SESSION 06

Haemoglobin: Is an iron containing protein in red blood cells that transports oxygen around the body

Anaemia: Is a reduction of the concentration in the Haemoglobin in the peripheral blood below the normal for the age and sex of the patient

Whole blood: Whole blood: is the red fluid composed of cells and plasma that has not clotted or been allowed to separate.

Haemoglobin estimation is performed to determine the concentration of haemoglobin in blood.

The aim of haemoglobin estimation is to determine the oxygen carrying capacity of the blood whether is

Increased,

Decreased or

Normal.

ANAEMIA

Other conditions of HIGH HAEMOGLOBIN e.g. polycythaemia vera (Cancer that result into high count of red blood cells).

Anemia is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen Such as Iron deficiency anemia and Hemolytic anemia of new born.

Symptoms are

Feeling tired

Weakness

Shortness of breath

Poor ability to exercise.

To investigate anaemia a number of haematological tests are performed including

Haemoglobin estimation

Blood film for malaria

White blood cell total count a

Differential count

Red cell morphology

Sickling test

BY USING HEMOGLOBINOMETER(HEMOCUE)

Purpose of Test

To outline the procedures for the use of HemoCue Hb 201+ meters used for Point of Care Testing (PoCT) of blood haemoglobin levels.

Quantitative determination of haemoglobin in capillary, venous or arterial blood. Sodium deoxycholate haemolyses red cells and haemoglobin is consequently released.

Sodium nitrite converts the haemoglobin to methaemoglobin which, together with sodium azide, gives azidemethaemoglobin. The absorbance of azidemethaemoglobin is measured at two wavelengths (570nm and 880nm) the second wave compensates for turbidity in the sample.

A drop of fresh whole venous, capillary or arterial blood. Blood collected into appropriate tubes containing anticoagulant can also be used but it is recommended that the anticoagulant is in solid form, in order to avoid a dilution effect, e.g. EDTA or Heparin/Fluoride

Assembles important equipment, materials and

supplies

Gloves

Pipettes

HemoCue machine

QC solution

A test tube

A clean cuvette

Start up the HemoCue machine according to SOPs

Washes hands with soap and water

Dries hands by using paper towel

Puts on gloves

Clean patient with antiseptic wipe, generally middle or ring finger is best

Prick side of finger with pre-prepared lancet

7.Wipe away first 2-3 blood drop

Re-apply light pressure towards fingertip until another drop of blood appear

Fill microcuvette in one continuous process. Do not overfill

Wipe off any excess blood outside of the microcuvette. Dot not draw out any blood from microcuvette during this process

Check that no air bubbles are present in the microcuvette –small bubbles around the edge of cuvette can be ignored. Presence of air bubbles will results in falsely low Hb reading

12.The Hb value displayed within 15-60 seconds, the result will be displayed as long as the cuvette is present in the holder

Record Hb result along with other essential information, attach to patient notes

Remove the cuvette and dispose of in clinical waste bin

15.To turn off-hold left button until the displays reads off and become blanK

Washes hands with soap and water after the procedure

Sample Material Capillary, venous or arterial whole blood

Sample Volume ~10 µL

Measuring Time within 60 seconds

Measurement Range (0–25.6 g/dL (0–256 g/L, 0–15.9 mmol/L)

Male: 13.0 to 18.0 grams per deciliter (g/dL)or 8.7- 11.2 mmol/L

Female: 12 to 16 g/dL or 7.4- 9.9 mmol/L

Pregnant women: 11 g/dL

Newborn: 14-24 g/dL

Children 6 month < 5 years: 9.5g/dL- 13g/dL

Interpretation of result is the same for all procedures.

Normal level of haemoglobin for newborn: 14.0 g/l

Normal level of haemoglobin for children age 2-5: 11.0-14.0 g/l

Normal level of haemoglobin for children age 6-12: 15.5 g/l

Normal level of haemoglobin for woman: 12.0 g/l

Normal level of haemoglobin for men: 13.0 g/l

Mild anaemia 10.0 g/l

Moderate anaemia 7.0-10.0 g/l

Severe anaemia < 7.0 g/l

HemoCue Hb 201+ measuring range is quoted as 0 – 25.6 g/dl. Values below 8.0 g/dl or above 20.0 must be confirmed by the haematology laboratory.

Values which trigger a request for blood for transfusion must be confirmed by the haematology laboratory. Values above 25.6 g/dl will display an error code “HHH”.