CURRICULUM VITAE

Dr. Noormartany, dr., SpPK, MSi

Konsultan Imunologi
RIWAYAT PENDIDIKAN :
Dokter ..
Dokter Spesialis Patologi Klinik ..
Magister Genetika & Biomolekuler
Konsultan Imunology
Doktor Imunologi Patologi Klinik

FK UNPAD
FK UNPAD
ITB
KOLEGIUM
UNPAD

RIWAYAT PEKERJAAN :
Ka. PKM Buahdua, Sumedang
1980 - 1083
Ka PKM Conggeang, Sumedang
1983 1984
Ka PKM Cimalaka Sumedang
1984 - 1986
Ka. Sie. P3M Dinkes DT II Sumedang
1986 - 1988
Ka. Instalasi Patologi Klinik RS Majalengka
1993 - 1994
SMF. Patologi Klinik RSHS
1994 - 1996
Ka. Instalasi Patologi Klinik RSHS
1996 - 2001
Direktur Penunjang dan Pendidikan RSHS
2001 - 2006
Direktur Umum dan Operasional RSHS
2006 - 2008
Ketua Bid. Organisasi Pengurus Pusat PDS Patklin
2005 2010
Ka. Unit Pelayanan Teknik Kesehatan UNPAD
2008 2013
Konsultan Rumah Sakit ASRI Jakarta
2009 - 2010
Dosen F.K- UNPAD ( S1 dan Pasca sarjana) 1996 - sekarang
Ka. Divisi Imunologi Departemen Pat. Klinik RSHS
1996 - sekarang
Ketua Program Studi Patologi Klinik FK UNPAD
2010 - sekarang
Wakil Ketua IV IDI Wilayah Jabar
2010 - sekarang
Sekjen Kolegium PDS-Patklin Indonesia
2011 - sekarang
Komite Internship Dokter Indonesia Prov. Jabar
2011 sekarang
Konsultan lab RS Pakuwon Sumedang
1996 sekarang
SMF Lab. RS Al Iksan
1996 sekarang

1979
1992
2000
2006
2009

Over View of
Blood
Dr. Noormartany, dr., Sp PK., M Si
Konsultan Immunology

CLINICAL PATHOLOGY DEPARTEMENT

FACULTY OF MEDICINE PADJADJARAN UNIVERSITY

Functions of Blood
Heart pumps 8 to 12 pints of blood through more
than 70,000 miles of veins, arteries, and capillaries.
Hematology the study of blood
Hematologists study its function and composition
Blood has many functions, all of which are
important to overall health of the body.

Functions of Blood (cont.)

Blood does all the following:
Distributes oxygen, nutrients, and
hormones to body cells
Eliminates waste products
Maintains acid-base balance
Regulates body temperature
Attacks infecting pathogens
Protection against foreign substances
Regulatory molecules
Regulation of pH and osmosis
Clot formation
4

Composition of Blood
Plasma
liquid in which other components are suspended
Red blood cells (erythrocytes)
vital role in internal respiration
White blood cells (leukocytes)
protect the body against infection
Platelets (thrombocytes)
crucial to clot formation
5

Composition of Blood

Plasma
Liquid part of blood Pale yellow made up of 91% water, 9% other
Contain:
Albumin

Globulins
Fibrinogen
etc

: Important in regulation of water

movement between tissues and blood
: Immune system or transport molecules
: Responsible for formation of blood clots

Formed Elements
Red blood cells (erythrocytes)
White blood cells (leukocytes)
Granulocytes (UTS)

Neutrophils
Eosinophils
Basophils

Agranulocytes

Lymphocytes
Monocytes

Platelets (thrombocytes)
8

Production of Formed Elements

Hematopoiesis or hemopoiesis:
Process of blood cell production
Stem cells: All formed elements derived from
single population

Proerythroblasts : Develop into red blood cells

Myeloblasts : Develop into basophils,
neutrophils, eosinophils
Lymphoblasts
: Develop into lymphocytes
Monoblasts : Develop into monocytes
Megakaryoblasts : Develop into platelets
9

Hematopoiesis

10

Erythrocytes
Structure

Biconcave, anucleate

Components

Hemoglobin
Lipids, ATP, carbonic
anhydrase

Function

Transport oxygen from

lungs to tissues and
carbon dioxide from
tissues to lungs
11

Hemoglobin

Consists of:
4 globin molecules: Transport carbon dioxide (carbonic
anhydrase involved), nitric oxide
4 heme molecules: Transport oxygen
Iron is required for oxygen transport

12

Erythropoiesis

Production of red blood cells

Stem cells
proerythroblasts
early erythroblasts
intermediate
late
reticulocytes

Erythropoietin: Hormone to stimulate RBC

production

13

Hemoglobin Breakdown

14

Leukocytes
Protect body against microorganisms
and remove dead cells and debris
Movements

Ameboid
Diapedesis
Chemotaxis
Passive Immunity
Active Immunity
Antigen Antibody
15

Types of Leukocytes

Neutrophils : Most common; phagocytic cells destroy bacteria (UT

Eosinophils

: Detoxify chemicals; reduce inflammation

Basophils

: Alergic reactions; Release histamine, heparin

Lymphocytes : B & T Cel types

Monocytes

: Become macrophages

16

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Thrombocytes/ Platelet
Cell fragments pinched
off from megakaryocytes
in red bone marrow
Important in preventing
blood loss

Platelet plugs
Promoting formation and
contraction of clots

19-18

Collecting, Processing and

Testing Blood Specimens

19

 Examination of blood can

provide extensive information
about a patients condition.
Basic understanding of the
anatomy and physiology of the
circulatory system will help you
perform these tasks.

20

Collecting Blood Specimens

Reading and interpreting the test order
Assembling the equipment and supplies
Preparing the patient
Greeting and identifying the patient:
Confirming pretest preparations
Explaining the procedure and safety
precautions
Establishing chain of custody
Handling exposure incident

21

Identifying the Patient

Ask patient to state their full name.
Be sure you hear both the first and last names
correctly.
Verify that the name the patient gives is the name on
the order.
Some places, the phlebotomist may ask for social
security, patient ID, or chart number to further
identify the patient.

22

Drawing Blood
Some states permit medical
assistants to obtain blood
samples.
Your office will clarify
your duties
Venipuncture puncture
of a vein
Phlebotomy puncturing a
vein with a needle to collect
blood into a needle or tube

23

Venipuncture Equipment
Evacuation system (VACUTAINER) special
double-pointed needle, needle holder, and collection
tubes
Needle and syringe system use a sterile needle
and a syringe to draw blood specimen
Butterfly system winged infusion set and syringe
Collection tubes must mix blood with appropriate
sample containers
24

VACUTAINER

The VACUTAINER system uses interchangeable

collection tubes that allow you to draw several blood
specimens from the same venipuncture site.

25

Capillary Puncture

Superficial puncture of skin with sharp point to

draw small amount of blood.
Collected in small, calibrated glass tubes, slides, or
reagent strips.
26

Patient Needs
Alleviate patients fears or concerns
Provide more information about:

Pain
Bruises or scars
Serious diagnosis
Contracting a disease from procedure

27

Special Considerations
Children:
Talk with patient or caregivers before working
with child
Address them directly
Speak calmly in soothing voice
Explain the procedure briefly in terms they can
understand
Keep child informed of status of procedure
28

Special Considerations (cont.)

Elderly Patients:
Changes in skin conditions make elderly patients
prone to bruising
Decreased circulation makes it difficult to collect
enough blood
Speak in clear, low-pitched tone
Give the patient time to respond to questions

29

Special Considerations (cont.)

Patients at risk of uncontrolled bleeding such
as hemophilia or taking blood-thinning drugs
Be careful and alert
Hold cotton ball over the puncture site for at
least 5 minutes
Notify physician if bleeding is uncontrollable

30

Special Considerations
(cont.)
Difficult venipuncture:
Try a second time and then give the patient
a rest
Fainting patient:
Position before venipuncture so no injury
will occur
31

Special Considerations (cont.)

Angry or violent patients:

Encourage patient to submit to test and then
talk with doctor
Do not force the issue
Patient has the right to refuse

32

What is one precaution you can take

when drawing blood from a patient who
had hemophilia?
Hold cotton ball over the puncture site for at least

5 minutes
Be careful and alert
Notify physician if bleeding is uncontrollable

33

Performing Common
Blood Tests
Results can aid in the diagnosis of specific
conditions, disease, and disorders
Chemicals in lab:
Anticoagulants
Serum separators
Stains
34

Hazardous Waste
Hazardous waste products include:

Blood and blood products

Body fluids and tissue
Cultures
Vaccines
Sharps
Gloves
Specula
Inoculating loops
Paper product contaminated with body fluids
35

Hematologic Tests
Performed on venous or capillary blood specimens
Blood counts
Red blood cells
White blood cells
Platelets
Hematocrit
Hemoglobin

Centrifuged Capillary Sample

36

Hematologic Tests (cont.)

Erythrocyte sedimentation rate (ESR):
measures rate at which red blood cells settle
to the bottom of blood sample
Put freshly collected blood into calibrated
tube and place in sedimentation rack
In one hour determine how far the red blood
cells have fallen
Record in mm/hr

37

Chemistry Tests
Highly detailed tests are not
performed in POL labs because
of expensive, sophisticated
equipment and techniques.
Some tests such as blood glucose
monitoring are often performed
by medical assistant.

38

Serologic Tests
Detect presence of specific substances in
blood samples.
Refer to the introduction of an antigen or
antibody into the specimen and to detect
specific reaction to the antigen or
antibody.
Used to detect disease antibodies, drugs,
hormones and vitamins.
39

Immunoassays
Serological tests use the introduction of an
antigen or antibody into the specimen to
detect specific reactions to the antigen or
antibody.

Enzyme-linked immunosorbent assay (ELISA)

Western blot
Radio-immunoassay (RIA)
etc

40

Summary
Successful phlebotomy procedures require not
only superior technical skills but also excellent
interpersonal communication skills

You may be called on to complete certain testing

procedures or to explain the purpose of tests to
patients
41

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