These are used to perform
complete blood counts,
erythrocyte sedimentation rates (ESRs), or
coagulation tests.
Cell counters Automated cell counters sample the blood, and quantify, classify, and describe cell populations using both electrical and optical techniques. Electrical analysis involves passing a dilute solution of the blood through an aperture across which an electrical current is flowing. The passage of cells through the current changes the
impedance between the terminals (the
Coulter principle). A lytic reagent is added to the blood solution to selectively lyse the
red cells (RBCs), leaving only
white cells (WBCs), and
platelets intact. Then the solution is passed through a second detector. This allows the counts of RBCs, WBCs, and platelets to be obtained. The platelet count is easily separated from the WBC count by the smaller impedance spikes they produce in the detector due to their lower cell volumes. Optical detection may be utilised to gain a differential count of the populations of white cell types. A dilute suspension of cells is passed through a flow cell, which passes cells one at a time through a capillary tube past a laser beam. The reflectance, transmission and scattering of light from each cell is analysed by sophisticated software giving a numerical representation of the likely overall distribution of cell populations. Some of the latest haematology instruments may report
Cell Population Data that consist in
Leukocyte morphological information that may be used for flagging
Cell abnormalities that trigger the suspect of some
diseases.
Reticulocyte counts can now be performed by many analysers, giving an alternative to time-consuming manual counts. Many automated reticulocyte counts, like their manual counterparts, employ the use of a
supravital dye such as
new methylene blue to stain the red cells containing
reticulin prior to counting. Some analysers have a modular slide maker which is able to both produce a blood film of consistent quality and stain the film, which is then reviewed by a medical laboratory professional.
Coagulometers Automated coagulation machines or Coagulometers measure the ability of blood to clot by performing any of several types of tests including
Partial thromboplastin times,
Prothrombin times (and the calculated
INRs commonly used for therapeutic evaluation),
Lupus anticoagulant screens,
D dimer assays, and factor assays. Coagulometers require blood samples that have been drawn in tubes containing
sodium citrate as an anticoagulant. These are used because the mechanism behind the anticoagulant effect of sodium citrate is reversible. Depending on the test, different substances can be added to the blood plasma to trigger a clotting reaction. The progress of clotting may be monitored optically by measuring the absorbance of a particular wavelength of light by the sample and how it changes over time.
Other haematology apparatus Automatic
erythrocyte sedimentation rate (ESR) readers, while not strictly analysers, do preferably have to comply to the 2011-published CLSI (Clinical and Laboratory Standards Institute) "Procedures for the Erythrocyte Sedimentation Rate Test: H02-A5 and to the ICSH (International Council for Standardization in Haematology) published "ICSH review of the measurement of the erythrocyte sedimentation rate", both indicating the only reference method, being Westergren, explicitly indicating the use of
diluted blood (with sodium citrate), in 200 mm pipettes, bore 2.55 mm. After 30 or 60 minutes being in a vertical position, with no draughts and vibration or direct sunlight allowed, an optical reader determines how far the
red cells have fallen by detecting the level. ==Miscellaneous analysers==