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Automated CBC Parameters and Quality Control

Automated CBC Parameters and Quality Control. Joanna Ellis, MLS(ASCP). The Automated Complete Blood Count. Most common test in the Hematology lab. Main Components of the CBC: Cell counts Hgb RBC indices WBC differential absolute values and percent Indications for CBC : Fatigue

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Automated CBC Parameters and Quality Control

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  1. Automated CBC Parameters and Quality Control Joanna Ellis, MLS(ASCP)

  2. The Automated Complete Blood Count • Most common test in the Hematology lab. • Main Components of the CBC: • Cell counts • Hgb • RBC indices • WBC differential absolute values and percent • Indications for CBC: • Fatigue • Weakness • Infection • Inflammation • Bruising • Bleeding

  3. CBC Parameters

  4. M77221

  5. CBCAdult Reference Ranges

  6. Linearity(Reportable Range) • Instruments are calibrated for each analyte with a range that is clinically relevant. • With concentrations above or below the reportable range or Linearity range, the result does not correspond with the calibration curve in linear fashion. • Results outside of linearity are NOT acceptable. • Linearity ranges vary by instrument. • Example:

  7. AdviaLinearity Instrument Codes

  8. CBC Quality Control • Commercial Controls: • 3 levels (low, normal, high) • Values stored in instrument computer • Levey-Jennings graph generated and stored for each parameter • Mode to Mode QC: • Most automated hematology instruments have a primary and secondary mode of sample aspiration. Controls must be run on BOTH and correlate. • Primary=Automated or Closed • Secondary=Manual or Open • Delta Checks • When the Laboratory Information System (LIS) and the instrument are interfaced (connected) delta checks are conducted by the LIS on select parameters. • Current values compared to most previous result • Differences greater than the limits set within the LIS are flagged

  9. WBC Parameter Interfering substances and Implications

  10. RBC Parameter Interfering substances and Implications

  11. HGB Parameter Interfering substances and Implications

  12. HCT Parameter Interfering substances and Implications

  13. MCV Parameter Interfering substances and Implications

  14. RDW Parameter Interfering substances and Implications

  15. Plt Parameter Interfering substances and Implications

  16. WBC Differential ParametersClinical Implications in Adults

  17. References • Harmening., Denise, Clinical Hematology and Fundamentals of Hemostasis, 3rd edition, pp. 593-599. • Turgeon, Mary Louise, Clinical Hematology - Theories and Procedures, 3rd edition, pp373, 376-382. • Rodak, Bernadette, Diagnostic Hematology, 1st edition, p.605-606. • Coulter STKS Operating Manual • McKenzie, Shirlyn, Clinical Laboratory Hematology, 2nd edition,pp 813-829. • "Complete Blood Count: The Test." Lab Tests Online: Welcome! American Association for Clinical Chemistry, 18 June 2010. Web. 13 Sept. 2010. <http://www.labtestsonline.org/understanding/analytes/cbc /test.html#how>. • "WBC Differential Count: The Test." Lab Tests Online: Welcome! American Association for Clinical Chemistry, 18 June 2010. Web. 13 Sept. 2010.http://www.labtestsonline.org/understanding/analytes/dif ferential/test.html#what>.

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