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Department of Haematology
Notes

Full blood counts are performed on automated equipment and provide haemoglobin concentration, red cell indices, white cell count (with a differential count) and platelet count.
The presence of abnormal white cell and red cell morphology is flagged by the analysers.
Blood films may be inspected to confirm and interpret abnormalities identified by the cell counter, or to look for certain specific haematological abnormalities.
Grossly abnormal FBC results and abnormal blood films will be phoned through to the requestor.
There is no need to request a blood film to obtain a differential white count. It is, however, important that clinical details are provided to allow the laboratory to decide whether a blood film, in addition to the automated analysis, is required.
Under some circumstances a differential is not routinely performed, e.g. pre-op, post-op, antenatal and postnatal requests.
Full Blood Counts are performed at CGH and GRH
See also: Reticulocyte Count

The FBC comprises the following tests
Standard

Haemoglobin (Hb)
White Blood Count (WBC)
Platelet Count (Plt)
Red Cell Count (RBC)
Haematocrit (HCT)
Mean Cell Volume - Red cell (MCV)
Mean Cell Haemoglobin (MCH)

Differential White Cell Count (where applicable)

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils

And if appropriate

Blood Film

Sample Requirements
2ml or 4ml EDTA sample or a Paediatric 1ml EDTA sample.

 

Sample Storage and Retention

Pre analysis storage: do not store, send to laboratory within 4 hours.
Sample retention by lab: EDTA samples are retained for a minimum of 48 hours at 2-10°C
Transport of samples may affect sample viability, i.e. FBC results will degenerate if exposed to high temperatures, such as prolonged transportation in a hot car in summer.

This test can be added on to a previous request as long as there is sufficient sample remaining and the sample is less than 24 hours old.
Turnaround Times

Clinical emergency: 30 mins
Other urgent sample: 60 mins
Routine: within 2 hours

Reference Ranges


If references ranges are required for paediatric patients please contact the laboratory for these.

Parameter Patient Reference Range Units Haemoglobin Adult Male 130 - 180 g/L   Adult Female 115 - 165 g/L Red Cell Count Adult Male 4.50 - 6.50 x10^12/L   Adult Female 3.80 - 5.80 x10^12/L Haematocrit Adult Male 0.40 - 0.54 L/L   Adult Female 0.37 - 0.47 L/L Mean Cell Volume Adult 80 - 100 fL Mean Cell Haemoglobin Adult 27 - 32 pg White Cell Count Adult 3.6 - 11.0 x10^9/L Neutrophils Adult 1.8 - 7.5 x10^9/L Lymphocytes Adult 1.0 - 4.0 x10^9/L Monocytes Adult 0.2 - 0.8 x10^9/L Eosinophils Adult 0.1 - 0.4 x10^9/L Basophils Adult 0.02 - 0.10 x10^9/L Platelet Count Adult 140 - 400 x10^9/L


 




 

Does this test have other names?
ESR, sed rate
What is this test?
Erythrocyte sedimentation rate (ESR) is a blood test. It measures how quickly erythrocytes, or red blood cells, separate from a blood sample that has been treated so the blood will not clot. During this test, a small amount of your blood will be put in an upright tube. A lab specialist will measure the rate that your red blood cells settle toward the bottom of the tube after 1 hour.
If you have a condition that causes inflammation or cell damage, your red blood cells tend to clump together. This makes them heavier, so they settle faster. The faster your red blood cells settle and fall, the higher your ESR. A high ESR tells your healthcare provider that you may have an active disease process in your body.
Why do I need this test?
You may need this test if you have symptoms of one of the diseases that may cause ESR to go up.
You may also need this test if you have already been diagnosed with a disease that causes a high ESR. The test can allow your healthcare provider to see how well you are responding to treatment.
The ESR blood test is most useful for diagnosing or monitoring diseases that cause pain and swelling from inflammation. Other symptoms may include fever and weight loss. These diseases include:


Temporal arteritis


Rheumatoid arthritis


Polymyalgia rheumatica


ESR is not used as a screening test in people who do not have symptoms or to diagnose disease because many conditions can cause it to increase. It might also go up in many normal cases. ESR doesn't tell your healthcare provider whether you have a specific disease. It only suggests that you may have an active disease process in your body.
What other tests might I have along with this test?
You may have other tests if your healthcare provider is doing this test to diagnose a disease. One of these tests is called a C-reactive protein test, or CRP. This test also measures active inflammation in the body.
Your healthcare provider may do an ESR alone if they are monitoring a disease you already have.
Because ESR tells your healthcare provider only what is happening right now, you may need to have the test repeated over time.
What do my test results mean?
Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
ESR is measured in millimeters per hour (mm/hr). The normal values are:


0 to 15 mm/hr in men


0 to 20 mm/hr in women


ESR above 100 mm/h is most likely caused by an active disease. For instance, you may have:


A disease that causes inflammation in your body


An active infection


Cancer


Heart disease


Kidney disease


Blood disease


Diabetes


Collagen vascular disease


How is this test done?
The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand.
Does this test pose any risks?
Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore.
What might affect my test results?
Many things that are not active diseases can increase your ESR. These include:


Pregnancy


Old age


Being female


Having a menstrual period


Having recently eaten a fatty meal


Being obese


Taking certain medicines


How do I get ready for this test?
You don't need to prepare for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use. Tell your healthcare provider if you ate a fatty meal recently, if you are having your period, or if you may be pregnant.

Medical Reviewers:

Chad Haldeman-Englert MD
Raymond Turley Jr PA-C
Tara Novick BSN MSN

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