Procedural Steps for Full Blood Count (FBC)
The standardized procedure for obtaining a Full Blood Count (FBC) requires proper venipuncture technique, appropriate sample collection tubes, and specific handling protocols to ensure accurate results. 1
Patient Preparation and Equipment
- Verify patient identity using at least two identifiers and ensure proper labeling of collection tubes to prevent sample mix-up 2
- Select appropriate blood collection tubes (typically EDTA tubes for FBC) 2
- Prepare necessary equipment including:
- Apply personal protective equipment (PPE) to minimize infection risk 2
Venipuncture Procedure
- Apply tourniquet for no more than 60 seconds to locate a suitable vein (prolonged application may affect results) 2
- Perform proper hand hygiene before beginning the procedure 2
- Clean the venipuncture site with chlorhexidine-alcohol using a scrubbing motion and allow to dry completely 2
- Use sterile technique throughout the procedure (sterile gloves can reduce contamination rates by 43-90%) 2
- Insert needle at appropriate angle into the selected vein 2
- Collect blood directly into the appropriate tube, filling until vacuum is exhausted 2
Sample Handling
- Immediately after collection, gently invert the EDTA tube 5-10 times to ensure proper mixing with anticoagulant 2
- Avoid vigorous shaking which may cause hemolysis 2
- Process samples as quickly as possible, ideally within 1 hour of collection 2
- If immediate processing is not possible, store whole blood samples at room temperature (not refrigerated) 2
- Transport samples by hand carrier rather than pneumatic tube systems, as pneumatic transport can significantly alter blood cell parameters 2
Laboratory Processing
- Perform automated analysis using calibrated hematology analyzers 1
- Ensure quality control measures are in place with analyzers achieving at least 90% lymphocyte purity within the lymphocyte gate 1
- For abnormal results, prepare blood smears for manual review 2
- Calculate absolute values for cell populations when reporting results 1
Result Reporting
- Report results with corresponding reference ranges, which may vary by laboratory, age, and sex 1
- Include both percentages and absolute counts when available 1
- Ensure proper documentation of any pre-analytical variables that might affect interpretation 1
Quality Assurance Considerations
- Trained phlebotomists consistently achieve lower blood contamination rates compared to other healthcare providers 2
- Proper labeling and patient identification are critical to prevent errors 2
- Hemolysis is the primary cause of unusable specimens and should be documented using a standardized scale 2
- Provide relevant clinical information with the request to aid in appropriate interpretation 3
By following these standardized steps, healthcare providers can ensure accurate and reliable FBC results that properly inform clinical decision-making.