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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
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
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
- **LEAVE NO BUBBLES
- 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
What are the normal values for the ESR procedure?
- Adult female: 0-20mm/hr
- Adult male: 0-15mm/hr
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
What are the factors that affect the ESR procedure?
- Plasma factors (viscosity, etc)
- RBC factors (size, etc)
- Mechanical factors