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Lecture 7 POCT. POCT ( haematology and coagulation) . FBC differential granulocytes, lymphocytes and monocytes or neutrophils , lymphocytes and mixed cell ( monocytes , eosinophils and basophils ) counts Haemoglobin concentration. Full blood counts . Small bench top devices

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poct haematology and coagulation
POCT (haematology and coagulation)
  • FBC
  • differential
  • granulocytes, lymphocytes and monocytes or neutrophils,
  • lymphocytes and mixed cell (monocytes, eosinophils and basophils) counts
  • Haemoglobinconcentration
full blood counts
Full blood counts
  • Small bench top devices
    • smaller versions of laboratory analysers providing a full blood count (FBC)
    • automated calibration and quality control
    • they may be too large
  • Hand held analyzers
    • haemoglobin concentration
    • haemoglobin, leucocytes
coagulation
Coagulation
  • prothrombin time (PT)
  • activated partial thromboplastin time (APTT)
  • International Normalized Ratio (INR)
  • reagent system is enclosed in a disposable test strip, cuvette, or cartridge
  • blood is applied to a sample reservoir
  • built in internal quality control (IQC) system
slide5

Whole blood clotting time

    • - this is used in Cardiac Theatres to monitor the heparin effect
  • PT and APTT devices - e.g. Coaguchek–
    • these are designed mainly for testing patients on oral anticoagulants
  • Thromboelastogram–
    • The TEG is used in Liver and Cardiac units.
    • platelet function, clot strength and fibrinolysis within about 15 minutes
  • In-vitro Platelet Function (PFA-100)
    • platelet defects.
glycosylated hemoglobin hba1c
Glycosylated hemoglobin HbA1c
  • Variants of hemoglobin may affect its levels presence of Hemoglobin S.
  • So pt with hemoglobinopathies should be investigated cautiously for the hemoglobin varients.
urine strip tests
Urine strip tests
  • Dip sticks
  • Standard dipstick contains up to 10 different chemical pads or reagents which react (change colour)  urine sample
  • 60- 120 second after dipping
  • Leukocyte
  • Glucose
  • Ketones
  • Proteins
slide8

Urobilinogen

  • Bilirubin
  • Specific gravity
  • pH
  • nitrite
slide9

Diseases identified with dip sticks

  • Diseases of the kidneys and the urinary tract
  • Carbohydrate metabolism disorders (diabetes mellitus)
  • Liver diseases and haemolytic disorders
urine toxicology screening
Urine toxicology screening
  • A toxicology screen refers to various tests to determine the type and approximate amount of legal and illegal drugs a person has taken.
  • to take urine sample in the presence of the nurse or technician.

"10-panel urine screen“

1. Amphetamines (including Methamphetamine)

2. Barbiturates

3. Benzodiazepines

slide12

4. Cannabinoids (THC)

5. Cocaine

6. Methadone

7. Methaqualone

8. Opiates (Codeine,Morphine, Heroin, Oxycodone, Hydrocodone, etc.)

9. Phencyclidine (PCP)

10. Propoxyphene

slide13

chain of custody

  • split the urine into two aliquots
  • First do screening test
  • Then confirmatory test with GC-MS