The document provides an overview of clinical biochemistry, focusing on the analysis of body fluids, methods of specimen collection, and the importance of various blood tests. It discusses phlebotomy techniques, types of blood collection tubes, and common laboratory procedures, highlighting the significance of accurate sample handling and reporting. Additionally, it outlines typical biochemical investigations and their relevance in medical diagnosis and treatment.

1. Clinical Biochemistry
Dr Sarath Krishnan M P MBBS
Junior Resident 2
Department of biochemistry
All India Institute of Medical Sciences, Rishikesh-249203

2. What will we do?
 Medical biochemistry.
 Concerned with analysis of body fluids.
25-11-2022
Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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3. Body fluids
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Rishikesh
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Body Fluid Investigation
Performed
Method of Collection
WHOLE
BLOOD
Blood gases, Urea
Glucose
Obtained by arterial or venipuncture; collected
with anticoagulants like heparin;
PLASMA Enzymes, Metabolites
Electrolytes
Blood with anticoagulants centrifuged at 2000
rpm; the supernatant is plasma
SERUM Enzymes
Metabolites
Electrolytes
Blood collected in a plain glass container,
without any anticoagulant, centrifuged at 2000
rpm after clotting, the supernatant is serum
URINE Glucose, Proteins
Bile salts & pigments,
Blood, Steroids
Directly passed into a glass container,
sometimes a catheter is introduced into the
bladder
CEREBRO- SPINAL
FLUID
Glucose, Protein,
Chloride
Lumbar puncture from subarachnoid space
GASTRIC
JUICE
HCl, Blood Aspiration by Ryle’s tube
SEROUS
FLUIDS
Proteins Needle puncture to the serous space
(E.g.,Pleural, Peritoneal)
SWEAT Chloride Soaked into a filter paper

4. Clinical Biochemistry process
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Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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5. Phases
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Rishikesh
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6. Ideal Requisition form contains…
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Rishikesh
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(Name of Hospital)

7. Collection And Transportation of
Specimens
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Rishikesh
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8. Things needed for phlebotomy
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Rishikesh
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9. Blood Collection Accessories
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Rishikesh
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10. Blood Collection Accessories
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Rishikesh
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11. Blood Collection Accessories
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Rishikesh
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Top Color Additives Principle Uses
Lavender/Purple EDTA -The strongest anti-coagulant
Ca+2 chelating agent
- To preserve blood cellscomponents
Hematology
Blood bank (ABO) HbA1C (Glycated Hb)
Light Blue SodiumCitrate Ca+2 chelating agent PT: Prothrombin Time
PTT: Partial Thromboplastin Time
Green Sodium Heparin
orLithium
Heparin
Heparin binds to Thrombin
and inhibitsthe second step in
the coagulation cascade
(Prothrombin Thrombin)
Fibrinogen
Fibrin
Enzymes Hormones
Electrolytes (Na+, K+, Mg+, Cl-)
Black Sodium
Citrate
Ca+2 chelating agent ESR (Erythrocyte Sedimentation Rate)
Gray Sodium
Fluoride +
Potassium
Oxalate
Glycolysis inhibitorAnti-
Coagulant
Glucose tests
Royal Blue Heparin Na-
EDTA
Anti-Coagulant Tube should
not becontaminated with
metals
Toxicology
Trace Elements and metals
Yellow ACD (Acid-
Citrate Dextrose)
Anti-Coagulant DNA StudiesPaternity Test
HLA Tissue Typing
HLA (Human Leukocyte Antigen)

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Top Color Additives Principle Uses
Red Sometimes it
has gel or
silicon atthe
bottomof tube
toreduce
hemolysis
Enhancing the
formation of blood clot
- Serology
- Antibodies
- Hormones
- Drugs
- Virology
- Chemistry
- Blood cross matching before blood
transfusion
Gold It has gel at
the bottom of
the tube to
separate
serum from
the blood
Serum separating from the
blood through the gel in
the tube
Serology Chemistry

14. Order of Draw
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Rishikesh
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Blood Draw Order Tube Color Description
1 Color Varies Blood Cultures
2 Light Blue Sodium Citrate
3 Red Clot Activator
4 Gold SST
5 Light Green Lithium Heparin
6 Dark Green Sodium Heparin
7 Lavender EDTA
8 Gray Sodium Fluoride
9 Yellow ACD Solution

15. Phlebotomy and its step
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Rishikesh
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17. Common site
 Median Cubital vein
Avoid
 IV line
 Mastectomy
 Scarring
 Hematoma
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Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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18. Rejection Criteria For Specimens
I. Hemolyzed Specimen
II. Lipemic Sera
III. Mislabeled/Wrongly Labeled Specimen
IV. No Requisition Form
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Rishikesh
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19. Turn Around Time
 Time taken from receipt of Specimen in Lab to dispatch of
the report out from lab
 For most of the Clinical Biochemistry Stat investigations TAT
is 2 to 4 hours.
 Same day Specimens Received, Analyzed and Reports
Dispatched.
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Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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20. Functional Instrumentations
 Fully Automated Chemical Analyzers
 Chemiluminescence Immuno Assay Analyzer
 Electrolyte Analyzers
 Blood Gas Analyzers
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Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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21. Routine Biochemical Investigations
 Blood Glucose {Fasting, Post prandial
and Random}
 Non Protein Nitrogenous Substances -
Urea ,Uric Acid, Creatinine.(KFT)
 Serum and urinary Proteins-Total
Proteins, Albumin (LFT)
 Lipids-Tri Acyl Glycerol, Cholesterol,
Lipoproteins
 Enzymes-AST,ALT,GGT,ALP(LFT)
 Bilirubin-Total ,Direct, Indirect (LFT)
 Electrolytes- ( Na, K)
 Minerals-( Ca, P, Mg, Lithium)
 Blood- pH, Anion
Gap,pO2,pCO2,Bicarbonates.
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Rishikesh
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22. Normal values of important biochemical
parameters
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23. Significance Of Clinical Biochemistry
Laboratory
Results Reported with Reference Range
 Diagnosis
 Treatment
 Prognosis
 Screening
 Research Data for Publication
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Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS
Rishikesh
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24. Thank you 
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