Phlebotomy and the Health Care Setting Part 2 Fall 2007 Terry Kotrla, MS, MT(ASCP)BBSlide 2
Department of Clinical Laboratory Medicine - Laboratory Departments Clinical Chemistry Hematology Coagulation Urinalysis Microbiology Serology ImmunohematologySlide 3
Clinical Chemistry Clinical Chemistry is the biggest research facility office.Slide 4
Clinical Chemistry Through synthetic examination of serum or plasma numerous infections of the significant organs frameworks can be analyzed, for example, heart assaults, hepatitis, renal disappointment, diabetes, and so forth ( Drawn in red or green stoppered tube ) Perform compound investigations on serum and plasma.Slide 5
Clinical Chemistry Blood to which an anticoagulant has been included won\'t cluster. Platelets will settle to the base of the tube leaving plasma at the highest point of the tube.Slide 6
Clinical Chemistry Blood to which no anticoagulant has been included will cluster. Platelets get got in the coagulation abandoning serum.Slide 7
Clinical Chemistry Blood lipids (fat) c. Iron and aggregate iron restricting ability to analyze weakness. Electrolytes - sodium, potassium, CO2 and chloride Uric corrosive Creatinine and Blood Urea Nitrogen (BUN) Liver capacity tests - AST, ALT, soluble phosphatase, LDH, and bilirubin. Heart catalysts - CK, ALT, LDH alongside electrolytes Amylase and lipase Glucose to analyze and screen diabetes. ( May utilize dark stoppered tube ) Hormones, for example, thyroxine (T4), parathyroid hormone, insulin, testosterone, renin movement, luteinizing hormone, prolactin, and cortisolSlide 8
Clinical Chemistry Drug investigation is of two sorts: Therapeutic medication observing (TDM) to guarantee patient is keeping up helpful blood levels of medications, for example, gentamycin, dilantin, tobramycin, digoxin,etc. Medications of mishandle testing to recognize blood liquor, barbiturates, salicylates, and so onSlide 9
Clinical Chemistry Special science where electrophoresis is done Immunoassay Chemistry profilesSlide 10
Hematology The investigation of the framed components of the blood to distinguish illnesses connected with blood and blood shaping tissues. Hematology tests help the doctor in diagnosing diseases, leukemia, polycythemia, iron deficiency and other blood dyscrasias (variations from the norm).Slide 11
Hematology The most usually requested hematology test is the entire blood number (CBC) which is routinely performed on computerized instruments, for example, the Coulter counter , that electronically tally the phones and ascertain comes about.Slide 12
Hematology CBC is really a multi-part measure which incorporates the accompanying ( purple stoppered tube ): hematocrit (HCT) hemoglobin (HGB) red platelet (RBC) number white platelet (WBC) check platelet countmean corpuscular hemoglobin (MCH) mean corpuscular hemoglobin focus (MCHC) mean corpuscular volume (MCV) differential (DIFF)- done on a blood spread.Slide 13
Hematology AnalyzerSlide 14
Hematology Other tests performed in the hematology office include: reticulocyte number ( purple )Slide 15
Hematology erythrocyte sedimentation rate (ESR or Sed Rate) ( purple or dark )Slide 16
Hematology Eosinophil tally ( purple )Slide 17
Hematology sickle cell readiness ( purple )Slide 18
Hematology Cell tallies and differential on body liquids, for example, CSF, pleural, synovial, and pericardial.Slide 19
Coagulation frequently housed in the hematology region Coagulation manages the investigation of deformities in the blood thickening instrument and checking of prescription given to patients as "blood thinners" or anticoagulant treatment.Slide 20
Coagulation Blood for the accompanying tests is constantly gathered in blue stoppered tubes. Prothrombin time (PT) Partial thromboplastin time (PTT) Fibrinogen Fibrin split items or fibrin corruption items (FDP)Slide 21
Urinalysis Often housed in the hematology territory too. Urinalysis is a normal test performed on pee that includes synthetic tests to screen for substances which may show infection or harm.Slide 22
Urinalysis UA dipstick will distinguish variations from the norm or the nearness of the accompanying - pH, particular gravity, protein, glucose, bilirubin, urobilinogen, nitrites, leukocytes, mysterious blood, and ketones.Slide 23
Urinalysis The pee is centrifuged , emptied and the little part that is left is analyzed for the nearness and number of the accompanying - yeast, microorganisms, WBCs, RBCs, mucous, epithelial cells, precious stones and parasites.Slide 24
Urinalysis Pregnancy tests are performed in this office moreover. Remember that societies (UA C&S) are ordinarily requested on pee. The pee must be taken to the microbiology office first to process.Slide 25
Microbiology Department that investigates body liquids and tissues for the nearness of pathogenic microorganisms principally by method for culture and affectability (C&S).Slide 26
Microbiology Results of the C&S tell the doctor the sort of life forms present and additionally the specific anti-toxin that would be best for treatment.Slide 27
Microbiology Collecting and transporting microbiology examples is critical in the distinguishing proof of microorganisms and must be taken care of with incredible care.Slide 28
Microbiology Subsections of microbiology incorporate bacteriology (investigation of microscopic organisms), parasitology (investigation of parasites), mycology (investigation of growths), and virology (investigation of infections).Slide 29
Microbiology Test habitually requested incorporate the accompanying: Acid-quick bacilli (AFB) spread AFB culture organism coordinate spread Culture and affectability Gram recolor GC (gonococcal) culture Pinworm prep Ova and parasite (O&P) Occult blood Strep screen growth culture throat culture pee culture blood culture fecal cultureSlide 30
Parasitology & MycologySlide 31
Serology Tests done in this division are intended to identify the body\'s reaction to the nearness of bacterial, viral, contagious, parasitic and different conditions which animate discernible antigen-immune response responses in a test framework to help in the finding of the patient.Slide 32
Serology The accompanying tests might be performed in the Serology office ( red stoppered tube ): Cold agglutinins (CAG) - example must be kept warm. Against streptolysin O titer (ASO) or screen, for example, Streptozyme Infectious Mononucleosis (IM) tests, for example, Monospot Rheumatoid joint inflammation (RA) VDRL, RPR or FTABS to analyze syphilis Haptoglobin (HP) Rubella Pregnancy Testing C-Reactive Protein (CRP)Slide 33
Immunohematology Also known as the blood donation center performs tests to give blood and blood items to patients for transfusion purposes. The blood donation center technologist depends on the phlebotomist to perform recognizable proof of the patient without blunder , since patients will pass on if given the wrong blood classification.Slide 34
Immunohematology All blood for blood donation center testing must be attracted a plain red top tube with the exception of the Direct Antiglobulin tests which is drawn into a purple top. Tests incorporate the accompanying: ABO/D (Rh) writing Antibody screen AKA roundabout antiglobulin test (IAT). Sort and Screen (T&S) Crossmatch Direct Antiglobulin Test (DAT or DC) Rh Immune Globulin (RHIG) or Rhogam workup Antibody titer Antigen writing Antibody IdentificationSlide 35
Immunohematology Requests for parts, for example, RBCs, platelets, cryoprecipitate (CRYO) and crisp solidified plasma (FFP) will be conveyed to the blood donation centerSlide 36
Anatomic and surgical pathology Include the accompanying divisions: Cytology forms body liquids and other tissue examples for discovery and symptomatic elucidation of cell changes Histology plans and process tissue tests expelled amid surgery, dissection or other medicinal systems for minute examination and assessment by a pathologist. Cytogenetics gives point by point investigation of individual chromosomes that can identify hereditary or obtained sicknesses or clutters. DNA test investigation tests for hereditary issue, harmful clutters, diseases, pathogens and DNA fingerprinting in legal pharmaceutical.Slide 37
Education and Research Develops new methodology and in addition essential research adding to clinical lab sciences. Performed by pathologists, Phds and Medical technologists. For the most part done in vast showing healing centers with affiliations with a substantial college.Slide 38
Interdepartmental Relationships The procedure of the right test outcomes getting to the patient\'s outline includes various people. No one but specialists can arrange lab tests, they compose it on the graph. Medical caretaker or ward agent sends demand to the lab. Phlebotomist draws the right examples and comes back to the lab. Examples are conveyed, handled and tried in the suitable lab divisions. The outcomes created are conveyed to the floor to be put on the patient\'s outline. The specialist audits the outcomes to analyze and treat the patient. The grouping of these outcomes must be performed in an auspicious way with a specific end goal to give quality care to the patient.
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