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Hematology Instruments/ techniques : Course Code RLT-621


Hematology instruments are machines that analyze blood. Used in medical labs, hematology instruments can do blood counts, detect proteins or enzymes, and help to diagnose illnesses or genetic defects. The instruments include analyzers, flow cytometers, coagulation analyzers, and slide stainers.


Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs. If a hemoglobin test reveals that your hemoglobin level is lower than normal, it means you have a low red blood cell count (anemia).


ESR Introduction

Erythrocyte sedimentation rate (ESR) is a measure of the rate of fall of RBCs at the bottom of a test tube when held upright in a fixed position for a specified time. Essentially, the ESR is a physical process that occurs in normal conditions but can increase in response to an altered blood suspension caused by numerous conditions and pathologies.

Though not precise, the ESR test serves three purposes, 1) it rules out the possibility of any underlying pathology, mainly infection and hyperinflammatory conditions (osteoarthritis, rheumatoid arthritis), 2) helps monitor disease course, and 3) is used as a screening parameter for a neoplastic pathology.

Blood response to inflammatory processes in several diseases and conditions is more or less the same. Inflammation triggers the recruitment of inflammatory mediators, which are essentially “acute phase proteins” responsible for producing the typical signs of inflammation. As the levels of the mediator proteins increase in response to inflammation, the ESR also rises simultaneously to the severity of inflammation. 

Hemoglobin Structure

         Hemoglobin Structure

Hemoglobin has a quaternary structure. It consists of two pairs of different proteins, designated the α and β chains. There are 141 and 146 amino acids in the α and β chains of hemoglobin, respectively. As in myoglobin, each subunit is linked covalently to a molecule of heme.

 Hemoglobin Function

Hemoglobin is a two-way respiratory carrier, transporting oxygen from the lungs to the tissues and facilitating the return transport of carbon dioxide. In the arterial circulation, hemoglobin has a high affinity for oxygen and a low affinity for carbon dioxide, organic phosphates, and hydrogen and chloride ions.

Medical Test (ESR)

An erythrocyte sedimentation rate (ESR) is a blood test that that can show if you have inflammation in your body. Inflammation is your immune system's response to injury, infection, and many types of conditions, including immune system disorders, certain cancers, and blood disorders. Erythrocytes are red blood cells.

Procedure How to do Erythrocyte Sedimentation Rate (ESR) by Wintrobe method:

  • ESR should be done within 2 hours of the collection of the blood. ...
  • Take 0.2 mL of ESR solution + 1.8 mL of oxalate blood or blood in EDTA.
  • Fill the Wintrobe ESR tube. ...
  • Mount in the ESR stand.
  • Start the clock for one hour

Mechanism of ESR

  • Normal RBC’s settle slowly as they do not form rouleaux due to the negative charge on their surface which causes them to repel each other
  • Plasma proteins especially fibrinogen adhere to the red cells membranes & neutralize the surface negative charges promoting cell adherence & rouleaux formation
  • ESR is directly proportional to the weight of the cell aggregate and inversely proportional to the surface area.


   Hemoglobin measurement methods

  • Hemoglobincyanide (HiCN) Method. ...
  • Vanzetti's Azide Methemoglobin. ...
  • “Reagent-Less” Methods. ...
  • Non-Invasive Methods. ...
  • Sahli´s Method. ...
  • Hematology Analyzer. ...
  • Blood Gas Analyzer (BGA

Hemoglobin Estimation

The healthy range for hemoglobin is: For men, 13.2 to 16.6 grams per deciliter. For women, 11.6 to 15 grams per deciliter.

Hematocrit Test

A hematocrit (he-MAT-uh-krit) test measures the proportion of red blood cells in your blood. Red blood cells carry oxygen throughout your body. Having too few or too many red blood cells can be a sign of certain diseases. The hematocrit test, also known as a packed-cell volume (PCV) test, is a simple blood test.

Purpose of the test

  1. It is used to diagnose anemia.
  2. Hct is done in patients with bleeding or blood loss.
  3. It is part of a complete blood count.