good area of the slide then scan at 25x or 50x examining cells at 100x as needed. Role of peripheral blood examination evaluation of anemia evaluation of thrombocytopenia thrombocytosis identification of abnormal cells inclusions like basophilic stippling, howelljolly bodies, cabot ring infections like. Making a quality blood smear although there are several techniques described for making blood smears, most people use the wedge or push technique. A blood smear is a blood test used to look for abnormalities in blood cells. The test request form must be completed with patient history, including pertinent clinical information and physicians name and telephone number. A good quality smear, thorough examination and proper interpretation in line with patients clinical state should be ensured by the haematopathologist. The smear offers a window into the functional status of the bone marrow, the factory.
It highlights the procedure to be followed and the equipment required. During the first week of illness a microscopic examination of a peripheral blood smear might reveal morulae microcolonies of anaplasmae in the cytoplasm of granulocytes and is highly suggestive of a diagnosis. Spreader slide pushed across the slide in a jerky manner. The importance of peripheral blood film examination in the evaluation of cytopenias cannot be overemphasized. Microscopic examination of peripheral blood smear pbs for detection of microorganisms is simple method that can be used for doctors to confirm the septicemia more swiftly and to select more. A blood smear reveals information about the number and shape of blood cells in the body. It is then treated with a special stain and studied under a microscope to examine the blood cells. 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. A blood smear is often used as a followup test to abnormal results on a total blood count cbc to evaluate the various types of blood cells. Highquality, bevelededge microscope slides are recommended. Atlas of canine and feline peripheral blood smears.
May 01, 2014 leukemia is a clonal proliferation of hematopoietic stem cells in the bone marrow. Filarial worms are arthropod borne parasites residing in the lymphatic, subcutaneous and cutaneous tissues of man. Examination of a blood smear is an integral part of a hemogram. A routine peripheral blood smear showed many intraleukocytic and extracellular cocci and diplococci figure. The blood smear should be evaluated in all cases where a platelet disorder is suspected. Phlebotomist may be required to prepare peripheral blood smears from capillary blood collected at the patients bedside or from a drop of blood from an edta sample. Sep 19, 2014 examination of giemsastained peripheral blood smear is the standard test for the diagnosis of malarial infection. The adult female filarial worm produces microfilariae, which are found in peripheral blood and skin.
With the advent of hematological automated machines, complete and highly accurate hematological data and parameters can be obtained within a few minutes. Hematopathology consultation, peripheral smear labcorp. The four broad subtypes most likely to be encountered by primary care physicians are acute lymphoblastic, acute. Part 2 examination of peripheral blood smear duration. Peripheral blood smear test purpose, procedure, results. 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 examination and interpretation of peripheral blood smears is an important component of clinical pathology.
Practical challenges in peripheral blood smear evaluation. Demonstrate the appropriate technique for preparing a peripheral blood smear discussion phlebotomist may be required to prepare peripheral blood smears from capillary blood collected at the patients bedside or from a drop of blood from an edta sample. Jul 15, 2019 a peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. The wedge smear is a convenient and commonly used technique for making peripheral blood smears. Peripheral blood smear examination under microscope duration. Malaria continues to be a global public health challenge especially in the tropical and subtropical countries. Romanowsky stain 8 is used for staining peripheral blood films and bone marrow smears. This is a microscopic pathology image showing irondeficiency anemia.
Peripheral blood smear, preparation, examination, interpretation, reporting, blood cells morphology. It consists of an automated microscope for capturing microscopic images of a blood sample, and a software. 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 satisfactory replacement for a blood smear. Complete blood cell count and peripheral blood film, its. Many hematological diagnoses depend upon this procedure and often a definitive diagnosis can be established from the careful examination of the blood film. The examination of blood films stained with wrights stain frequently provides important clues in the diagnosis of anemias and various disorders of. Peripheral blood smear analysis using image processing. A peripheral blood smear is a glass microscope slide coated on one side with a thin layer of venous blood. This video provides guidelines on interpretation of peripheral blood smears. This video describes the preparation of a peripheral blood smear. Blood smear analysis allows quantitation of the different types of leukocytes called the differential count, estimation of the platelet count, and detection of morphologic abnormalities that may be indicators of pathophysiologic processes.
Examination of the peripheral blood smear begins on low power. The three main blood cells that the test focuses on are. Second, appearance of the organism in peripheral blood, especially in cats, can be. Failure to keep the spreader slide at a 30 angle with the slide. Tube filled to capacity and two freshly prepared blood films. Over 1,000 fullcolor photomicrographs depict abnormalities within each blood cell line, with multiple pictures of each morphologic abnormality and. The usual findings of the assessment of peripheral blood films of healthy individuals are very small quantity of poikilocytes, i. 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. An accurate peripheral blood smear report can elucidate a vast spectrum of hematologic disorders, guide further testing, and have a critical impact on patient care. The smear is greater than 25 mm long and the feathered edge stops approximately 10 mm from the end of the slide. An illustrated guide to the morphology of blood cells, atlas of canine and feline peripheral blood smears covers patient assessment for common hematologic disorders and diseases in dogs and cats. Part 2 examination of peripheral blood smear youtube.
In this article, we have attempted to define and delineate the purpose and criteria for each of these 3 types of smear examination, as practiced by professionals. All parts of the smear should be examined, however the monolayer is the area where the cells are examined in close detail and differential cell counts performed. A variety of methods are available for preparing and staining blood smears, the most common of which are discussed in this atlas. It is useful in establishing the diagnosis of malaria, identifying the plasmodium spp as well as determining the degree of parasitaemia. A blood smear scan serves to at least a verify the flagged automated hematology results and b determine if a manual differential leukocyte count needs to be performed. Examination of the blood smear the blood smear should be evaluated in all cases where a platelet disorder is suspected.
The peripheral blood film remains a very useful tool in hematological assessment. The key to an accurate peripheral blood examination is a goodquality peripheral blood smear with different zones that can be evaluated, dr. A college student in previous good health presented with recent onset of fever, rigors, headache, and nuchal rigidity. The drop of blood used for a blood smear test contains numerous red blood cells rbcs, white blood cells wbcs, and platelets.
This test provides information about the number and shape of these cells. These are considered polychrome stains because they contain both eosin and methylene blue. Examination of the peripheral blood film and correlation with. Pdf analyzing microscopic images of peripheral blood. Peripheralbloodtutor used in the study had 2 distinct but equiv alent 20 question examinations. Atlas of hematology and analysis of peripheral blood smears. Meningococcemia diagnosed by peripheral blood smear jama. 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. Introduction to peripheral blood smear examination. It has a wide range of uses, including distinguishing viral infections from bacterial infections, evaluating anemia, looking for causes of jaundice, and even diagnosing malaria. Peripheral blood smear clinical methods ncbi bookshelf.
A blood filmor peripheral blood smearis 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. Pdf gram negative bacteremia diagnosed on peripheral blood. A peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. Clinical and laboratory diagnosis anaplasmosis cdc. Thrombocytopenia is associated with many diseases such as malaria, dengue, pregnancyinduced hypertension, etc. Jun 08, 2018 this video provides guidelines on interpretation of peripheral blood smears. May 01, 2015 peripheral blood smear examination macroscopic view. One slide serves as the blood smear slide and the other as the spreader 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. 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.
Any inclusion bodies eg, howelljolly bodies or malarial parasites will also be noted. Peripheral blood test your knowledge below is a slide at high magnification under an oil immersion lens. Blood smears are needed for microscopic examination of the blood. Peripheral blood smear examination medical laboratories. As previously mentioned in rbc abnormalities, one takes a venous blood sample, and then it is submitted for a cbc analysis \. It is good practice to prepare two slides for each sample. A properly prepared blood smear is essential to accurate assessment of cellular morphology. 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. This paper presents a new automated peripheral blood smear analysis system, shonit 1. 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. The smear is stained with wrights stain and performed after the complete blood count is run. The blood smear test or peripheral smear test is a type of blood test that is done to procure detailed information about the number and shape of blood cells. These are the same cases that you studied in the two labs the normal smear is in there as well.
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