Slide and Stain Quality
- Page ID
- 70219
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The ability to perform a white blood cell differential, red blood cell morphology and platelet evaluation depends on the quality of the peripheral blood smear and staining process.
Ideal Reading Area
To find the ideal reading area of a peripheral blood smear for evaluation, you should navigate to the region of the slide that is just in from the feather edge, where the red blood cells are evenly distributed and not overlapping. This area will give the most even distribution of cells.
Ideal Reading Area \(\PageIndex{}\)
Too Thin of an Area on Peripheral Smear
In the feather edge region of the smear, the red blood cells will be unevenly spaced and clumped together, leaving large clear spaces. Avoid this area.
Too Thin \(\PageIndex{}\)
Too Thick of an Area on Peripheral Smear
Once you enter the thicker region of the smear (closer to the original drop of blood), the red blood cells begin to stack on top of each other and become distorted. Be careful, this area can begin to mimic rouleaux. The white blood cells are no longer spread out and the cytoplasm condenses around the nucleus, making identification difficult. Avoid this area.
Too Thick \(\PageIndex{}\)
Water Artifact
Water artifact on the peripheral smear will most often appear as refractile objects on the red blood cells. This may be caused by staining a smear that is not completely dry, a humid environment or water contamination of the stain.
Water Artifact \(\PageIndex{}\)
Stain Precipitate
Stain precipitate appears as aggregated material on the peripheral smear. It usually lacks a distinct morphology but be careful not to confuse it with bacteria.
Stain Precipitate \(\PageIndex{}\)
Fibrin Strand
Fibrin strands are fairly colorless threadlike objects that indicate the initiation of coagulation. If you look closely, you can see it sitting on top of red cells. If detected, the specimen should be checked for clots. If a clot is found, the specimen should be rejected as all hematological tests may be affected. If only an occasional fibrin strand is found, the CBC results are usually acceptable.
Fibrin Strand \(\PageIndex{}\)