When citrated blood is left undisturbed in a vertically positioned wintergreen pipette, red cells aggregate, clump together to form rolox, and sediment through the plasma. "ESR is the rate at which this sedimentation occurs in 1 hour because Erythrocyte sedimentation rate esr tests red cells, measured in millimeters". Sediment increases when the ratio of red cells to plasma is altered, such as in anemia, when red cells are abnormally shaped, such as sickle cells.
Precautions:
1- E.S.R should be administered within two hours of blood collection.
2. Keep the E.S.R. vertical tube during heating.
3- Do not place the E.S.R TUBE and E.S.R in a place where there is movement or in a place that is not level.
4 E.S.R tube is not affected by overheating, canal port will not be correct.
5. Keep the pet mat indoors out of direct sunlight.
6. The proportion of blood in the sodium citrate solution was not found to be abnormal.
E.S.R. Variations in: Sedimentation rate
1). Physical Variation:
2). E.S.R in pregnancy is about 35 mm (1st hour).
From the 10-12th week, the beginning increased. It goes back to normal.
Level in 3-4 weeks after delivery.
3). An Old Age: E.S.R. increased.
4). A newborn: E.S.R is the lowest (0.5 mm first hour).
5). E.S.R in children is 13-30 mm in the first hour.
6). It increases significantly during menstruation.
Pathological variations:
The following pathological conditions increase the E.S.R.
1). Acute and chronic infections,
2). Anemia other than sickle cell anemia,
3). Severe trauma, burns, fractures.
4). Septicemia
5). exasperating circumstances,
6). pulmonary tuberculosis,
7). Dishonesty
Elevation of ESR / Causes:
ESR is not specific for any disease. ESR may be high in the following situations:
1 Chronic infections such as tuberculosis.
2- Pregnancy.
3. After birth
4 - After a heart attack.
5 - Chronic pain in the joints.
6 - Kidney disease.
7- Chronic liver disease.
8 - Cancer
9 - All infections
10 - All chronic diseases especially TB (chronic diseases)
esr test
E.S.R. Factors Affecting:
1). RBC size and shape.
2). The plasma protein content, neutralizes fibrinogen zeta. potential (-Ve) RBCs so that they bind to each other, resulting in increased E.S.R.
3). The speed of Rolex creation.
4). Specific gravity of corpuscles,
5). Cholesterol concentration.
6). Temperature: If the temperature is above 20°C, the E.S.R will be increased.
7). Specific Gravity: With high specific gravity,
RBCs sink more rapidly.
8) Decrease in viscosity increases E.S.R.
E.S.R. Exacerbating factors:
1). Increase O2 concentration.
2) Increased cholesterol
3) Increase in alpha globulin
4) Increase in fibrinogen
5) Temperature above 20°C
6) Acute infection: In acute infection
Enter the plasma from the protein site.
Infection
Luggage:
1): Winter green ESR glass pipette. Wintergreen pipettes are 300mm long and graduated from 0-200mm. Thay Dimitr Mast Now No loger Bay Much Less Than 2. Fifth Five Mother. When reusing pipettes, care should be taken to ensure that the pipettes are completely clean and dry.
2): The timer is able to do 1 hour accurately.
3): Reagent: trisodium citrate, 32 g (3.2% W/v) anticoagulant. Store the reagent at 4-8°C.
Test Procedure:
1). Pipette 0.4 mL of sodium citrate anticoagulant into a small container.
2). Add 1.6 mL of venous blood or EDTA-clotted blood and mix well. Remove the cap.
Place the container and sample in the ESR stand. Insert the wintergreen pipette and make sure it is in a vertical position.
3) Using a safe suction method, avoiding air bubbles, draw blood up to the 0 mark of a wintergreen pipette.
4) Check that the ESR stand is level by making sure that the bubble is centered on the spirit level. If needed, adjust the screws on the bottom of the stand.
5) Set a timer for 1 hour.
6). After exactly 1 hour, read the level at which the plasma meets the red cells in millimeters.
7) After reading the ESR, return the blood to its container, carefully remove the pipette and soak it in sodium hypochlorite (2500 ppm disinfectant).
8) Dispose of blood safely and clean the container before washing and also the ESR stand.
The circumstances in which E.S.R. Decreases:
I. Cardiac failure.
ii Polycythemia.
111. A Fibrinogenemia.
Clinical Significance of E.S.R.:
Diagnostic Significance: E.S.R helps in diagnosis of disorders and infections. The presence of an elevated E.S.R. in the absence of other symptoms indicates an organic disease.
Diagnostic Significance: E.S.R also helps in diagnostic approach whether drug is effective against malignancy or infection.
Normal values of E.S.R. in first hour:
1. Westergreen method:
Male = 5-10 mm
Females = 10-15 mm
2. Method of Wintrobes:
Male = 0-10 mm
Females = 0-15 mm
Reference Limits:
Men ................. up to ten millimeters per hour
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