Hb Estimation.docx

INTRODUCTION A hemoglobin test measures the amount of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs.If a hemoglobin test reveals that your hemoglobin level is lower than normal, it means you have a low red blood cell count (anemia). Anemia can have many different causes, including vitamin deficiencies, bleeding and chronic diseases. Hemoglobin can be estimated by different methods 1. Visual colour comparison method: 

Sahil’s method

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Dares method

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Hadens method

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Wintrobes method

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Haldances method

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Tallquists method.

2. Gasometric method: 

Van slyke method

3. Spectrophotometric method: 

Oxyhemoglobin method

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Cyanmethemoglobin method

4. Automated hemoglobinometry 5. Non- automated hemoglobinometry 6. Other methods:

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Alkaline –hematin method

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Specific gravity method

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Comparator method.

Normal values of hemoglobin: Adult Male : 14-18 (16 + 2 ) g/dl of blood Adult Female : 12-16 (14+ 2) g/dl of blood. In new borns,hemoglobin concentration is normally 16-22g /dl. It decreases to 9- 14 g/dl by about 2 months of age. By 10 years of age , the normal hemoglobin concentration will be 1214g / dl. There may be slight decrease in hemoglobin level after 50 years of age. CHECKING HEMOGLOBIN AT HOME BY USING TESTING PAPER ( Telequist Scale) Equipments required:    

Hemoglobin testing paper/ filter paper,talliqus, Hb scale. Disposable lancet Alcohol swabs Paper bag

Procedure : Procedure Identify the person who needs to check Hb level by Checking for anemia Explain the procedure to person and family Do hand washing and dry hands Follow the bag technique steps and take out the necessary articles and keep it in a clean area Wear gloves Clean the fingertip with alcohol swab Create stasis by pressing on the distal joint of the finger to produce redness at the end of finger. Prick on the skin sharply and quickly with lancet Release pressure on the finger Wipe of the 1st drop of blood Place one drop of blood on the testing filter paper and wait for one minute. Apply gentle pressure over the puncture site

Rationale To determine who needs the sevices To win acceptance and reduce anxiety To prevent contamination of bag and articles It aids safe performance of test

To prevent cross infection To reduce risk of infection

It allows time for absorption of blood by the paper.

with dry cotton swabs until bleeding stops To aids in stopping the bleeding Compare the testing paper with standardized To estimate the % of hemoglobin color chart Inform the person and family the result and record it Keep lancet in a puncture proof container and carry it to health centre for proper disposal Remove gloves Wash hands Replace the articles to bag

ESTIMATION OF HEMOGLOBIN AT HAEMOGLOBINOMETER (SAHLI METHOD) Articles:         

Hemoglobinometer (Sahli hemoglobinometer) N/10 hydrochloric acid solution Filter Capillary pipette Hemoglobin meter tube Water pipette Stirrer Disposable lancet Alcohol swabs.

HOME

USING

Procedure: Procedure steps Identify the client in need for hemoglobin estimation on at home Explain the procedure to be done to the client and family members Assemble all articles in a clean surface

Rationale To determine the appropriateness of the procedure To reduce the anxiety about the procedure

To facilitate safe performance of the procedure Do hand washing by following principles of To avoid contamination of articles bag technique Fill the graduated measuring tube up to To ensures accuracy in results bottom graduation line (10% or 2g %) with N/10 hydrochloric acid by using a dropper. Clean fingertip with alcohol and a prick with To reduce risk of infection a lancet Wait for a drop of blood to form at the finger tip. Suck blood into capillary pipette precisely To ensures correct dilution and hence up to the mark,wipe the pipette point (up to accurate results 20cumm mark of pipette), and blow the blood into measuring tube. While sucking blood into pipette care should If an air bubble enters remove and discard be taken to prevent entry of air bubbles. This blood and make another drop of blood to is done by not lifting the tip of pipetting. repipette Achieve good mixture of liquid by repeated To ensures uniformity through out the suction and blowing or using a stirrer. The mixture mixture will be dark brown and clear after about one minute.

Add water by means of a water pipette and mix with the glass stirrer until the colour of the solution matches the color of the test rods. Wipe the tip of pipette immediately transfer the 0.2ml of blood from the pipette into the hemoglobinometer tube containing N/10 HCL by immersing tip of the pipette in the acid solution and blowing out the acid solution. Withdraw the pipette from the tube and make sure that no solution remains in pipette Leave the solution in the tube in hemoglobinometer,for about 10 minutes ( for maximum conversion of hemoglobin to acid hematin,which occurs in the first 10 minutes). Note.after addition of every drop of distilled water,the solution should be mixed and the color of the solution should be compared with the standard. While matching, take care to hold stirrer above the level of the solution But remember that at no stage should the strirrer by taken out of the tube. Read the results in diffused day light exactly 3 minutes after adding blood to hydrochloric acid Record result in family folder Normal Hb in blood expressed in gm per 100ml of blood Male -14-17gm% Female 12-16gm%

CONCLUSION

The hemoglobin is one of the type of globular protein present in the human blood (more specifically in the RBCs). Hemoglobin is the major constituent of the red cell cytoplasm, accounting for approximately 90% of the dry weight of the mature cell .Its concentration in the blood tells us about many pathological conditions.

BIBLIOGRAPHY 1. Shincy George, “A Comprehensive Procedure Manual of Community Health Nursing”, EMMESS Medical publishers, First Edition ,2015: 30-34. 2. Shyamala D Manivannan, “Procedure Manual Community Health Nursing” ,CBS Publishers, First Edition,2016 : .

Internet

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https://www.slideshare.net/VarugheseGeorge/hemoglobin-estimation-70214533

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https://www.slideshare.net/SheniDIMT/hemoglobin-estimation-6726375

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https://www.slideshare.net/SheHej/hb-estimation

MAR BASELIOS COLLEGE OF NURSING, BHOPAL

SUBJECT: COMMUNITY HEALTH NURSING PROCEDURE ON HB ESTIMATION

SUBMITTED TO :-

SUBMITTED BY

Mrs. Riya Joy

Mrs MarietAbraham

Assistant Professor

M.Sc. Nursing I Year Date : 28/ 03 / 2019