Peripheral smear
Alternative names:
blood smear; differential stain
How the test is performed:
Adult or child: Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
Infant or young child (may also be used for adults): The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.
The blood is examined under a microscope. It may be examined by a special automated "calculator", a technologist, and/or a pathologist. Information is obtained about the relative number of white blood cells (differential), morphological (shape) abnormalities of all types of blood cells, and a rough estimate of white cell and platelet counts.
How to prepare for the test:
Adults: No special preparation is necessary.
Infants and children: The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
When 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.
Why the test is performed:
This test may be performed as part of a general health examination, to help in the diagnosis of many illnesses, or when an abnormality of any type of blood cell is suspected.
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