Canadian Society for Medical Laboratory Science (CSMLS) Practice Exam

What should be done if small clots are seen when making a blood smear?

1. Make the smear and note the slide that clots are present

2. Mix the blood specimens for one hour and then make the smear

3. Request a new specimen before doing the blood work

4. Add more anticoagulant to the blood tube, and then make the blood smear

The correct answer is: Request a new specimen before doing the blood work

When small clots are observed while making a blood smear, requesting a new specimen is advisable because the presence of clots can lead to inaccurate results in the analysis. Clots can interfere with the proper distribution of cells across the slide, making it difficult to obtain a representative sample for microscopic examination. This can ultimately affect the interpretation of blood cell morphology, potentially leading to misdiagnoses or missed abnormalities. In clinical practice, quality and accuracy of results are paramount. A fresh specimen ensures that the blood remains in a state suitable for creating a proper film and obtaining reliable data. When clots are present in the specimen, it is often indicative of either an issue with the blood collection or improper sample handling, thus warranting a new sample to eliminate any uncertainties associated with the current one. Other approaches, like making the smear and noting the presence of clots or mixing the specimen beforehand, may not resolve the underlying problem of the clots affecting the smear quality. Moreover, adding more anticoagulant is typically not a recommended practice as it does not guarantee that prior clotting will not affect the sample and could lead to potential dilution or alterations in cell counts.