Professional Documents
Culture Documents
Laboratory
360 Amsden Avenue
Versailles, Kentucky 40383
Procedure Description:
Approved by:
_______________________________ ______
Norma J. Whitworth, BSMT(ASCP)
Date
Laboratory Manager
________________________________
Richard Lozano, M.D.
Medical Director
Effective Date:
_______
Date
Revised:
Annual Review:
Principle:
The Cell-Dyn 3200 uses two independent measurement channels to measure, count, and
calculate hematological parameters. The Optical channel uses flow cytometry to determine the
WBC, NOC, and RBC/PLT data. The Hemoglobin channel uses colorimetric determination for
hemoglobin. During each instrument cycle, the sample is aspirated, diluted, and mixed before
each parameter is measured. The Cell-Dyn 3200 monitors instrument conditions and data
criteria that may affect results and displays appropriate operational messages and flags for
operator review. Certain messages and flags prompt the lab technologist to perform a SCAN
or Manual Differential (Man Diff) of a peripheral blood smear. Findings after a SCAN may
designate a manual differential to be performed. The following protocol designates SCAN and
Man Diff criteria.
Precautions:
Blood and body fluids should always be tested using Universal Precautions. Gloves, spill-proof
gown, and protective eyewear may be needed. Reagents used for CBC and individual
parameters are not for invitro testing. Refer to each reagents MSDS sheet for specific
information regarding handling and hazards.
A 3 CC EDTA whole blood specimen is required. Refer to the Blood Smear Preparation
procedure in the Hematology SOP for details are preparing a peripheral blood smear for scan or
differential review.
Materials Needed:
Cell-Dyn 3200
EDTA vacutainer tube
Frosted slide
Diff-safe segment or heparinized capillary tube
Wright Stain
Microscope
Oil Immersion
Quality Control:
Peripheral smear review policy is reviewed annually and approved by MedExec. Technologists
are evaluated annually and quarterly on proficiency specimens.
Procedure:
1. Sample a 3 cc EDTA whole blood specimen with the Cell-Dyn 3200.
2. Review histogram for any interpretative messages and/or flags. Refer to the Cell-Dyn
3200 Operators Manual for detail discussion of histograms.
3. Refer to the chart below to evaluate results for the need for a peripheral smear scan or
differential.
TEST
CBC with Differential
CBC without Differential
FLAG/MESSAGE
NWBC
NRBC
WBC
FWBC
VAR LYMPH or VAR LYM
DFLT
IG (immature granulocytes)
TEST
FLAG/MESSAGE
ACTION
Scan: review for platelet
clumps, giant platelets, or
NRBCs. If no other flags or
criteria for manual diff
present, report automated
WBC and diff.
Scan: review smear for
NRBCs.
Confirm WBC by Unopette
method.
Repeat CBC test in FWBC
mode. The NOC result will
be reported for the WBC.
Scan: review smear to
confirm
lymph
count,
perform a manual diff if
variant/atypical lymphs are
noted.
Perform a manual
differential.
Perform a manual
differential.
ACTION
BLAST
BAND
RBC MORPH
Flag is triggered if
following
limits
exceeded:
MCV < 80 or > 100 fL
MCH < 25 or > 34 pg
MCHC < 29 or > 37 g/dL
RDW > 18.5 %
Perform a manual
differential.
Scan: review smear for
bands, perform a manual diff
if indicated.
Perform a RBC morphology
only.
Indicate platelet
the morphology and platelet
are estimate also.
RRBC
LRI
Cause: debris, contaminated
reagent, microbubbles, dirty
diluent/sheath filter
Manual
WBC
Manual Diff
Lymphocytes
> 60.0 %
Manual Diff
Monocytes
> 15 %
Manual Diff
> 10.0
Manual Diff
> 8.0
FLAG/MESSAGE
Manual Diff
ACTION
Hemoglobin (HGB)
RBC Morphology
Hematocrit (HCT)
RBC Morphology
MCV
RBC Morphology
Platelet Count
Platelet Morphology
Estimate
RDW
> 18.5 %
RBC Morphology
and
References:
1. Abbott Diagnostics: Cell-Dyn System 3200 Operators Manual, Abbott Park, IL, 60064,
2001-2002.