Instruments

1. VIM SILVER MAN’S BIOPSY NEEDLE FOR LIVER BIOPSY

Two Methods:-
Wedge biopsy – Open biopsy
Needle biopsy – Parts –cutting needle,
canula, prongs.
Indications:-
1. Hepatomegaly of undetermined cause.
2. Ascites & GI bleeding.
3. Cirrhosis.
4. Storage disorder.
2. BONE MARROW ASPIRATION NEEDLE
(A) SALAH BONE MARROW ASPIRATION NEEDLE
(B) JAMSHIDI NEEDLE

Sites:-
1. Posterior Superior iliac spine
2. Anterior superior iliac spine
3. Iliac crest
4. Sternal puncture
5. Tibial tuberosity children.
Indications
RBCs disorders – Megaloblastic ,anemia aplastic anemia.
WBCs disorders – Myeloma, staging of leukemia.
Platelets – ITP
Infections – miliary tuberculosis, Leishmania, malaria, fungal infections
Infiltrations – Gaucher’s disease, Neimann Pick disease, tumor
Metastasis.
Others – myelofibrosis, myelosclerosis.

3. LUMBAR PUNCTURE NEEDLE

Sites:-
Between the lumbar vertebra
L3 / L4, or
L4 / L5.
Indications:-
1. Meningitis – TB, Viral, Fungal.
2. Subarachnoid hemorrhage.
3. CNS Malignancies
4. Demyelinating diseases
5. Gullain- Barre syndrome.
4. SHALI’S HEMOGLOBINOMETER
It is colour matching method for Hb
estimation
Various methods of Hb estimation
- Shali’s
- Hematology analysis ( Cell counters)
- Oxyhaemoglobin
- Types of Haemoglobin:-
- Hba, Hb A2, HbF
Disadvantages
1. Carboxy – meth and sulfheamoglobin cannot be converted.
2. Visual error
3. Lower Hb obtained if reading taken after
10min because colour of acid hematin
because starts fading.
5. HAEMOGLOBIN PIPETTE:-
Used for Hb estimation
- It has mark of 0.02ml ( 20 mm)
- Blood is taken till this mark
Principle
Hb converted to Acid haematin
Method:
After adding blood wait – 10min for conversion Add Dist water till color
matches with comparator.
Corboxy, meth and sulfhemoglobin do not convert.
Error: Technical – Improper mixing, improper filling, calibration
timing, subjective error of matching.

6. RBC DILUTING PIPETTE:-

Identification:-
Markings – 0.5, 1 , 101
Bulb contain red bead.
Dilution 1:200
Uses:-
- RBC count
- Platelet count
RBC Diluting fluid
Hayem’s fluid:-
- Sodium citrate
- Sodium chloride
- Mercuric chloride
- Distilled water.
7. WBC PIPETTE
Identification points
1. Markings:- 0.5, 1, 11
2. Bulb has white bead
Dilution 1:20
Uses:-
1. WBC Count
2. Counting of cells in Body fluids- CSF,
asciticfluid
3. Sperm count
Fluid – 3% Glacial acetic acid lysis of RBC Distill water.
Gention violet- stain nuclei.
8. NEUBAUER’S COUNTING CHAMBER.
- Depth of chamber is 0.1mm
- A single chamber consists of 9 large squares each measuring 1mm2
- Central square for counting of RBC’s
- Four corner squares for counting of WBC’s

9. WINTROBE’S TUBE:-
Identification points:
1. Thick walled, cylindrical glass tube, with flat bottom.
2. 110mm long, 3mm in diameter.
3. Marking:-
Two reading.
a. from 0 at the bottom – for PCV Reading
b. from 0 at the top - for ESR Reading
Amount of Blood: 1ml.
Uses:
1. PCV Estimation
2. ESR Estimation.
Anticoagulant used – EDTA Double Oxalate.
10. WESTERGREN’S TUBE OR PIPETTE.
Identification Points :
Straight tube 30cm long, 2.5mm in diameter Open at
both ends.
Use: ESR estimation
Anticoagulant used is 3.8% sodium citrate.
Tube is placed in vertical position and readings are
taken after 1 hour.

Normal value of ESR

Men – 0-9mm/hr.
Women – 0-20
Children – 1-15
11. URINOMETER
40ml of urine is taken into cylinder.
The urinometer is inserted gently to float freely without
touching slides or bottom, once settled, reading is read on
urinometer.
Normal specific gravity.
1.015 to 1.025
- It depends upon the concentration of solutes in urine.
- Increased in – DM, Proteinuria, Dehydration, sweating
- Decreased in – Excessive water intake, Excessive IV fluid.
Temperature correction factor urinometer calibrated for 200c: Add or
subtract 0.001 for every 30 degree increase or decrease from 200c

12. PLASTIC VACUTAINERS

Vacutainer/sample tube types for venipuncture/phlebotomy   edit

Tube cap
color or Additive Usage and comments
type

Usually drawn first for minimal risk of

Blood Sodium polyanethol contamination.[8] Two bottles are typically
culture bottl sulfonate (anticoagulant) and growth collected in one blood draw; one
e media for microorganisms for aerobic organisms and one
for anaerobic organisms.[9]
 Coagulation tests such as prothrombin
time (PT) and partial thromboplastin
Light blue Sodium citrate (anticoagulant)
time (PTT) and thrombin time (TT). Tube
must be filled 100%.

Serum: Total complement
Plain red No additive
activity, cryoglobulins

Serum-separating tube: Tube

Clot activator and serum inversions promote clotting. Most
Gold
separating gel[10] chemistry, endocrine and serology tests,
including hepatitis and HIV.

Chromosome
Dark green Sodium heparin (anticoagulant)
testing, ammonia, lactate, HLA typing

Mint green Lithium heparin (anticoagulant) Plasma. Tube inversions prevent clotting

Whole blood: CBC, ESR, blood levels

Lavender
EDTA (chelator / anticoagulant) of tacrolimus and cyclosporin, platelet
("purple")
antibodies, Coombs test, flow cytometry

Blood typing and cross-matching,
Pink EDTA (chelator / anticoagulant)
direct Coombs test, HIV viral load

Trace elements, heavy metals, most drug

Royal blue EDTA (chelator / anticoagulant)
levels, toxicology

Tan EDTA (chelator / anticoagulant) Lead

 Sodium fluoride (glycolysis inh
ibitor)
Gray Glucose, lactate[12]
 Potassium oxalate (anticoagula
nt)[11]
Acid-citrate-dextrose A (anticoagulan
Yellow Tissue typing, DNA studies, HIV cultures
t)
Pearl PCR for adenovirus, toxoplasma and HH
Separating gel and (K2)EDTA
("white") V-6
13. BLOOD COLLECTION BAG
Anticoagulants used
1. ACD – Acid, citrate, Dextrose
2. CPD – Citrate phosphate Dextrose
3. CPDA- Citrate Phosphate Dextrose adenine.
ACD/ CPD storage – 21 days
CPDA storage 35-40 days
Anticoagulant – 45ml
Blood collected -300ml
Citrate – prevents clotting
Dextrose – nutrition / energy to cells.
Adenine – prologs RBC life
Acid – maintains PH
Phosphate – PH maintenance.