Perform and Interpret a Peripheral Blood Smear

Microscopic Examination: Red Blood Cell Morphology Assessment

A peripheral blood smear is a valuable diagnostic tool used to evaluate the morphology of red blood cells (RBCs). This examination helps identify hematologic disorders, infections, and systemic diseases, particularly in pediatric patients.

Steps to Perform a Peripheral Blood Smear

1. Prepare the Sample: Use fresh anticoagulated blood.
2. Make the Smear: Place a drop of blood on a clean glass slide and spread it evenly using another slide at a 30-45 degree angle.
3. Staining: Use Wright or Giemsa stain for proper visualization.
4. Microscopic Examination: Use a microscope at 100x magnification to assess RBC morphology.

Key Morphological Findings in RBCs

• Normocytic, Normochromic: Normal RBC morphology.
• Microcytic, Hypochromic: Seen in iron deficiency anemia.
• Macrocytic: Associated with B12 or folate deficiency.
• Polychromasia: Indicates immature RBCs, often in hemolysis.
• Target Cells: Found in thalassemia and liver disease.
• Spherocytes: Suggest hereditary spherocytosis or autoimmune hemolytic anemia.

Clinical Relevance in Pediatrics

In pediatric patients, peripheral blood smear analysis plays a crucial role in diagnosing congenital and acquired hematologic disorders such as sickle cell disease, thalassemia, and hemolytic anemias.

Conclusion

The peripheral blood smear remains a cornerstone of hematologic diagnostics, offering insights into RBC abnormalities that aid in early disease detection and effective treatment planning.