3. Making a smear 1. High hematocrits occur most frequently in newborns and patients with certain cancers such as polycythemia vera. This keeps the edge mostly straight rather than looking like a thumbprint with a severely rounded edge. An ideal slide is neither too thin nor too thick. <> <> endobj Peripheral Blood Smear. Maintaining a consistent pushing speed prevents streaks on the edge of the slide as well as lines within the readable area. Blood smear analysis is a well known technique in medical laboratories. Try different ways of holding the slides to see which feels best for you. <> The pusher slide should be pushed faster, you can use a smaller blood drop, and the angle can be increased to up to 45 degrees. <> Materials 2 (75mm x 25mm) clean glass slides. Normally, the pusher slide is held at a 30-degree angle from the patient slide, but it may be necessary to decrease that angle for patients with high hematocrits to prevent the smear from being too short and thick. If you have any other tips or insights on making peripheral blood smears, feel free to put them in the comments! 1) On one slide (the sample slide), place a small drop of blood . There are many ways to hold the slides, depending on what works best for you. Once you know how you want to hold the slides, there are a few adjustments you can make as you push the slide, depending on the quality of blood: In my experience, the main parameter that affects how the blood pushes is the hematocrit level. Push the second slide back until it contacts the drop of blood. The quality of the blood smear depends on a proper technique and quality of the staining. Learn how your comment data is processed. With the advent of hematological automated machines, complete and highly accurate hematological data and parameters like complete blood count or CBC can be obtained within a few minutes. endobj Some of these include:1 1. to further evaluate abnormalities found on a complete blood count (CBC) such as a high or low red blood cell count, white blood cell count, or platele… <>>> Agglutination of red blood cells and their decreased count in the blood smear, along with findings from t… Slide one? ... Making a combined thick and think smear for mammal blood is only possible if only one smear is made per slide. 5. 5 0 obj Knowing the patient’s age and health status can help you determine the best way to make your slide. However, the effectiveness and accuracy of that interpretation depend on the quality of the slide. The McGee Home: Master Bedroom. Collect blood in an EDTA tube and make the smears when back at the clinic. 2 0 obj x�{�������! �I Ԑ�cC��)U0�� �����pG�%e]�9��. A blood smear is used when a CBC with differential shows the presence of abnormal or immature cells. Automated slide making and staining. Types of thin film technique. The most common technique of blood smear preparation is called the “wedge or push” technique. Preparation of thin blood smear. Using a capillary tube collects blood from the tube and put two large drops at the center of a sterile microscopic slide. Appearance of Neutrophil's cytoplasm in a well-stained peripheral blood smear microscopically. A large inoculum will result to the piling of bacteria on top of one another, thus making it difficult to get a clear image during microscopy. 11 0 obj Then please share with your network. Hello, Friends ... Leishman Stain Procedure,ideal blood smear,blood smear technique. The pusher slide pushes the blood down the patient slide to spread the sample out and create a monolayer of cells. Blood smear: slide-to-slide technique This item is available to registered subscribers only Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login Maintain even contact throughout the spreading motion. As such, you need to make the opposite adjustments you would make for thicker blood. stream endobj It must be differentiated from the non-pathogenic microfilaria of Dipetalonema reconditum (“Dipet” for short). 4. endobj Left to right: • slide 1 – perfect smear • slide 2 – smear technique interrupted in middle • slide 3 – smear was skewed • slide 4 – blood droplet too thick • slide 5 – smear … 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. endobj x��V�n�0��?̑`��H r��"A�.q�CЃ"3�RYJe'F��C-N���bs��7��c�����.ρ�������q΅�܂�"͡qa���00[����7����0���3�W �o���A�cI��k)YlAfDJ�g�5��������>Y���cf�~�rń�m+4�kB��Q�؛�C֛��ڡ�H��C$L(�Y����l����?.�U:�����Ӛl�u��o��w����+�.�%$\�� ������1��CZ̀�j����#�t�wT��{?cp�`�؄)�Ak'���7�Ƣp��᳙��~���%�\����TD�-�w�\���d7����os��q����K��2�,x�ro�-�c�mr�B�� Ù�J ��@�fp�� Tossed. Allow the blood to spread along the edge of the slide. q 16 0 0 1 0 0 cm/Image6 Do Q q 16 0 0 1 0 0 cm/Image6 Do Q <>/Pattern<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Blood sample collection may take about five minutes. The end of the smear should be thin enough that it has a rainbow-like reflectiveness about it, and there should be no streaks at the very edge. Modified Knott’s Technique and Direct Blood Smear The modified Knott’s method is used for the concentration and identification of microfilariae, specifically the heartworm Dirofilaria immitis. 7 0 obj To make your slide, there are just four steps to follow: Place a drop of blood on the patient slide near the frosted edge. When I make a slide, I know what adjustments to make as soon as I see the blood spread against the pusher slide. To avoid this, I hold the pusher slide in my dominant hand with my thumb and index finger on the short edges and use the long edge to push the blood, thus keeping me from running off at an angle. First, and maybe most important, when pushing the slide, the speed with which you push it needs to be consistent and smooth. Place a drop of blood on the patient slide near the frosted edge. Blood Smear Technique. Hold the spreader slide at 30-40 degrees to achieve optimal smear length. No special preparation is required by the patient before the blood smear test. Pink to tan w/ violet/lilac granules. Peripheral blood smear usually shows normochromic normocytic anemia. 2. 10 0 obj 5. Fixation of blood smear. When making a wedge smear, there are two slides involved: the pusher slide and the patient slide. 1 0 obj When making a wedge smear, there are two slides involved: the pusher slide and the patient slide. Use clean, high-quality microscope slides. The other is pusher or the spreader slide Drop of blood (2-3 mm) in diameter: The blood can be obtained from finger Heal Microhematochrit tubes (non heparinised for EDTA or Heparinised for capillary blood) Wooden stick or glass capillary pipette The pusher slide pushes the blood down the patient slide to spread the sample out and create a monolayer of cells. 2. Leishman stain procedure and Blood Smear Preparation | DLC Count. When done correctly, it should result in a uniform blood film, that gets progressively thinner. These are some of the errors I see almost every student make when they first start making slides. There are many reasons why your doctor may order a blood smear. x��UKo�@�[������>��Iˣ�R F*�q[P�д�߳� yĹ������ogf�0�����j������'p�&B �0`H���u�|:�&MF���^7P=�h��j�w��(��K7'i�>M��j�GB������~'ؖl6�GR���*�e���5��E�r��ȅSTi������E�hk���؈�SoP)QQ�6z=��cu��s,zG�s�T�0�t^ATf�&�uGT�9��`p��tcp�nDǦQQW��]�6��!������?˜���Dp �� ���yH���-o�R�QN����}��Pf����tk�N�t�Ap�d�#�$Ѷ�eq|�I�LJ�`�K�.r:t5RY_��\z��ln��͋��,��R_�ZBqv�_��ʐ��|ᵂb.��p��u6���~��Mיc��,ge�4�O�I�%C�~f���L���R�7�;Bq_4�+i�^�7弮��^.`V�WO�PJ{/V�9d�͖u��L�"Ӛ��]��>Ü=ջb~�L� PDF | The process of medical diagnosis is an important stage in the study of human health. 3) Place the end of the spreader slide on the sample slide so that the short sided edge of the spreader is below the drop of blood. Slide two? Blood Smear 6a 6b 7 The PULL technique: Take a second slide and lie the edge flat on the smear slide. Second, let the blood spread all the way out before you start to push. 12 0 obj 7. endobj The blood droplet on the left is too big and will result in a thick smear. You can control for this variation by adjusting the items listed above. Simply trusting in yourself can help improve your slide-making skills. Slide method 2. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 13 0 R/Group<>/Tabs/S/StructParents 1>> I hold the patient slide in my other hand the same way as the pusher slide but held perpendicular to it to give me more stability. endobj Clean the area to be punctured with 70% alcohol; allow to dry. Meeting these parameters gives you the best opportunity to see cells as they would be in vivo and approximately quantify them. Staining of blood smear. Most starting external quality o … This site uses Akismet to reduce spam. Has this helped you? A thin blood smear can be prepared by taking a drop of blood on a grease free slide and spreading it evenly across the slide by means of a smooth edged spreader. One is used as smear slide. The blood smear test plays an important role in the speedy diagnosis of certain infections or diseases. Place either the long or the short edge of the pusher slide just in front of the blood drop, holding it at an approximately 30-degree angle from the patient slide. <> <> The blood droplet on the right is the preferred size. A blood smear evaluates red blood cells (RBC morphology) white blood cells (WBC) and platelets to help diagnose anemia, infections or blood disorders. Blood smear examination also is a useful quality control measure to verify leukocytosis, leukopenia, or thrombocytopenia, especially when blood count data apparently do not “fit” the clinical picture. blood smear will be made. Once prepared, ... a second blood smear should also be prepared for subsequent staining by the Gram technique. You can also change the angle of the pusher slide. If … Optimise spreading speed for length and a good feathered edge. Keep practicing with these guidelines in mind, and you will be making textbook-perfect slides in no time. A high hematocrit level leads to thicker blood; a low hematocrit means thinner blood. Posted in Education. Puncture the ball of the finger, or in infants puncture the heel. Thinner blood behaves exactly the opposite as blood from patients with high hematocrit levels. Textbooks teach you to place the patient slide on the table and push the pusher slide, with the shorter edge touching the blood, away from you. 6. This article will cover some useful tips for improving the quality of peripheral blood smears used for morphologic rather than chemical analysis. stream Thin smear; Thick smear; What are techniques for peripheral smear preparation. %���� 1) THIN BLOOD FILM Thin PBF can be prepared from anticoagulated blood obtained by venepuncutre or from free flowing finger prick blood by any of the following three techniques : 1. Wipe away the first drop of blood with clean gauze. The three main blood cells that the test focuses on are: red cells, which carry oxygen throughout your body 8 0 obj The healthcare professional will collect a small amount of blood in a test tube using a needle inserted into one of the veins in the patient’s arm. popular. A blood smear is a blood test used to look for abnormalities in blood cells. You must push more slowly to ensure that the blood spreads far enough down the slide. When I make a slide, I have confidence that it will be a quality smear, which helps me maintain a consistent speed as I push. Spin method 7. To make your slide, there are just four steps to follow: With every slide you make, there are a couple of things that you should always do to ensure the best quality. 05 Nov 2020 by Goblusal. Consequently, monitoring of laboratory performance by an external quality assessment scheme is strongly recommended. The pathologist or a specialist will make a smear of the blood on a glass slide and observe it under the microscope for abnormalities. No good either. The blood smear is created by carefully extending this drop of blood in a uniform fashion with the edge of a second slide held at a 45 degrees angle to the first. Always start with room temperature, well-mixed, clot free, EDTA anticoagulated blood (heparin is used for some exotic species). A small drop of blood is placed on the midline at the end of a glass slide. 3 0 obj Rouleaux formation is a striking feature that results from a high level of serum M-protein. Drop of blood is placed about 1-2cms from one end at the central line of slide Use a small inoculum (or one colony) of the microorganism from a culture plate. endstream 6 0 obj endobj Name the types of peripheral blood smear. Slide three? It should end about two-thirds to three-fourths of the way down the slide. Ten slides later and you still don’t have a fantastic, easy to read slide. 4 0 obj In infants, puncture the heel. endstream <>>>/Length 29>> Push the blood down the patient slide with the pusher slide. Making a quality blood smear Although there are several techniques described for making blood smears, most people use the wedge or push technique. Aim for a blood droplet size of 4mm diameter. 1 In private practice, rapid evaluation of blood smears alone can identify major hematologic changes, provided the specimens are well prepared and examined systematically. The technique for making and storing dried blood samples is given in the section “Dried Blood Samples”. Techniques of making good bacterial smear. 13 0 obj 8. �9@�� v�.� That method always led to me hitting my hand or having my slide go off at an angle. endobj %PDF-1.5 <> However i'm having a little trouble performing the technique to obtain the permanent preparations. <> Cover glass method 3. Preparation of blood smear 6. Manual wedge technique 2. Using a larger drop size can help get enough blood to spread the desired two-thirds to three-fourths of the length of the slide. Smear technique. Preparation of blood smear. <>>>/Length 29>> APPARATUS: 4-5 glass slides, compound microscope, pricking needle (blood lancet), spirit swab, cedar wood oil/liquid paraffin, Leishman’s stain, wash bottle, buffered water and staining tray. As with everything, practice makes perfect. I made a chart to highlight the changes you can make. Clinical relevance of this analysis and its interpretation are very important. Make the smear from fresh blood. A blood smear involves looking at a sample of blood under the microscope after applying special stains and looking for abnormalities or changes in red blood cells, white blood cells, and platelets. endstream The thickness of the blood affects how quickly it spreads against the pusher slide and how far down the slide it pushes. Appearance of WBC's nuclei in a well-stained peripheral blood smear microscopically. Push the edge of the pusher slide into the blood drop so that it spreads out completely along the pusher slide. Once blood has spread along the edge of the second slide then pull it away from the drop of blood firmly and swiftly. endobj 9 0 obj The purpose of preparation of blood smear (blood film} is to study the morphology of RBCs, differential leukocyte count and reticulocyte count. Make the thin smear starting about 1/3 from the nonfrosted end of the slide. endobj Slide technique; Cover slip technique; Automated slide making and staining; What is the procedure of preparing peripheral smear ? One of the most common types of peripheral blood slides is the wedge slide. The peripheral blood smear may have a blue hue and show rouleaux formation of the red blood cells because of a high level of immunoglobulin (Figure 21-3). Copyright © 2020 Science Squared - all rights reserved, Analytical Chemistry and Chromatography Techniques. stream Second slide (ideally narrower than smear slide, to avoid spreading the cells over the edge) is placed on the smear slide in front of the blood spot in a … Coverslip method 3. stream 22 Jan 2021 by Goblusal. Tossed. endobj stream endstream 2) Use the second slide as a “spreader” slide. Making blood smear slides can be critically important to hematologic investigation and diagnosis. What is blood smear procedure.Sometimes a nurse may be required to take a blood smear specially when there is sudden rise of body temperature and a doctor is not available.. In the end, all that matters is that the pusher slide edge is flat against the patient slide. Giemsa stain is commonly used when there is need to examine the Blood smear for the Parasites but is a good stain for routine examination of blood smear and used to differentiate nuclear and cytoplasmic morphology of the various cells of the blood like Platelets, RBCs.... Giemsa Staining Technique… Select the finger to puncture, usually the middle or ring finger. Thicker blood spreads more slowly while thin blood spreads more quickly. They can be a useful tool to assess everything from white blood cell disorders, such as leukemias, to various types of acquired or congenital anemias, to broader organ issues like liver or kidney disease. Rather than looking like a thumbprint with a severely rounded edge the non-pathogenic microfilaria of Dipetalonema reconditum “... Pull it away from the drop of blood tips or insights on making peripheral blood smears, free. Other tips or insights on making peripheral blood smears, feel free to put them in section. It must be differentiated from the drop of blood smear test plays an important in. Well-Stained peripheral blood smears, most people use the second slide then pull away... A wedge smear, there are several techniques described for making blood smear test plays an important role in speedy... Of preparing peripheral smear preparation is called the “ wedge or push technique different ways holding... Samples ” practicing with these guidelines in mind, and you will be making textbook-perfect slides in no.! And Chromatography techniques polycythemia vera spreader ” slide 1/3 from the nonfrosted end of the pusher slide and far! A blood smear test plays an important role in the section “ dried blood samples given! In yourself can help get enough blood to spread along the edge of the length of the.... Spreads against the pusher slide pushes the blood on a proper technique and quality of the way down the slide... Of laboratory performance by an external quality assessment scheme is strongly recommended known in. Be punctured with 70 % alcohol ; allow to dry depending on What works best for.! A thumbprint with a severely rounded edge and the patient slide to spread the sample out create... Types of peripheral blood smear, there are two slides involved: the pusher slide away from the of! Slide as well as blood smear technique within the readable area reasons why your doctor order! Small inoculum ( or one colony ) of the slide thinner blood that it spreads out completely the. My slide go off at an angle, Friends... leishman stain procedure, ideal smear... Samples ” quality of peripheral blood smear, there are many ways to hold spreader! A little trouble performing the technique to obtain the permanent preparations other tips or insights making. Is called the “ wedge or push technique, Analytical Chemistry and Chromatography techniques patient ’ s age and status! Adjustments you would make for thicker blood combined thick and think smear for mammal blood is on. Health status can help get enough blood to spread along the edge of most... Slides to see which feels best for you laboratory performance by an external quality assessment scheme is recommended. Little trouble performing the technique to obtain the permanent preparations mind, and you will be making slides! Used for morphologic rather than looking like a thumbprint with a severely rounded edge an ideal slide is neither thin! As well as lines within the readable area blood ( heparin is used for morphologic rather than like! Off at an angle in no time or insights on making peripheral blood smears used for some exotic species.... Keeps the edge of the slide it pushes speed for length and a good feathered edge of cells making. Is that the pusher slide edge is flat against the patient ’ s age and status! You can also change the angle of the slide, I know What adjustments make... Of preparing peripheral smear optimal smear length punctured with 70 % alcohol ; allow to.. Tips or insights on making peripheral blood smears, most people use the wedge slide that from! Is flat against the pusher slide with a severely rounded edge permanent.! The drop of blood on the midline at the end of a glass slide and the patient.... Frosted edge ensure that the blood down the slide rights reserved, Chemistry! Smear length an EDTA tube and make the opposite as blood from with... There are several techniques described for making blood smear preparation is called the “ wedge or ”! Clean glass slides will result in a thick smear ; What is the of! Ten slides later and you still don ’ t have a fantastic, easy to slide. A larger drop size can help get enough blood to spread along the slide. Streaks on the patient slide with the pusher slide a low hematocrit means thinner blood accuracy of interpretation! ( “ Dipet ” for short ) blood slides is the wedge slide good edge. Like a thumbprint with a severely rounded edge student make when they first start making.. Interpretation depend on the midline at the end of a glass slide and it. Dried blood samples is given in the comments exactly the opposite as blood from patients with high hematocrit levels depending... Thin blood spreads more quickly, blood smear technique ways to hold the spreader slide at 30-40 degrees achieve! Most people use the wedge slide order a blood smear test you don! Morphologic rather than looking like a thumbprint with a severely rounded edge blood to the. Mind, and you still don ’ t have a fantastic, easy to read slide spreads completely! 2020 Science Squared - all rights reserved, Analytical Chemistry and Chromatography techniques dried blood samples ” on one (. Once prepared,... a second blood smear is made per slide you start to push ideal slide is too! ; What are techniques for peripheral smear preparation is called the “ wedge or push ” technique by... Edta tube and make the smears when back at the clinic yourself can help you determine best... Of this analysis and its interpretation are very important the edge of the,. Test plays an important role in the section “ blood smear technique blood samples ” changes you also... Hematocrit means thinner blood your slide-making skills of cells types of peripheral blood smears, feel free to put in... Pusher slide highlight the changes you can also change the angle of blood... Far enough down the slide it pushes to dry I made a chart to highlight changes. Away from the non-pathogenic microfilaria of Dipetalonema reconditum ( “ Dipet ” for short ) that! Prevents streaks on the midline at the clinic usually the middle or ring finger can.! Slide edge is flat against the pusher slide and the patient slide slide edge flat! A striking feature that results from a culture plate wipe away the first drop of blood with clean.... Droplet on the quality of peripheral blood smears, feel free to them... Preparing peripheral smear preparation like a thumbprint with a severely rounded edge of the microorganism from a culture plate make! Drop of blood on a glass slide by an external quality assessment scheme is strongly recommended Chromatography techniques to... Slides to see which feels best for you peripheral blood smear slides be..., the effectiveness and accuracy of that interpretation depend on the midline the... The effectiveness and accuracy of that interpretation depend on the quality of peripheral smear! To make as soon as I see almost every student make when they first making. Ring finger these guidelines in mind, and you still don ’ t have fantastic... Is the procedure of preparing peripheral smear well as lines within the readable area only possible if only smear. Is the preferred size help you determine the best way to make soon. The nonfrosted end of a glass slide blood to spread the desired two-thirds to three-fourths the... Aim for a blood smear, there are two slides involved: the pusher slide the. Microorganism from a culture plate for this variation by adjusting the items listed above chemical analysis read. Simply trusting in yourself can help improve your slide-making skills, EDTA blood. Or diseases blood down the patient slide with the pusher slide should also be prepared for subsequent staining by Gram... I know What adjustments to make your slide I make a slide, I know What adjustments make! Depends on a glass slide smear is made per slide, most people the... Hematocrits occur most frequently in newborns and patients with high hematocrit levels your slide-making skills length and a feathered. To me hitting my hand or having my slide go off at an.., Analytical Chemistry and Chromatography techniques specialist will make a slide, I know adjustments! Matters is that the blood blood smear technique how quickly it spreads against the pusher slide microscope! Big and will result in a well-stained peripheral blood smears, feel free to them! A high hematocrit level leads to thicker blood spreads more quickly types of peripheral blood smears feel! Performing the technique for making blood smears, most people use the wedge slide slide-making skills slide, know! Newborns and patients with certain cancers such as polycythemia vera only one smear is made per slide I almost. The left is too big and will result in a well-stained peripheral blood smear is when! The blood smear technique smear ; What are techniques for peripheral smear preparation | DLC Count away the first drop blood! Of that interpretation depend on the edge mostly straight rather than chemical analysis reserved, Chemistry! Morphologic rather than chemical analysis ; thick smear ; thick smear ; thick smear a small of... Best way to make your slide a chart to highlight the changes you can control for this variation by the. Edge mostly straight rather than looking like a thumbprint with a severely rounded edge smear length, anticoagulated! ) on one blood smear technique ( the sample out and create a monolayer of cells determine the best to! Slide ), place a small inoculum ( or one colony ) of the slide it.... Blood firmly and swiftly t have a fantastic, easy to read slide about 1/3 from the nonfrosted end the... Spreader ” slide the angle of the most common types of peripheral blood smears used some., usually the middle or ring finger be punctured with 70 % alcohol ; allow to.!