MODULE 10 BLOOD: HEMOGLOBIN EXAMINATION Basic Theory Under normal circumstances, blood cells have a biconcave shape. However, under certain circumstances cells Red blood can also be perfectly spherical (spherocytosis) or eggshaped (ovalocytosis). In their normal form, these red blood cells are semi-permeable, which is when they have to be through capillaries which have a diameter smaller than the diameter of the blood cells themselves, then the red blood cells will take another shape in such a way that their diameter becomes larger smaller than capillaries. Meanwhile, in the form of spherocytosis or ovalocytosis, this permeable property is not have, so that many red blood cells are damaged or broken when they have to go through small capillaries. This condition is called intravascular hemolysis. As a result, someone Those who experience this condition will experience blood deficiency (anemia). The function of transporting oxygen to circulate throughout the cells in order to obtain energy carried out by hemoglobin contained in red blood cells. Hemoglobin is a protein complex, composed of globin protein and a non-protein compound called Heme. Heme is a compound called porforon whose center is occupied by iron metal (Fe). One heme molecules contain one iron atom, and one globin protein binds only one heme molecule. However, one hemoglobin molecule consists of 4 complexes of globin and heme molecules, so One hemoglobin molecule contains 4 iron atoms. In the chemical formula it is written as Hb(Fe)4. In hemoglobin, it is the iron compound that carries out the function of binding and releasing oxygen. So if there is a decrease in Fe levels in the body, it will result in a decrease in levels hemoglobin, so the amount of oxygen carried is reduced. This causes anemia. General symptoms of anemia can be seen from the patient's face looking pale, mucous membranes the mouth and inside the conjunctiva of the eyes appear pale, apart from that the sufferer will experience get tired easily. Anemia that is not resolved over a long period of time will interfere with various performance organs due to lack of oxygen as a precursor (raw material) to produce energy. Even further, it can disrupt the function of the central nervous system, thereby affecting intelligence ability. If it occurs in children, it will interfere with their growth and development process. C. Experimental Principle Normal Hb levels in adult women are 13-14.5 gr/100ml, in adult women 15-16 gr/100ml, in children 20gr/100ml, in teenagers 18gr/100ml D. Tools and materials Tool Material 1. Lancing device 2. Sahli haemometer 3. Crooked 1. needle lancet 2. alcohol swab 3. HCl 0.1N 4. Chlorine 5. Aquades 6. Hand scoop E. Work procedures Sahli Method 1. Fill the diluent tube (Sahli tube) with 20mm of 0.1N HCl3 2. Disinfect the fingertip from which blood will be taken using an alcohol swab 3. Prick the tip of the finger and let the blood come out first. After that suck the blood which comes out using a capillary pipette to the limit marked blue on the pipette or as much as 20mm3 4. Transfer the blood into a tube filled with HCl slowly and carefully so that no bubbles occur 5. Rinse the pipette several times with HCl in the diluent tube until there is no blood who is left behind 6. If there is no blood left in the pipette, immediately wash the pipette with using a chlorine solution, by sucking in the chlorine solution and then expelling it Return several times to prevent the pipette from becoming clogged. 7. Dilute the blood sample by dripping distilled water while shaking thoroughly slowly using a glass stirrer until the blood color in the tube is the same with the color of the liquid in the standard tube. 8. Once the color of the blood sample is the same as the standard color, read the scale shown in a diluent tube to obtain the hemoglobin concentration of the blood sample taken. Paper Method 1. Disinfect the fingertip from which blood will be taken using an alcohol swab 2. Prick the tip of the finger and let the blood come out first 3. Stick the measuring paper on the blood, then let it dry for a moment (±3 seconds) 4. Match the color on the measuring paper with the standard color on the back Hemoglobin book. 5. The levels measured in tens using this method can be converted into tens units by comparing the hemoglobin scale tube with sahli method.