Bleddind Time Clotting Time Demonstration

bleddind time clotting time

1. PY2.11 (7) Determination Of Bleeding Time And Clotting Time

2. PY2.11 (7) (a) Describe the clinical significance of determining of BT and CT PY 2.11(7) (b ) List the steps in determining of BT by Duke’s method PY 2.11 (7) (c) Explain the physiological basis of stoppage of bleeding when determining the BT PY 2.11 (7) (d) List the steps in determination of CT by capillary tube method PY 2.11 (7) (e ) Mention the normal values of BT and CT PY 2.11 (7) (f) Explain the steps in coagulation of blood PY 2.11 (7) (g) List the precautions to be taken while determining the BT and CT PY 2.11 (7) (h) Enumerate the test for platelet function PY2.11 (7) ( i ) List the test to assess the efficiency of intrinsic and extrinsic pathway PY 2.11 (7) (j) List test to assess the efficiency of intrinsic and extrinsic pathway PY 2.11 (7) (k) Explain the principles and clinical significance of different tests for investigation of bleeding disorders

3. THEORY – A. Bleeding time - The time taken from the puncture of blood vessel to stoppage of bleeding. B. Clotting time - The time taken from the puncture of blood vessel to the formation of fibrin thread

4. Clinical significance clinical significance of determining of BT and CT It is very important to know BT and CT in the following conditions: 1. Before surgery. 2. Before any biopsy, especially liver or bone marrow biopsy. 3. Before putting any patient on anticoagulant therapy.

5. Apparatus Pricking Apparatus, Filter Paper, Thin Capillary tubes, Stop Watch, Sprit Swab.

6. Procedure Bleeding time – It is carried out by two methods: Duke’s method and Ivy’s method, but Duke’s method is commonly used for determining the BT.

7. A. Duke’s method 1-Clean tip of finger by spirit and let it dry . 2-Puncure finger with a needle, it should be deep enough to ensure free flow of blood without squeezing .

8. 3- Immediately note the time, the time of puncture is taken as zero. 4 -Then wipe the blood drop by a piece of filter paper every ( 30 )second 5 - continue the procedure until no more blood spot is on the filter paper 6 -Therefore each drop on filter paper represents 30 sec. 7 -Count the total no. of spots on filter paper and multiply it with 1/2 8 -Normal bleeding time 2-6 minutes Note: By Ivy’s method normal BT is 3-6 min at 37°C.

9. Clotting time - The time taken from the puncture of blood vessel to the formation of fibrin thread . Two methods are commonly used for determining the CT: Capillary glass tube method and Lee and White Method

10. Procedure 1-Clean the tip of finger by spirit & let it dry . 2-Prick finger by needle deep enough to ensure free flow of blood . Immediately note the time, the time of puncture is taken as zero. 3-When a large drop of blood is formed introduce the end of the capillary tube into the drop holding the tube such that its other end will be at lower level. Blood flows rapidly into the capillary tube. 4-Hold the tube in the palm so as to maintain it at body temperature.

11. 4-At the end of one minute break a small piece of the tube from one end and notice if a thread of fibrin connects the broken ends of tube. 5-If there is no fibrin thread, repeat the procedure every 30 sec till a fibrin thread appears. The appearance of fibrin thread indicates that the blood has clotted. 6-Normal clotting time ( 3-8) minutes at 37°C. Note: By Lee and White method normal CT is in glass tube 6-12 min. or in silicon tube 20-60 min.

12. No Thread No Thread

13. Thread Thread

14. Precautions Finger should be pricked by a single stabbing action to give free flowing blood. At no stage it should be squeezed to obtain the blood. Be alert and carefully note the zero time. Glass capillary tube should never be filled with blood by means of sucking at the other end of the tube. Strictly follow the procedure steps and preferably experiment should be carried out at normal body temperature of 37°C.

15. Result My bleeding time is ……………… minutes and clotting time is ……………… minutes.

16. Conditions in which BT is prolonged, but CT is normal: - 1. Thrombocytopenia due to any cause. 2. Thrombasthenia. 3. Idiopathic thrombocytopenia purpura . Conditions in which CT is prolonged, but BT is normal: - 1. Hemophilia. 2. Christmas disease. 3. Any bleeding disorder in which clotting factors are deficient.

17. Thank you