practical

1. Erythrocyte sedimentation rate
and
blood groups

2. Erythrocyte sedimentation rate (ESR)
 Definition:
It is the distance by which RBCs
sedimented in a vertical
anticoagulated undisturbed
column of blood after 1st and 2nd
hour

3.  Normal values
 Why the values of ESR is higher in females than
that in males?
Because females has lower hemoglobin content
Male Female
1st hour 6 mm 10 mm
2nd hour 8 mm 16 mm

4. Factors affecting ESR
 Physiological factors
1- Pregnancy
2- Menstruation
4- Exercise

5.  Pathological factors
Tissue infection
e,g T.B
Tissue inflammation
e.g autoimmune
diseases
Tissue
destruction e.g
cancer
Clinical significance of ESR
It is prognostic test used for follow up of the
patients not diagnostic if you depends on it alone

6. Blood groups

9. Principle
 If A antigen only → blood group A
 If B antigen only → blood group B
 If A and B antigens → blood group AB
 If no antigens → blood group O
 If D antigen → RH +ve
 If no D antigen → RH -ve
Antigens (agglutinogen) present on surface of
RBCS

10. Materials
Anti AAnti B

11. Method
1. Add 1 drop of anti A, anti B, anti D separately on slide
2. Add 1 drop of blood to each drop of the above 3 drops
3. Mix by using 3 glass rods
4. Observe for agglutination

13. Method
Agglutination with anti A only

14. Result
 If agglutination with anti A only → blood group A
 If agglutination with anti B only → blood group B
 If agglutination with anti A and B → blood group AB
 If no agglutination with anti A and B → blood group O

15. Result
 If agglutination with anti D → RH +ve
 If no agglutination with D → RH -ve

16. Result
Blood group A
Blood group B
Blood group O

17. Blood transfusion
Blood group O→ universal donor
Blood group AB → universal recipient

18. Indications of transfusion
1. To restore whole blood as in
haemorrhage.
2. To restore one element e.g. RBCs,
WBC, platelets, plasma proteins,
clotting factors.
3. In erythroblastosis foetalis.

19. Precautions of transfusion
1. Compatible by cross matching.
2. Rh- person is transfused with Rh- blood.
3. Free from blood born diseases.
4. Free from contamination.
5. Fresh & with high Hb%.
6. Must be stored at 4 C for 21 days maximum

20. Complication of transfusion
1. Agglutination
2. Physical: excessive transfusion→
overloading →HF.
3. Infective: e.g. infective hepatitis, AIDS or malaria.
4. Mechanical: air or fat embolism.

21. Effects of incompatible blood transfusion
(Agglutination)
a. Blockade of capillaries:-
Backache & joint pain
Angina pain (if coronary arteries are occluded).
b. Hemolysis→ liberation of:-
1. Hemoglobin:
• increase blood viscosity → HF
• Jaundice
• Renal failure: death
2. Potassium: hyperkalemia → arrhythmia.
3. Toxic substances e.g. histamine → VD & shock

22. THE RH GROUP

23. Erythroplastosis foetalis
Sensitization
 When Rh+ve male marries an Rh -ve female = fetus will be Rh+ve
 Only during delivery a large number of the Rh+ fetal RBCs enter the
mother's circulation
 An anti-D agglutinins are formed (sensitized)

27. Erythroplastosis foetalis
 When sensitized mother becomes pregnant again with Rh+ child
 The antibodies (IgG) [small enough] cross the placenta to the fetus
 Agglutination & hemolysis of fetal RBCs:-
A. Usually born dead.
B. If alive: severely anemic, jaundiced and kernicterus, due to ++ bilirubin which
crosses blood brain barrier (BBB) [not well developed]→brain damage called
kernicterus

28. Important notes
 1st baby may be affected if Rh- mother is already sensitized by Rh+ blood
transfusion.
 ABO anti-bodies (IgM) [Large] cannot cross placenta.
 Rh- female should never receive Rh+ blood
 When an Rh- female delivers Rh+ fetus, anti-D antibodies are given to her
immediately after delivery to neutralize the D antigen & prevent
sensitization.