A BRIEF INTRODUCTION TO PLATELETS / THROMBOCYTES
The Platelets, also known as Thrombocytes, are the Oval, Round or rod-like cells present in the blood that helps mainly in the clotting of blood. On an average, the size of the Platelets is 2 – 4 µm (microns). The mature Thrombocytes are non-nucleated cells with a minute granules present in the cytoplasm and there is no pigment present in Platelets. The Average lifespan of Platelets is 3-10 days. Normally about 150,000 – 450,000 cells are present per cubic millimeter (mm3) of blood.
Check out the Composition of Blood
THE AIM / PURPOSE OF PERFORMING TOTAL PLATELETS COUNT
The purpose of performing Total Platelets count is to know whether or not you are suffering from Thrombocytosis a.k.a. Thrombocythemia (i.e. the increase in the no. of Platelets or Thrombocytes to more than 700,000/mm3) or Thrombocytopenia a.k.a. Thrombopenia (i.e. the Decrease in the no. of Platelets / Thrombocytes to less than 50,000/mm3).
PRINCIPLE OF TOTAL PLATELET COUNT USING HEMOCYTOMETER
Very large numbers of Platelets/ Thrombocytes are present in the Blood Specimen. Practically, counting this amount of Platelets directly under the microscope is highly impossible. So, the Platelets / Thrombocytes are counted by using a special type of chamber, designed for the counting of blood cells in the specimen, known as Hemocytometer or Neubauer’s chamber.
For this, the blood specimen is diluted (usually in 1:20 ratio) with the help of Platelet diluting fluid (commonly the Rees – Ecker Fluid) which preserve and fix the Platelets / Thrombocytes and stains it. The Rees – Ecker fluid is isotonic to the Platelets / Thrombocytes and does not cause any damage to it whereas causes the lysis of red blood cells.
After diluting the specimen in appropriate dilutions, the content is charged on Hemocytometer / Neubauer’s chamber and the cells are counted in the areas specific for Platelets count.
The composition of Platelet diluting Fluid (Rees – Ecker Fluid)
COMPONENTS QUANTITY
Trisodium Citrate 3.8 gm
Brilliant Cresyl Blue 0.1 gm
40% Formalin 0.2 ml
Distilled Water 100 ml
The Final pH of the solution (at 25°C) varies from 6.8 – 7.0 which depends on the composition and companies who manufacture it.
Hemocytometer / Neubauer’s Chamber –
This is a special type of glass chamber that is used for the cell counting, especially for Blood cells. Nowadays, most commonly Improved Neubauer’s Chamber is used and in some laboratories, other types of chambers are also employed like Burkers chamber, Levy’s chamber and Fusch – Rosenthal chamber etc.
The Neubauer’s Chamber has ruled the area of total 9 square mm and the depth is 0.1 mm as when the coverslip is placed on the surface of the counting chamber, the space between the bottom of the cover glass and the base of grooved area measures 0.1 mm in depth.
The central 1 square is highly ruled which is divided into 25 squares. Each square of the Central Square is further subdivided into 16 small squares.
For Platelets Count, the cells are counted in the 5 squares of the Central square as 4 Corner squares of the Central square (divided into 25 squares) and 1 central square of the Larger Central Square (divided into 25 squares) which is same as for Red Blood Cells.
Each square of the Central Square (divided into 25 squares) contains 16 small squares so the total no. of the area to be counted for Total Platelet Count –
16 × 5 = 80 small squares
Two Method has been developed for the Manual Estimation of Total Platelets / Thrombocytes Count Using Hemocytometer / Neubauer’s chamber –
Microdilution Method
Macrodilution Method
Here, I’ll explain both the methods but the Microdilution method is not preferred nowadays due to the use of Mouth pipettes. So let’s start with Microdilution method and then we’ll move to Macrodilution method….
MICRODILUTION METHOD FOR THE ESTIMATION OF PLATELETS USING HEMOCYTOMETER
Materials Required for the Total Platelet Count by Microdilution Method
- Blood sample (Capillary blood or EDTA anticoagulated specimen)
- Platelet diluting fluid (preferably Rees – Ecker fluid)
- Gauze piece or Cotton
- WBC pipette
- Hemocytometer a.k.a. Neubauer’s Chamber
- Coverslip
- Microscope
A Brief Introduction to WBC Pipette
WBC pipette is a graduated pipette that gives the dilution of 1:20. It has two markings at the bottom as 0.5 and 1 and the top of the pipette is marked 11. It has a round shape bulb which contains the White bead to mix the blood specimen and the diluting fluid. On the top, a rubber tube is attached to the pipette for sucking the blood specimen and diluting fluid.
When blood is sucked up to 0.5 mark and the diluting fluid up to 11 marks, gives the 1:20 dilution of Blood: Diluting fluid and When the Blood is sucked up to 1 mark and the diluting fluid up to 11, gives the 1:10 dilution of Blood: Diluting fluid which less commonly used. After sucking the Specimen & Diluting fluid, the content is gently mixed by rotating the pipette on its long axis to ensure thorough mixing of blood and diluting fluid.
Note: Nowadays Mouth pipetting is banned in most of the laboratories due to the high risk of getting infected with highly contaminated specimens of the patients. So instead of Microdilution method, the Macrodilution methods are employed in Laboratories…..
Procedure of the Total Platelet Count by Microdilution Method
⇒ Fill the WBC pipette up to the 0.5 mark with the blood specimen and wipe out the pipette externally to avoid false high results.
⇒ Fill the same pipette with the Platelet diluting fluid (i.e. the Rees – Ecker Fluid) up to the mark 11.
⇒ Be cautious that there should be no air bubble in the pipette bulb.
⇒ Mix the Blood and Diluting fluid in the pipette by rotating the pipette (horizontally) between your palms.
⇒ Take out the Neubauer’s chamber / Hemocytometer from its case and clean it using a swab or gauze piece. Similarly, clean out the cover glass and place it over the grooved area of Hemocytometer.
Note: Here a special type of cover glass is used which is 0.4 mm thick with very smooth surface and even thickness so that the space between the grooved area of the chamber and cover glass is exactly 0.1 mm.
⇒ Now, put the WBC pipette, mix the solution present in it again and then discard 1-2 drops from the pipette before charging the chamber.
⇒ Gently press the rubber tube of the WBC pipette, so that the next drop of fluid is in hanging position.
⇒ Touch the Tip of the pipette with the hanging drop against the edge of the coverslip making an angle of 45° approximately.
⇒ Allow a small amount of fluid from the pipette to fill into the chamber which occurs by the Capillary action. Do not overcharge the chamber and there should be no air bubble in the Chamber.
⇒ After charging, Put the charged chamber in a moist condition for 10-15 min so that the cells settle down in the chamber without getting dried & then focus the chamber under the microscope to calculate Platelets.
MACRODILUTION METHOD FOR THE ESTIMATION OF PLATELETS USING HEMOCYTOMETER
Materials Required for the Total Platelet Count by Macrodilution Method
- Blood sample (Capillary blood or EDTA anticoagulated specimen)
- Platelet diluting fluid (preferably Rees – Ecker fluid)
- Hb pipette or Micropipette (0.02 ml or 20 µl)
- Hemocytometer / Neubauer’s Chamber
- Gauze piece or Cotton swab
- Graduated Pipette (5 ml)
- Test tubes
- Cover Slip
Procedure of the Total Platelet Count by Macrodilution Method
⇒ Take 3.98 ml of Platelet diluting fluid i.e. Rees – Ecker Fluid in a Clean, Dry and Grease free Test tube.
Note: If you don’t have variable pipette in the lab which can measure 3.98ml or 3980 µl of Diluting fluid then take 4 ml of Diluting fluid with the help of 5ml Graduated pipette in the test tube and discard 20 µl of fluid using a micropipette or WBC pipette.
⇒ Now add 0.02 ml or 20 µl of Blood Specimen (1:200 Dilution) to the tube containing diluting fluid with the help of micropipette or WBC pipette.
⇒ Mix well for few minutes and ready your Hemocytometer / Neubauer’s Chamber.
⇒ Take out the Neubauer’s chamber / Hemocytometer from its case and clean it using a swab or gauze piece. Similarly, clean out the cover glass and place it over the grooved area of Hemocytometer.
Note: Here a special type of cover glass is used which is 0.4 mm thick with very smooth surface and even thickness so that the space between the grooved area of the chamber and cover glass is exactly 0.1 mm.
⇒ Now, take out the WBC pipette and fill it with the Diluted Specimen, mix the solution well and then discard 1-2 drops from the pipette before charging the chamber.
⇒ Gently press the rubber tube of the WBC pipette, so that the next drop of fluid is in hanging position.
⇒ Touch the Tip of the pipette with the hanging drop against the edge of the coverslip making an angle of 45° approximately.
⇒ Allow a small amount of fluid from the pipette to fill into the chamber which occurs by the Capillary action. Do not overcharge the chamber and there should be no air bubble in the Chamber.
Using Micropipette instead of WBC pipette for charging the Hemocytometer
⇒ You can also use a micropipette instead of WBC pipette for charging the Hemocytometer. So, with a micropipette, carefully draw up around 20 µl of the diluted specimen. Press the knob of the pipette to make a hanging drop at the tip of the micropipette.
⇒ Now gently place the pipette tip against the edge of the cover glass and if required slowly expel the more liquid until the counting chamber is full. This process occurs by Capillary action, but care should be taken not to overfill the chamber. A volume of 10ml is sufficient to fill out the one counting chamber.
⇒ After charging, Put the charged chamber in a moist condition for 10-15 min so that the cells settle down in the chamber without getting dried & then focus the chamber under the microscope to calculate Platelets.
COUNTING THE PLATELETS / THROMBOCYTES UNDER THE MICROSCOPE
⇒ Focus the ruling using the 10x Objective lens and then Count the Platelets in 5 small squares of the central square as described above, using the 40x Objective lens.
⇒ Count the cells which are lying on the right and lower lines of the 5 small squares but not the opposite line. In case of marginal cells, count the cells on ‘L’ line that is either on Right and Lower lines or Left and Upper lines.
CALCULATIONS FOR THE TOTAL PLATELET COUNT USING HEMOCYTOMETER
⇒ After counting the cells under the microscope, we know the No. of Platelets in 5 squares of the central square. Let’s consider it as ‘N’ no. of cells.
⇒ Now, the volume of the fluid inside the chamber is the product of Area and depth of the Hemocytometer / Neubauer’s chamber.
⇒ The central area is the 1 sq. mm which is divided into 25 parts so the area is
25 squares = 1 sq. mm
⇒ Out of these 25 squares, the Platelets are counted in 5 squares. So the Area of 5 small squares is
5/25 i.e. 1/5
⇒ The depth of the Hemocytometer is 0.1 mm as described above in a short description of Hemocytometer.
Now Apply the Following formula to get the Total Platelets Count –
Total Platelets Count = N × Dilution / Area × Depth
N × 20 / (1/5 × 0.1)
Total Platelet count = N × 1000 / mm3
Using the Above formula we can calculate the Total No. of Platelets / Thrombocytes present in the Blood Specimen.
NORMAL VALUES OF PLATELETS / THROMBOCYTES
Normally about 150,000 to 450,000 platelets are present in Healthy individuals. These Values show variations in various physiological and Pathological Conditions.
PRECAUTIONS TO BE TAKEN WHILE PERFORMING TOTAL PLATELET COUNT BY HEMOCYTOMETER
⇒ Use of Mouth pipettes (WBC pipette) is banned in many countries. However, in case you have to use it, be cautious that you should not intake the diluting fluid or Specimen.
⇒ Accurately measure the amount of specimen and Diluting Fluid to avoid any error in the results.
⇒ In case you are performing this test by Microdilution method, mix the specimen and diluting fluid appropriately by gently rotating in between your palms.
⇒ Carefully charge the Hemocytometer or Neubauer’s chamber that it should not be overcharged and do not contain any air bubble in it.
Check out the Total RBC Count Using Hemocytometer
Check out the Total Leucocyte Count Using Hemocytometer
Hi, I’m the Founder and Developer of Paramedics World, a blog truly devoted to Paramedics. I am a Medical Lab Tech, a Web Developer and Bibliophiliac. My greatest hobby is to teach and motivate other peoples to do whatever they wanna do in life.
Best explanation ever. I have been searching for this topic for two days. And this is the best answer i got. Thank you paramedicsworld.
Hi, thanks for the nice presentation 😉
Btw I came across a little typo in the macro dilution paragraph : 20 µL in 3.98 mL isn’t a 1:20 dilution rather a 1:200. This is not consistent with the micro dilution paragraph where the 1:20 ratio is clearly mentioned.
So which ratio do you use when you count platelets ?
Well, it is clearly mentioned that 1:20 dilutions are used in Micro method and 1:200 dilution in Macro method.
Why dont we use the RBC pipette instead
Because for platlet count we usually dilute it in 1:20 ratio, but with the help of rbc pipette we can dilute in 1:100 or 1:200 ratio only.
what is the difference between platelet diluting fluid and platelet counting fluid
Highly educating and lavishly helpful.