Hemogram - Fairbanks Memorial Hospital

Additional Codes

Cerner	NextGen
Hemogram	Hemogram

Useful For

Examination of the numerical and/or morphological findings of the complete blood count by the physician are useful in the diagnosis of disease states such as anemias, leukemias, allergic reactions, viral, bacterial, and parasitic infections.

Methodology

Sysmex XN: The analyzer performs hematology analysis according to the hydrodynamic focusing (DC Detection), flow cytometry method (semiconductor laser), and SLS-hemoglobin methods.

Patient Preparation

None

Collection Instructions

Do not place samples on a mechanical rocker.

Specimen Requirements

Preferred Volume	12 x 75 mm tube EDTA-2K or EDTA-3K Lavender filled to capacity
Minimum Volume	1mL of whole blood in 12 x 75 mm tube EDTA-2K or EDTA-3K Lavender 160 μL of whole blood in microtube EDTA-2K or EDTA-3K Lavender
Container	12 x 75 mm tube EDTA-2K or EDTA-3K Lavender Microtube EDTA-2K or EDTA-3K Lavender
Stability	Sample stability at room temperature is 24 hours. Stored at 2-8^oC, EDTA blood samples with normal results may be analyzed up to 48 hours
Rejection Criteria	Clotted samples or those containing clots, fibrin strands, or platelet clumps. All specimens will be checked visually for obvious clots prior to sampling by the analyzer. Grossly hemolyzed samples. Samples drawn above an IV line.

Result Reporting and Reference Values

Reported Parameters

WBC
RBC
Hgb
Hct
MCV
MCH
MCHC
RDW-CV
PLT

Reference Ranges

Parameter	Units	Sex	Age	Reference Range
WBC	x10³/µL	M	0D-15D	5	--	30
			15D-30D	5	--	20
			30D-1Y	5	--	17.5
			1Y-10Y	4	--	13.5
			10Y-15Y	4.5	--	13
			15Y-150Y	4.8	--	10.5
		F	0D-15D	5	--	30
			15D-30D	5	--	20
			30D-1Y	5	--	17.5
			1Y-10Y	4.5	--	13.5
			10Y-15Y	4.5	--	13
			15Y-150Y	4	--	11

RBC	x10⁶/µL	All	0D-30D	3.8	--	6.4
			30D-3Y	3.1	--	5.1
			3Y-10Y	3.8	--	5.1
			10Y-12Y	3.9	--	5.2
		M	12Y-15Y	4.2	--	5.5
		M	15Y-150Y	4.4	--	5.8
		F	12Y-15Y	4	--	5.4
		F	15Y-150Y	3.9	--	5.2

HGB	gm/dL	All	0D-15D	12	--	23
			15D-30D	10	--	20
			30D-60D	11	--	14.5
			60D-120D	10	--	14.5
			120D-150D	10.5	--	14.5
			150D-180D	10.8	--	14.5
		M	180D-3Y	11	--	14.5
			3Y-4Y	11.4	--	14.5
			4Y-8Y	11.5	--	14.5
			8Y-12Y	11.8	--	14.5
			12Y-15Y	13	--	15
			15Y-150Y	13.5	--	17.5
		F	180D-2Y	11	--	14.5
			2Y-3Y	11.4	--	14.5
			3Y-7Y	11.5	--	14.5
			7Y-11Y	11.8	--	14.5
			11Y-12Y	12	--	14.5
			12Y-120Y	11.7	--	15.7

HCT	vol%	All	0D-15D	36	--	64
		All	15D-30D	31	--	55
		M	30D-60D	31	--	56
		F	30D-60D	30	--	56
		All	60D-90D	28	--	49
			90D-1Y	30	--	49
			1Y-7Y	30	--	40
			7Y-15Y	33	--	44
		M	15Y-150Y	40	--	52
		F	15Y-150Y	35	--	46

MCV	fL	All	0D-3D	95	--	121
			3D-7D	88	--	126
			7D-14D	86	--	124
			14D-30D	85	--	123
			30D-60D	77	--	115
			60D-6Months	74	--	108
			6Months-2Y	70	--	86
			2Y-6Y	75	--	87
			6Y-12Y	77		95
			12Y-18Y	78		98
		M	18Y-150Y	81	--	100
		F	18Y-150Y	82	--	102

MCH	pcg	M	0D-30D	32	--	41
			30D-60D	32	--	40
			60D-90D	29	--	35
			90D-1Y	27	--	30
			1Y-4Y	24	--	30
			4Y-5Y	24	--	32
			5Y-15Y	25	--	34
			15Y-150Y	26	--	34
		F	0D-30D	32	--	41
			30D-60D	32	--	40
			60D-90D	29	--	35
			90D-1Y	27	--	30
			1Y-4Y	24	--	30
			4Y-5Y	24	--	32
			5Y-15Y	25	--	34
			15Y-120Y	25.5	--	34
			120Y-150Y	26	--	34

MCHC	gm/dL	M	0D-30D	30	--	36
			30D-180D	32	--	36
			180D-15Y	30	--	35
			15Y-150Y	32	--	36
		F	0D-30D	30	--	36
			30D-180D	32	--	36
			180D-15Y	30	--	36
			15Y-120Y	31	--	35
			120Y-150Y	32	--	36

RDW-CV	%	All	0D-150Y	11	--	15

PLT	10³/µL	All	0D-30D	100	--	300
PLT	10³/µL	All	30D-150Y	150	--	450

Critical Ranges

Parameter	Units	Sex	Age	Critical
WBC	10³/µL	All	0D- 150Y	<2	>50
HGB	gm/dL	All	0D-15D	<6	>24
HGB	gm/dL	All	0D-150Y	<6	>22
HCT	vol%	All	0D-15D	<18	>65
HCT	vol%	All	15D-150Y	<18	>58
PLT	10³/µL	All	0D- 150Y	<30	>1000

Reflex Testing

A fluorescent platelet may be performed when:
- Red cell fragments, microcytic RBC's or white cell cytoplasmic fragments may interfere with automated platelet counts.
- If >10 megakaryocytes/100 WBC are seen on Slide examination
Slide examination occurs when:
- Instrument parameter flags indicate abnormal cell populations, requiring a technologist to review slides to verify cell identity and abnormal morphology.
- WBC count of <2,000/µL or >25,000/µL
- RBC count <2.5 x 10⁶ cells/µL or >7.5 x 10⁶ cells/µL
- HGB <7gm/dL or > 18 gm/dL for 12Years -150Years; >24gm/dL for 0-15 days; and >21 gm/dL for 15Days -30Days
- MCV <70 fL or > 108 fL for 60 Days -150 Years; >131 fL for 0D-30Days; and >110 fL for 30D-60Days
- MCHC >37.5%
- RDW-CV >20%
- PLT <50,000/ µL or >700,000/ µL
- Abnormal red blood cell quantitations.

Abnormal Heme Smear Path Review will be performed for:
- Unexplained Hgb <7 gm/dL if accompanied by abnormal RBC morphology or low or high MCV.
- Any bizarre cells
- MCV > 110 fL
- MCH < 2 pcg or > 37 pcg
- MCHC >37 gm/dL
- RDW >22%
- PLT <50,000/ µL or > 1,000,000/ µL (first time only).

Limitations

Delta check: Hgb change of > 2 gm/dL without explanation requires a rerun or redrawn specimen.
Red cell fragments, microcytic RBC's or white cell cytoplasmic fragments may interfere with automated platelet counts. A fluorescent platelet may be performed to avoid this interference.
WBC's greater than 100,000/µL may cause turbidity and falsely increase the hemoglobin, RBC and HCT values.
Giant platelets and clumped platelets may falsely elevate the WBC count and falsely decrease the platelet count.
Abnormal paraproteins found in blood from patients with Multiple Myeloma can falsely increase the HGB.
Severely icteric samples may falsely elevate the HGB value and related indices
Megakaryocytes may falsely increase WBC counts on automated hematology analyzers.

Fairbanks Memorial Hospital powered by Mayo Clinic Laboratories

Search

Browse by Name

Test Code Hemogram Hemogram