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  1. What does the ESR test for?
    • Nonspecific test, but is elevated during inflammatory response (eg. rheumatoid arthritis, hepatitis, multiple myeloma, etc)
    • Often run before surgery as an indicator of infection
  2. What is the principle of the ESR procedure?
    • The rate of erythrocytes settling out of anticoagulated whole blood is measured
    • ↑RBC mass = ↑ESR
    • ↑plasma viscosity = ↓ESR
  3. Describe the ESR procedure in detail
    • Collect patient blood in EDTA tube (anticoagulant)
    • Thoroughly mix by inversion (no bubbles)
    • Using a long-tipped Pasteur pipette fill the sed rate tube by placing the pipette tip in the bottom of the tube (@ 45° angle) and slowly removing the pipette while filling the tube w/ blood meniscus exactly at 0
    • Place the filled tube in a rack in exact vertical position
    • Note time and room temperature
    • After exactly 1 hour read the level the RBCs have settled (do not include buffy coat)
    • Report results as distance of fall per hour
  4. What are the normal values for the ESR procedure?
    • Adult female: 0-20mm/hr
    • Adult male: 0-15mm/hr
  5. What are the possible interferences for the ESR procedure?
    • Improper anticoagulant
    • Delay in performing the test
    • Temperature is too high (eg. direct sunlight on tube)
    • Tube isn't verticle
    • Dirty tubes
    • Vibration or movement
  6. What are the factors that affect the ESR procedure?
    • Plasma factors (viscosity, etc)
    • RBC factors (size, etc)
    • anticoagulants
    • Mechanical factors
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