INTRODUCTION

A hemoglobin test measures the amount of hemoglobin in your blood. Hemoglobin is a

protein in your red blood cells that carries oxygen to your body's organs and tissues and
transports carbon dioxide from your organs and tissues back to your lungs.If a hemoglobin
test reveals that your hemoglobin level is lower than normal, it means you have a low red
blood cell count (anemia). Anemia can have many different causes, including vitamin
deficiencies, bleeding and chronic diseases.

Hemoglobin can be estimated by different methods

1. Visual colour comparison method:

 Sahil’s method

 Dares method

 Hadens method

 Wintrobes method

 Haldances method

 Tallquists method.

2. Gasometric method:

 Van slyke method

3. Spectrophotometric method:

 Oxyhemoglobin method

 Cyanmethemoglobin method

4. Automated hemoglobinometry

5. Non- automated hemoglobinometry

6. Other methods:
  Alkaline –hematin method

 Specific gravity method

 Comparator method.

Normal values of hemoglobin:

Adult Male : 14-18 (16 + 2 ) g/dl of blood

Adult Female : 12-16 (14+ 2) g/dl of blood.

In new borns,hemoglobin concentration is normally 16-22g /dl. It decreases to 9- 14 g/dl by

about 2 months of age. By 10 years of age , the normal hemoglobin concentration will be 12-
14g / dl. There may be slight decrease in hemoglobin level after 50 years of age.

CHECKING HEMOGLOBIN AT HOME BY USING TESTING PAPER ( Telequist

Scale)

Equipments required:

 Hemoglobin testing paper/ filter paper,talliqus, Hb scale.

 Disposable lancet
 Alcohol swabs
 Paper bag

Procedure :

Procedure Rationale
Identify the person who needs to check Hb To determine who needs the sevices
level by Checking for anemia
Explain the procedure to person and family To win acceptance and reduce anxiety
Do hand washing and dry hands To prevent contamination of bag and articles
Follow the bag technique steps and take out It aids safe performance of test
the necessary articles and keep it in a clean
area
Wear gloves To prevent cross infection
Clean the fingertip with alcohol swab To reduce risk of infection
Create stasis by pressing on the distal joint of
the finger to produce redness at the end of
finger.
Prick on the skin sharply and quickly with
lancet
Release pressure on the finger
Wipe of the 1st drop of blood
Place one drop of blood on the testing filter It allows time for absorption of blood by the
paper and wait for one minute. paper.
Apply gentle pressure over the puncture site
with dry cotton swabs until bleeding stops To aids in stopping the bleeding
Compare the testing paper with standardized To estimate the % of hemoglobin
color chart
Inform the person and family the result and
record it
Keep lancet in a puncture proof container and
carry it to health centre for proper disposal
Remove gloves
Wash hands
Replace the articles to bag

ESTIMATION OF HEMOGLOBIN AT HOME USING

HAEMOGLOBINOMETER (SAHLI METHOD)
Articles:

 Hemoglobinometer (Sahli hemoglobinometer)

 N/10 hydrochloric acid solution
 Filter
 Capillary pipette
 Hemoglobin meter tube
 Water pipette
 Stirrer
 Disposable lancet
 Alcohol swabs.
Procedure:

Procedure steps Rationale

Identify the client in need for hemoglobin To determine the appropriateness of the
estimation on at home procedure
Explain the procedure to be done to the To reduce the anxiety about the procedure
client and family members
Assemble all articles in a clean surface To facilitate safe performance of the
procedure
Do hand washing by following principles of To avoid contamination of articles
bag technique
Fill the graduated measuring tube up to To ensures accuracy in results
bottom graduation line (10% or 2g %) with
N/10 hydrochloric acid by using a dropper.
Clean fingertip with alcohol and a prick with To reduce risk of infection
a lancet
Wait for a drop of blood to form at the finger
tip.
Suck blood into capillary pipette precisely To ensures correct dilution and hence
up to the mark,wipe the pipette point (up to accurate results
20cumm mark of pipette), and blow the
blood into measuring tube.
While sucking blood into pipette care should If an air bubble enters remove and discard
be taken to prevent entry of air bubbles. This blood and make another drop of blood to
is done by not lifting the tip of pipetting. repipette
Achieve good mixture of liquid by repeated To ensures uniformity through out the
suction and blowing or using a stirrer. The mixture
mixture will be dark brown and clear after
about one minute.
Add water by means of a water pipette and mix with the glass stirrer until the colour of the
solution matches the color of the test rods.
Wipe the tip of pipette immediately transfer the 0.2ml of blood from the pipette into the
hemoglobinometer tube containing N/10 HCL by immersing tip of the pipette in the acid
solution and blowing out the acid solution.
Withdraw the pipette from the tube and make sure that no solution remains in pipette
Leave the solution in the tube in hemoglobinometer,for about 10 minutes ( for maximum
conversion of hemoglobin to acid hematin,which occurs in the first 10 minutes).
Note.after addition of every drop of distilled water,the solution should be mixed and the
color of the solution should be compared with the standard.
While matching, take care to hold stirrer above the level of the solution

But remember that at no stage should the strirrer by taken out of the tube.
Read the results in diffused day light exactly 3 minutes after adding blood to hydrochloric
acid
Record result in family folder
Normal Hb in blood expressed in gm per 100ml of blood
Male -14-17gm%
Female 12-16gm%

CONCLUSION

The hemoglobin is one of the type of globular protein present in the human blood (more
specifically in the RBCs). Hemoglobin is the major constituent of the red cell cytoplasm,
accounting for approximately 90% of the dry weight of the mature cell .Its concentration
in the blood tells us about many pathological conditions.
BIBLIOGRAPHY

1. Shincy George, “A Comprehensive Procedure Manual of Community Health

Nursing”, EMMESS Medical publishers, First Edition ,2015: 30-34.
2. Shyamala D Manivannan, “Procedure Manual Community Health Nursing” ,CBS
Publishers, First Edition,2016 : .

Internet

 https://www.slideshare.net/VarugheseGeorge/hemoglobin-estimation-70214533

 https://www.slideshare.net/SheniDIMT/hemoglobin-estimation-6726375

 https://www.slideshare.net/SheHej/hb-estimation
 MAR BASELIOS COLLEGE OF NURSING, BHOPAL

SUBJECT: COMMUNITY HEALTH NURSING

PROCEDURE
ON
HB ESTIMATION

SUBMITTED TO :- SUBMITTED BY
Mrs. Riya Joy Mrs MarietAbraham
Assistant Professor M.Sc. Nursing I Year
Date : 28/ 03 / 2019