DefinitionThe Coombs' test looks for antibodies that may bind to your red blood cells and cause premature red blood cell destruction (hemolysis).Alternative NamesDirect antiglobulin test; Indirect antiglobulin testHow the test is performedBlood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. 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, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.How to prepare for the testNo special preparation is necessary for this test.How the test will feelWhen the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a bruise may develop at the site where the needle was inserted.Why the test is performedThere are two forms of the Coombs' test: direct and indirect.The direct Coombs' test is used to detect antibodies that are already bound to the surface of red blood cells. Many diseases and drugs (quinidine, methyldopa, and procainamide) can lead to production of these antibodies. These antibodies sometimes destroy red blood cells and cause anemia. This test is sometimes performed to diagnose the cause of anemia or jaundice.The indirect Coombs' test looks for unbound circulating antibodies against a series of standardized red blood cells. The indirect Coombs' test is only rarely used to diagnose a medical condition. More often, it is used to determine whether a person might have a reaction to a blood transfusion.Normal ValuesNo clumping of cells (agglutination), indicating that there are no antibodies to red blood cells, is normal.Normal value ranges may vary slightly among laboratories. Talk to your doctor about the meaning of your specific test results.What abnormal results meanAn abnormal (positive) direct Coombs' test means you have antibodies that act against your red blood cells. This may be due to:Autoimmune hemolytic anemia without another causeChronic lymphocytic leukemia or other lymphoproliferative disorderDrug-induced hemolytic anemia (many drugs have been associated with this complication)Erythroblastosis fetalis (hemolytic disease of the newborn)Infectious mononucleosisMycoplasmal infectionSyphilisSystemic lupus erythematosus or another rheumatologic conditionTransfusion reaction, such as one due to improperly matched units of bloodThe test is also abnormal in some people without any clear cause, especially among the elderly. Up to 3% of people who are in the hospital without a known blood disorder will have an abnormal direct Coombs' test.An abnormal (positive) indirect Coombs' test means you have antibodies that will act against red blood cells your body views as foreign. This may suggest:Autoimmune or drug-induced hemolytic anemiaErythroblastosis fetalis hemolytic diseaseIncompatible blood match (when used in blood banks)What the risks areVeins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.Other risks associated with having blood drawn are slight but may include:Excessive bleedingFainting or feeling light-headedHematoma (blood accumulating under the skin)Infection (a slight risk any time the skin is broken)ReferencesPowers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ Jr., Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingston Elsevier; 2008: chap 47.Schrier SL, Price EA. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr., Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingston Elsevier; 2008: chap 48.Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 164.
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The needle should form a 15 to 30 degree angle with the surface of the arm.
The major risk of drawing blood or starting an IV is
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A small needle attached to a collection vial will be inserted into a vein and a small amount of blood will be withdrawn. When the vial is full, the needle and strap will be removed and a cotton ball will be taped over the injection site.
The term venipuncture is a medical term which means to use intravenous for the sampling of blood for blood analysis. A small needle is inserted into the vein to withdraw blood.
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The major risk of drawing blood and starting IVs includes infection, bleeding, nerve damage, and bruising at the site of insertion. Additionally, there is a risk of complications if the needle is inserted incorrectly, such as infiltration or phlebitis.
It stings when the needle is inserted in the skin. However they don't last long and it is important to stay calm. If you tense your arms the test will cause more pain
The application of a tattoo requires a needle to be inserted into the skin. This needle use has the potential to spread bloodborne pathogens like HIV or hepatitis if the person giving the tattoo has not used appropriate infection control procedures.
The application of a tattoo requires a needle to be inserted into the skin. This needle use has the potential to spread bloodborne pathogens like HIV or hepatitis if the person giving the tattoo has not used appropriate infection control procedures.
A tourniquet should be left on the arm for no longer than 1-2 minutes for a blood draw. Leaving it on for longer can lead to complications like tissue damage, nerve injury, or blood pooling. It's important to release the tourniquet once the needle is inserted to prevent any adverse effects.