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A complete blood count (CBC) is a series of tests used to evaluate the composition and concentration of the cellular components

of blood. It measures the following: The number of red blood cells (RBCs) The number of white blood cells (WBCs) The total amount of hemoglobin in the blood The fraction of the blood composed of red blood cells (hematocrit) The mean corpuscular volume (MCV) the size of the red blood cells CBC also includes information about the red blood cells that is calculated from the other measurements: MCH (mean corpuscular hemoglobin) MCHC (mean corpuscular hemoglobin concentration) The platelet count is also usually included in the CBC. Purpose: The CBC provides valuable information about the blood and to some extent the bone marrow, which is the blood-forming tissue. The CBC is used for the following purposes: as a preoperative test to ensure both adequate oxygen carrying capacity and hemostasis to identify persons who may have an infection to diagnose anemia to identify acute and chronic illness, bleeding tendencies, and white blood cell disorders such as leukemia to monitor treatment for anemia and other blood diseases to determine the effects of chemotherapy and radiation therapy on blood cell production Preparation: There is no special preparation needed How the Test is Performed: Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic. An elastic band is placed around the upper arm to apply pressure and cause the vein to swell with blood. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, the area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. A bandage may be applied to the puncture site if there is any bleeding.

Normal Values: TEST NORMAL VALUES Leukocyte (White Blood Cell) X1000 cells/mm (L) Birth 9.0-30.0 24 hours 9.4-34.0 1 month 5.0-19.5 1-3 years 6.0-17.5 4-7 years 5.5-15.5 8-13 years 4.5-13.5 Adult 4.5-11.0 Neutrophils Bands 3-5% (total WBC count) Segs 54-62% Lymphocytes 25-33% Monocytes 3-7% Eosinophils 1-3% Basophils 0-0.75% Erythrocytes (Red Blood Cells) Cord 3.9-5.5 million/mm 1-3 days 4.0-6.6 million/mm 1 week 3.9-6.3 million/mm 2 weeks 3.6-6.2 million/mm 1 month 3.0-5.4 million/mm 2 months 2.7-4.9 million/mm 3-6 months 3.1-4.5 million/mm 0.5-2 years 3.7-5.3 million/mm 2-6 years 3.9-5.3 million/mm 6-12 years 4.0-5.2 million/mm 12-18 years (male) 4.5-5.3 million/mm 12-18 years (female) 4.1-5.1 million/mm Hemoglobin 1-3 days 14.5-22.5 g/dL 2 months 9.0-14.0 g/dL 6-12 years 11.5-15.5 g/dL 12-18 years (male) 13.0-16.0 g/dL 12-18 (female) 12.0-16.0g/dL Hematocrit 1 day 48-69% 2 days 48-75% 3 days 44-72% 2 months 28-42% 6-12 years 35-45% 12-18 years (male) 37-49% 12-18 years (female) 36-46% Mean Corpuscular Volume (MCV) 1-3 days 95-121m 0.5-2 years 70-86 m

6-12 years 77-95 m 12-18 years (male) 78-98 m 12-18 years (female) 78-102 m Mean Corpuscular Hemoglobin (MCH) Birth 31-37 pg/cell 1-3 days 31-37 pg/cell 1 week-1 month 28-40 pg/cell 2 months 26-34 pg/cell 3-6 months 25-35 pg/cell 0.5-2 years 23-31 pg/cell 2-6 years 24-30 pg/cell 6-12 years 25-33 pg/cell 12-18 years 25-35 pg/cell Mean Corpuscular Hemoglobin Concentration (MCHC) Birth 30-36 g Hg/dL RBC 1-3 days 29-37 g Hg/dL RBC 1-2 weeks 28-38 g Hg/dL RBC 1-2 months 29-37 g Hg/dL RBC 3 months-2 years 30-36 g Hg/dL RBC 2-18 years 31-37 g Hg/dL RBC Reticulocyte Count Infants 2-5% of RBCs Children 0.5-4% of RBCs 12-18 years (male) 0.5-1% of RBCs 12-18 years (female) 0.5-2.5% of RBCs Platelet Count Birth-1 week 84,000-478,000/mm Thereafter 150,000-400,000/mm ERYTHROCYTE SEDIMENTATION RATE (ESR) TEST NORMAL VALUE Westergren Child 0-10 mm/hour Adult (male) 0-15 mm/hour Adult (female) 0-20 mm/hour Wintrobe Child 0-13 mm/hour Adult (male) 0-9 mm/hour Adult (female) 0-20 mm/hour

What Abnormal Results Mean: High numbers of RBCs may indicate: Low oxygen tension in the blood Congenital heart disease Cor pulmonale Pulmonary fibrosis Polycythemia vera Dehydration (such as from severe diarrhea) Renal (kidney) disease with high erythropoietin production Low numbers of RBCs may indicate: Blood loss Anemia (various types) Hemorrhage Bone marrow failure (for example, from radiation, toxin, fibrosis, tumor) Erythropoietin deficiency (secondary to renal disease) Hemolysis (RBC destruction) Leukemia Multiple myeloma Malnutrition (nutritional deficiencies of iron, folate, vitamin B12, or vitamin B6) Low numbers of WBCs (leukopenia) may indicate: Bone marrow failure (for example, due to infection, tumor or fibrosis) Presence of cytotoxic substance Autoimmune/collagen-vascular diseases (such as lupus erythematosus) Disease of the liver or spleen Radiation exposure High numbers of WBCs (leukocytosis) may indicate: Infectious diseases Inflammatory disease (such as rheumatoid arthritis or allergy) Leukemia Severe emotional or physical stress Tissue damage (SUCH AS burns) Low hematocrit may indicate: Anemia (various types) Blood loss (hemorrhage) Bone marrow failure (for example, due to radiation, toxin, fibrosis, tumor) Hemolysis (RBC destruction) related to transfusion reaction Leukemia

Malnutrition or specific nutritional deficiency Multiple myeloma Rheumatoid arthritis High hematocrit may indicate: Dehydration Burns Diarrhea Polycythemia vera Low oxygen tension (smoking, congenital heart disease, living at high altitudes) Low hemoglobin values may indicate: Anemia (various types) Blood loss The test may be performed under many different conditions and in the assessment of many different diseases.