blood

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  • Blood
    • Taking a sample
      • apply tourniquet, clean area, insert needle, draw blood, apply pressure, add dressing
        • Blood Staining
          • Place samll drop on slide, drag blood down slide at 30', label, add ethanol and allow to dry. add leishmanns leave for 2 mins, wash off.
            • Haemocytom-eter
              • Counting erythrocytes
                • Fill pipette up to 0.5 with blood. then fill to 101 mark with daice's fluid. (1 in 200 dilution) let the first few drops go.
                  • Count the number of RBC in the five triple lined squares using the north west rule.
                    • REMEMBER!! each triple lined square has a volume of 0.004 mm3 the total volume of the whole 5 is 0.02mm3.
              • Counting Leucocytes
                • fill the pipette up to 0.5 mark with blood. then fill up to the 11 mark with diluting fluid. (diluting factor of 20) this will cause RBC to burst.
                  • Allow one third of the fluid to drain away. and this time count on the larger squares.
                    • the larger square measure 1X1 mm. the depth is 0.1mm. so therefore 1x1x0.1= 0.1mm3
    • Blood products
      • leuco-depleted blood
        • Blood that has as many lecocytes removed as possible
          • removing these makes immune responses unlikely
            • this is important for patients having repeated transfusions to prevent the lymphocytes from making antibodies to the transfused blood. this would make future transfusions harder.
      • Platelets
        • used for people with bone marrow failure
          • also used during transplants, chemotherapy and leukemia treatment
      • Plasma
        • blood with cells removed
          • fresh frozen plasma is used in cardiac surgery to reverse anti-coagulant treatment
            • also used to replace clotting factors after major traurma/transfusion
      • Clotting factors
        • plasma processd to provide clotting factors. (soluble proteins that aid clotting
          • used in conditions such as haemophillia
      • Whole blood
        • contains everything usually found in blood
          • erythrocytes, leucocytes, platelets and plasma
            • can be used in severe blood loss
      • packed red blood cells
        • separated erythrocytes
          • when needed they are diluted in a sugar and salt solution
            • used in many types of transfusion such as after childbirth
    • Blood pressire
      • commonly measured in hospitals as part of their 'obs'
        • blood pressure is measured using a sphygmomanometer
          • normal = 130/85 or below
          • but is good to have 120/70 or below
          • 180/110 is considered severe hypertension
      • Measuring Blood pressure
        • wrap cuff and initiate bulb. when arteries have cut off release pressure slowly. the first noise you hear is the systolic pressure. continue to release until you hear a muffle, that is the diastolic pressure.
    • Giving blood
      • there is a strict list of rules for giving blood. you cant give blood if you have any blood diseases, underweight, pregnant.
        • screening blood
          • a sample of blood is tested before giving blood to check for various things such as HIV HEP C. this is tested by dropping a small amount of antigen into the blood, if the blood has the right antibody it will attach. the blood is also tested for the blood group.
            • Storing blood
              • blood is kept at a constant temperature of 4'c. if the temperature fluctuates more than 2'c the alarm will sound.
              • Enzyme activity and temperature
                • blood clotting relies on enzyme activity. at low temperatures enzyme activity is very low, or not at all. due to the enzyme-substrate complexes not having enough kinetic energy. if the temperature exceeds the optimum temp the enzymes will denature.
                • Enzyme co-factors
                  • cofactors are substances needed for an enzyme controlled reaction to occur. calcium ions are usually preset in blood plasma. they are also released by damaged platelets. when blood is stored for transfusion, its important that calcium ions are removed to stop the blood clotting sodium cirate may be added to the blood as this destroys calcium ions.

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