What is Hematology?

"Hematology is the study of blood & blood-forming organs."

(McKenzie et al., 2016)

Hematology is one of the busiest areas in the lab. Even small labs provide hematology tests. Since blood is literally the "life-blood" of people, hematology is a very important branch of the lab.

(McKenie et al., 2016)

Blood Testing

Complete Blood Count (CBC)

One of the most common lab tests ordered.
Evaluation of overall health based on quantification & morphology of blood components such as:
Abnormal levels of these components can help indicate & diagnose diseases/disorders such as:
- Large Blood Loss from Trauma
- Bacterial Infection
- Different Types Anemia
  - Iron Deficiency anemia
  - Sickle Cell
- Malignancies
  - Lymphomas
  - Leukemias
- etc

Coagulation Factor Assays

Measurement of coagulation (clotting) factors
Help evaluate bleeding disorders & diseases
- Hemophilia
- Thrombosis
- von Willebrand Disease
- Multiple Myeloma
- etc

Blood Components

Erythrocytes/ Red blood cells (RBCs)
Thrombocytes/ Platelets (Plts)
Leukocytes/ White blood cells (WBCs)

In anti-coagulated samples:

Plasma is present which contains the clotting factor fibrinogen

In coagulated (clotted) samples:

Serum is present which does not contain fibrinogen (because it is used up in the clot).

RBCs

Function:

Carry oxygen throughout the body

Plts

Function:

Help blood to clot

WBCs

Function:

Immune System, defend body against xenobiotics

Use of Automation in Hematology Lab

Manual Testing in Hematology Lab

Whenever automated instruments are down or when the instruments detect an abnormal CBC. A manual CBC differential is necessary to maintain precise & accurate results.

Automation can never replace the knowledge & experience of lab professionals.

Laboratorians look under the microscope to count & differentiate cells while noting abnormal cell morphology.

Image above is a manual cell counter laboratorians use to help count the different cells on the slide

Automated instruments is very useful in testing multiple patient samples at once in high-volume labs.

Video above shows an example of a hematology analyzer, which does complete blood counts (CBC).

Laboratorians are important in maintaining these instruments, ensuring quality control, double-checking the results, and calling in critical results.

Even though technology greatly helps reduce turn around time, laboratorian always remain vigilant. For they are responsible for each result being released.

Sources:

McKenzie, S. B., Landis-Piwowar, K., & Williams, J. L. (2016). Clinical laboratory hematology (3rd ed.). Hoboken: Pearson

Cell Morphology:

Laboratorians' keen eye can discern abnormal shape & size of blood cell components to help aid in patient diagnosis.

Image above shows a comparison of normal rbc shape to sickle cell rbc. This can be seen under a microscope.