The normal values for hemoglobin determinationsare as follows:Methods for hemoglobin determination are manyand varied. The most widely used automated method isthe cyanmethemoglobin method. To perform thismethod, blood is mixed with Drabkin’s solution, asolution that contains ferricyanide and cyanide. Theferricyanide oxidizes the iron in the hemoglobin,thereby changing hemoglobin to methemoglobin.Methemoglobin then unites with the cyanide to formcyanmethemoglobin. Cyanmethemoglobin produces acolor which is measured in a colorimeter,spectrophotometer, or automated instrument. The colorrelates to the concentration of hemoglobin in the blood.Manual methods for determining blood hemoglobininclude the Haden-Hausse and Sahli-Hellige methods.In both methods, blood is mixed with dilute hydrochloricacid. This process hemolyzes the red cells, disrupting theintegrity of the red cells’ membrane and causing therelease of hemoglobin, which, in turn, is converted to abrownish-colored solution of acid hematin. The acidhematin solution is then compared with a color standard.HEMATOCRIT (PACKED CELL VOLUME)DETERMINATIONThe hematocrit or packed cell volume (PCV)determines the percentage of red blood cells (RBCs) inwhole blood.The normal hematocrit value for men is 42% to52%; for women, 37% to 47%; and for newborns, 53%to 65%. When hematocrit determinations are belownormal, medical conditions such as anemia andleukemia may be present. Above-normal hematocritdeterminations indicate medical conditions likedehydration, such as occur in severe burn cases.Currently, automated hematology analyzerssupply most hematocrits. However, when hematologyanalyzers are not available, hematocrit determinationscan be manually performed by the microhematocritmethod or macrohematocrit method. Both methodscall for the blood to be centrifuged, and the percentageof packed red cells is found by calculation.The microhematocrit method is the most accuratemanual method of determining blood volume andshould be used whenever feasible. Materialrequirements and the step-by-step procedures forperforming the microhematocrit method will becovered in the following sections.Materials Required for MicrohematocritProcedureTo perform a hematocrit using the micro-hematocrit method, the following materials arerequired.Capillary tubes, plain or heparinizedModeling clay sealantMicrohematocrit centrifugeMicrohematocrit readerMicrohematocrit ProcedureTo perform the microhematocrit method, youshould follow the steps listed below:1. Fill the capillary tube two-thirds tothree-quarters full with well-mixed, oxalatedvenous blood or fingertip blood. (For fingertipblood use heparinized tubes, and invert severaltimes to mix.)2. Seal one end of the tube with clay.3. Place the filled tube in the microhematocritcentrifuge, with the plugged end away from thecenter of the centrifuge.4. Centrifuge at a preset speed of 10,000 to 12,000rpm for 5 minutes. If the hematocrit exceeds 50percent, centrifuge for an additional 3 minutes.5. Place the tube in the microhematocrit reader.Read the hematocrit by following themanufacturer ’s instructions on themicrohematocrit reading device.TOTAL WHITE BLOOD CELL COUNTThe total white cell (leukocyte) count determinesthe number of white cells per cubic millimeter ofblood. A great deal of information can be derived fromwhite cell studies. The white blood cell count (WBC)and the differential count are common laboratory tests,and they are almost a necessity in determining thenature and severity of systemic infections. NormalWBC values in adults range from 4,500 to 11,000 cellsper cubic millimeter; in children the range is from5,000 to 15,000 cells per cubic millimeter; and in7-16Grams per100 ml bloodPercentWoman............................12.5 to 15.................83 to 110Men....................................14 to 17..................97 to 124Newborn infants................17 to 23..................97 to 138
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