CBC WITH DIFFERENTIAL

Test Includes: White blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), absolute and relative granulocyte count (GRAN), lymphocyte (LYMPH), monocyte (MONO), eosinophil (EOS), and basophil (BASO) counts, nucleated red blood cell count (NRBC), red blood cell morphology comments and white blood cell morphology comments.

Applies To: Evaluation of hematologic parameters, including white blood cell and red blood cell morphologic abnormalities.

Request Form: Hematology A

Collection: Routine venipuncture preferred; micro-collection acceptable

Storage Instructions: Stable at room temperature for 12 hours. Stable refrigerated for 24 hours.

Cause For Rejection: Specimens >24 hrs old, clotted, QNS, hemolysis, identification errors, wrong anticoagulant

Availability: Samples are accepted 24 hours/day at Sample Management, 5.136 McCullough

Turnaround Time: HEME PROFILE (only) STAT: 1 hour; Routine: 4 hours

Special Instructions: If specimen is >8 hours old, differential count may be omitted due to disintegrated white blood cells. STAT differential counts are not available.

Specimen: Blood

Volume: 2.0 ml

Minimum Volume: 1 ml (0.5 ml in extreme emergency)

Container: EDTA (Lavender-top tube)

Reference Ranges: Age/Sex Related [See patient chart]

Critical Values: WBC < 2.0 x 10³/μL; Hemoglobin < 7.0 g/dL (infants), <5.0 g/dL (children/adult); Hematocrit  <21% (infants), <15.0% (children/adult), Platelets < 50 or > 1000 x 10³/μL

Test Methodology: Automated multi-parameter counting of red blood cells (RBC) and platelets using electronic resistance detection enhanced by hydrodynamic focusing. The hematocrit is measured utilizing cumulative pulse height detection. Hemoglobin is measured using a sodium lauryl sulfate method. WBC count, differential and nucleated red blood cells are evaluated using flow cytometry. Manual microscopy is performed only in certain situations.

Interfering Substances: Clots or fibrin strands; inappropriate anticoagulant; extremely elevated WBC counts; sickle cells; clumped platelets; giant platelets, circulating micro-megakaryocytes; hemolysis; warm or cold agglutinins; elevated plasma lipids; elevated chylomicrons; elevated bilirubin.

Reviewed/10/11/07 by L. Emanuel, MT(ASCP)

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