CHAPTER I INTRODUCTION A. Background Today health development progresses, including the field of health analysts.

This is a more sophisticated inspection equipment and inspection methods are required so that energy analysts to become more professional. Professionalism is a service to the community and also adjustments to the technology have also increased. To promote the professionalism, the education of health analysts should be enhanced both in theory and practice. One way to improve the quality of education is through heath analyst internship program field (PKL). These programs not only improve the quality of the analyst's skills but also learning in management, labor relations. interpersonal relationships, and increase the experience for students. B. Objective by author With such a background. the CMS National Health Analysts had programmed the Surakarta by author for each student. CMS National Health Analysts Surakarta in the academic year 2009 has been implementing the program with the purpose of street vendors: 1. General Objectives With the street vendors, is expected to produce work manpower vocational level is able to work as an executive in the service system, especially in the field laboratory. 2. 1) 2) 3) 4) 5) Special purpose a. Improve skills so that students can recognize and implement: Planning and preparation in the laboratory examination. Sampling, sample treatment and sample examination. Recording of test results. Reporting the results of the examination. Use and storage devices.

b. Motivation to train students about the benefits of laboratory tests. c. Coaching development of cooperation with other health workers and provide opportunities to students to socialize themselves in the atmosphere or climate of the real working environment. well as wage workers or as independent workers. C. Development Goals Report The report was developed as the evaluation results by author who has been held in Semarang on BLK 9 November to 21 November 2009 and as a condition for final exam study program CMS National Health Analysts Surakarta. D. Benefits PKL 1. analysis. 2. Through street vendors are expected to measure student / compare setting between theory and practice gained during the implementation of educational practices in the field and laboratory as well as gain knowledge that might face problems and often arise before, during and after sampling so that laboratory tests carried out and other things related to laboratory analysis. 3. laboratory analysis. E. Report Outline Writing reports we make consists of: 1. a. b. Introduction Background Goals by author PKL is a means of evaluation for students to measure the readiness and ability in the skills possessed Obtain and consolidate the process of absorption of new technologies in the field of laboratory

c. d. e. 2. a. b. c. 3. 4. Implementation PKL

Report Writing Goals Benefits by author Systematics Report Examination Hematology Blood chemistry examination Immunology Serology Examination Discussion Conclusion and Suggestionsn

CHAPTER II IMPLEMENTATION PKL

A. Examination Hematology 1. Using Hematology Autoanalyzer Abx Pentra 60 a. How to turn on Steps START UP : Press the On position stavo. Press the On button on the back of the instrument ABX Turn on the printer button on the tool side of waiting 3 Press Escape, wait until the Start Up is complete (for

Pentra 60. minutes for a stable (Exit Main Menu). melihpt blank): WBC<0,3 RBC<0,2 Hb<0 HCt<0,l PLT<8 STAND BY : Press stand by, waiting to exit the switch-off Off his ABX Pentra 60 Off his printer

b. How to do the control (done every morning) Steps: Insert the printer paper

Press the ID, write control, ENTER Enter the reagent control, wait until the results come out, if

the Start Up Passed out or ready to use

c. How to fill a new control Steps : From the main menu, press the number 3 (Calibrasi), Press the number 2 (Coefisien), ENTER 2 times.i Enter the password, fill 123 Press number 1 (WBC), the contents of the value stated on Press number 1 (RBC), the contents of the value stated in ENTER

the table, ENTER the table, etc. d. How to do a sample of patients Steps: Insert the printer paper Press the ID, write the registration number or the name of Wait until the results come out I view old coefisien Enter the target HCT, press Escape, return to the Menu Press the button 3 (Calibrasi) ENTER Press the button 2 (Coefisien) ENTER Press the 1 key (Enter, write the password 123), ENTER Press examination HCT (read) 5

the patient, ENTER e. Steps:

f. How to enter coefisien Steps (Eg: HCT 45 % Vol %, Hb 16,a gr %)

Steps :

Enter a value of 1.15 HCT (X), ENTER Press the Escape key, return to the Menu

g. Calibration Place the paper in the printer From the Main Menu, press the number 3 (Calibrasi), enter Enter the Lot number (example MX 238), Enter 2 times Enter the target value of RBC, Enter (as table) Enter the target value of RBC, Enter and so on until Change the sample: write the number 3, Run Cal, ENTER Press start, enter 3 times the control reagent Wait until the results come out, if OK, run the sample of

2 times (Select OP), ENTER (Write the date and ED), enter (Target Change)

Platelets, ENTER

patients. h. The average (Test assessment results) WBC RBC HGB HCT PLT : 6,6 - 8,2 : 4,46-4,62 : 13,3-14,3 : 35,1-40,1 : 225 305

2. LED Method Westergreen a. Objectives: To find someone stated in the LED mm / hr b. Tools and materials: - Pipette wetergreen - Rack wetergreen - Syringe - Vial and EDTA c. Procedure: mix until homogeneous. 2) Suck the blood in the pipette to mark the limits westergreen then put 0 perpendicular to the rack westergreen for 60 minutes. 3) Viewing high plasma layer with millimeter and report these numbers as digits LED. d. Normal price: - Men : 10 mm/hr - Woman : 15 mm/hr B. Examination of Blood Chemistry 1. Cholesterol a. b. c. Merk : ST Reagensia Method : Enzimatic Trinder Principle : Cholesterol ester Cholesterol + O2
Cholesterol esterase

1) Insert the syringe of blood from the EDTA is given to the vial and

Cholesterol + Fatty Acid 4 Cholesterol H2O2

peroksidase

Cholesterol oksidase

H2O2 + 4 - Aminophenazone + Phenol d. e. Sample : clear serum Tools: 7

4-(p-

benzokinon- monoamino)-Phenazone + 4 H2O

1) Reaction tube + rack 2) Makropipette or dispenser 1 .0 mL 3) Mikropipette 0,01 mL ( 10 l ) 4) Colorimeter with wave length 492 - 546 nm 5) Inkubator 37C

f.

Procedure Into tube Serum/plasma Standart Working solution Blank 1.0 Standart 10 l 1.0 mL , Test 10 1 1.0 mL

Mix up and leave at room temperature for 20 minutes or at 37 C for 10 minutes. Read Absorbance test and standard against blank in a wave of 492 to 546 nm. g. a. b. c. Normal Price: 140-250 mg/dl Merk : ST Reagensia Method : IFCC Kinetick Principle: L-Aspartate + 2-Oxoglutarate Oxaloacetate + NADH
MDH GOT

2. AST (GOT)

Oxaloacetate + L-Glutamate

Malate + NAD
LDH

Sample Pyruvate + NADH d. e. Sample: Clear Serum Tools:

L - Lactate + NAD

1) Pipette l.0 ml 8

2) Mikropipette l00 l 3) Reaction tube 4) Photometer with wave length 340, 334, 365 nm f. Preparation and stability (making the solution of reagents) Add a bottle of solvent into the substrate in accordance with their packaging - masing.Campur well. After reagents stable for 30 days at a temperature of 2-8 C. Absorbance reagents blank solution should be around 1.8-1.0 AU aquadest when read against the wave of 340 nm. g. Procedure: 1) Wave : 334, 340, dan 365 nm 2) Temperature : 30C atau 37C Pipette into a test tube Serum Reagent solution minute for 3 minutes. h. Normal Price: 30C Men Woman 3. ALT(GPT) a. b. c. d. Merk : ST Reagensia Method : IFCC Kinetkk Sample : Clear Serum Tools: 6-25 6-21 37C 8-37 8-31 Test 100 l 1.0 ml

Mix well after 1 minute measure the increase in Absorbance per

1) Pipette 1.0 ml 2) Mikropipette 3) Reaction tube 4) Photometer with wave length 340, 334, 365 nm e. Preparation and stability (making the solution of reagents).

Add the solvent into the bottle according to the package substrate respectively. Mix well. After reagents setema stable 30 days at a temperature of 2-8 C. Absorbance reagents blank solution should be around 1.8-1.0 AU aquadest when read against the wave of 340 nm. f. Procedure Wave length: 334, 340, dan 365 nm Temperature : 30C atau 37C Pipette into a test tube Serum Reagent solution minute for 3 minutes. g. Men Woman 4. Uric Acid a. b. c. Merk : ST Reagensia Method : Enzimatik Trinder Principle : Uric Acid + O2 + H2O 2H2O2 + AAP + DHBS d. e. 1) 2) 3) 4) f. Procedure 10 Tools: Reaction tube Mikropipette 20 l Makropipette/dispenser 1,0 ml Kolorimeter with wave length 520-546 nm
Uricase

Test 100 l 1000 l

Mix well after 1 minute measure the increase in Absorbance per Price Normal: 30C 4-30 4-20 37C 6-40 6-31

Allation+ CO2 + H2O Quinoneimine + H2O

peroksidase

Sample : Serum, plasma EDTA

Into tube Serum Standard Reagensia

Blank 1,0 ml

Standard 20 l 1,0 ml

Test 20 l 1,0 ml

Mix well and leave at room temperature for 20 minutes or at 37 C for 5 minutes. Read Absorbance and standards on the wave 520 to 546 nm. g. C. Imser Examination 1. Widal test a. Materials : Serum With 0.08 ml clinipette serum taken place over the object Then add 1 drop of antigen of Salmonella typhi bacteria. On the other glass object placed each 0.08 ml of serum and Salmonella typhi H Salmonella paratyphi AH Salmonella paratyphi BH Shlmonella paratyphi CH Salmonella paratyphi AO Salmonella paratyphi BO Salmonella paratyphi CO Play in the rotator for 1 minute Read the presence or absence of Agglutination (+) Agglutination occurred 11 b. Procedure : glass. Normal Price : Men : 3,5 - 7,2 mg/dl Woman : 2,5 - 6,2 mg/dl

antigen added :

 suspension suspension suspension suspension

(-) Agglutination did not occur If the results (+) repeat examination with 0.04 0,08 ml of appropriate serum dilutions of serum 1 :20 0,04 ml of appropriate serum dilutions of serum 1 : 40 0,02 ml of appropriate serum dilutions of serum 1 : 80 0,01 ml of appropriate serum dilutions of serum 1 : 160 0,005 ml of appropriate serum dilutions of serum

ml;0.02 ml;0.01 ml and 0.005 ml of serum in which :

suspension 1 : 360

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CHAPTER III DISCUSSION Laboratory examination always preceded by analysis by doctors associated with the tests. Routine examination is a screening examination (early) that can help further examination of more specific, eg: people with DM, when routine urine glucose tests negative or positive, then proceed with the examination of blood sugar (GDS, GDN, GD 2 hours PP). At the heart disorder examination- HBDH, CKMB, CPK, AST, ALT, Gamma GT and others. Factors that affect test results: a. Food and drink Food and drink affect fasting blood sugar tests and triglyceride levels directly because the products consumed will circulate in the blood. So patients need to fast, fasting blood sugar for 10-12 hours, for a minimum of 12 hours of triglycerides. b. Medicine Diuretics : almost all the tests and enzymes in the blood will increase because there hemokonsentrasi, especially hemoglobin, blood cell count, Ht, elektolit Thiazid: blood glucose, GTT, blood urea Morphine : liver enzymes, SGOT, SGPT In addition, the Intramuscular administration will cause a trace of the muscles resulting in muscle enzymes into the blood and affect the CK and LDH tests. c. Fever An increase in blood sugar due to insulin release and decrease cholesterol levels, fever trigliseria early because of increased fat metabolism

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d.

Sampling has not evaporated.

Urine should be taken in the morning urine for substances found in urine Tuberculosis sputum examinations taken in the morning because of the possibility of finding greater BTA. For thypoid fever (Widal test examination) conducted in the acute phase. The first week or second week of illness used for blood cultures, whereas in the second or third week for urine or stool cultures. e. Sample container Made and the glass or plastic, clean, dry, does not affect the nature of substances in the specimen, not exposed to direct sunlight, sterile (for microbiological examination) f. caused by: Contamination and metabolism of bacteria and chemicals Evaporation, temperature and direction of sun exposure. Specimens that are not immediately sent or checked or preservatives should be stored in the refrigerator in accordance with the type of inspection that will be checked. Imunoserologi examination is often performed: HCGtest Dengue (IgG,IgM) Hbs Ag Widal Shipping and sample storage Specimens must be sent to laboratory due to specimen stability changes

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CHAPTER IV CLOSING

A. Conclusion After going through a series of activities to make an analysis of the results by author, then some conclusions can be drawn as follows: 1. the disease 2. Science is taught in schools with teaching practice in the field combination very closely, so as to encourage work fast, precise, effective, and efficient time and can meet the professional standards as an analyst. 3. Semarang BLK laboratory has a quality of dedication, as evidenced by the energy analysis and experienced professional, the inspection tool has high precision and accuracy are also supported by a comfortable workplace harmony. B. Suggestions We give this advice in order to improve the quality of each party (personnel). These suggestions we show to: 1. BLK Semarang a. Increase the good cooperation between the officers of the medical laboratory with another. That the existence of a laboratory installation in a hospital is a fundamental role in the health world, especially in diagnosing

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b. Discipline of time and optimal work discipline needs to be respected and enhanced. c. Welfare of employees should be noted. 2. CMS National Health Analysts Surakarta a. The lessons learned in school and at the time by author need to be considered carefully, because these things are very supportive of our work in the laboratory later. b. Results are precise and accurate depends on our skills in handling the sample. c. Honesty and discipline is the key to the work of our work. 3. a. b. c. Community Living a clean and healthy needs to be Living a clean and healthy is a practical way Use of health facilities that have the improved and cultivated in everyday life. to prevent and avoid the occurrence of a disease. maximum (laboratories, health centers, hospitals, etc.).

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