Blood Film Preparation and Staining Procedures

Berend Houwen
Department of Pathology and Human Anatomy
Loma Linda University School of Medicine, Loma Linda, California

Laboratory Hematology 6:1-7
© 2000 Carden Jennings Publishing Co., Ltd.

ABSTRACT

The blood film is one of the world's most widely used laboratory tests for screening, case finding, diagnosis, and monitoring of disease. This article provides guidelines that should enable clinical laboratories to prepare and stain good-quality blood films. Objective criteria have been applied as much as possible, although there remains some "art" in how a blood film is prepared manually. Troubleshooting of fixation and staining artifacts is included in the guidelines.

INTRODUCTION

The blood film is one of the world's most widely and frequently used tests, and yet there appears to be no comprehensive document that lists requirements, procedures, potential problems, etc., for blood film preparation. Although it is a simple procedure, there are many reasons that as a test it could easily fail or be less effective than it should be. This article was prepared at the request of the Cytometry Panel of the International Council for Standardization in Haematology (ICSH) as a guideline for laboratories. It is intended to give direction and some standardization in the preparation and staining of blood films for morphological evaluation in the clinical laboratory. Microscopic analysis procedures and interpretation are not within the scope of this article.

Methods include state-of-the-art techniques as well as methodologies applicable for laboratories in developing countries. When targets are stated, they are not at the maximum level but are targets that should be attained under all conditions lest diagnostic test quality and therefore patient care be compromised. This is especially important since results obtained from microscopic analysis of blood films are often final and definitive in clinical situations, whether for case finding, diagnosis, or monitoring of disease.

For easier reference use, this article uses a special format to describe the various steps that involve blood film preparation and staining.

LH.6.1.Houwen.pdf

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