HEMOGLOBIN ESTIMATION – Instructions (MATERNAL AND CHILD HEALTH NURSING)
Estimation of the level of hemoglobin (HB) is essential for the following
- To check for the presence of anemia and, if present, to what degree
- For the further management, prevention and/or treatment of anemia, in so far as the administration of IFA tablets is concerned. If the anemia is severe, the woman may need referral for taking injectable iron preparations or undergo a blood transfusion
- For the diagnosis of postpartum hemorrhage (PPH) in an anemic women, in whom a smaller amount of blood loss is taken as PPH
Estimate the Hb levels of pregnant women at the initial antenatal visit and again at 28 weeks. The initial Hb level will serve as a baseline to compare with the later results at 28-30 weeks. An Hb level below 11 g/dL at any time in pregnancy is considered to be anemia; an Hb level of 7-11 g/dL as moderate anemia, and less than 7 g/dL as severe anemia
If the woman is found to be anemic, start her on the therapeutic dose of. Estimate the Hb level again after 1 month. If there is no rise in the Hb level, refer the woman to a higher facility with a good laboratory infrastructure and trained personnel to find out the cause of anemia
How to measure hemoglobin: the level of hemoglobin is estimated by using a World Health Organization (WHO) – approved
Hemoglobin color scale: the hemoglobin color scale is a simple, reliable and inexpensive tool developed by WHO to screen for anemia in the absence of laboratory-based hemoglobinometry
The hemoglobin color scale comprises a small card with six shades of red that represent the Hb levels of 4, 6, 8, 10, 12 and 14 g/dL. The device is simple to use
FOLLOW THESE INSTRUCTIONS WHILE USING THE SCALE
- Use only approved test strips
- Add a drop of blood to one end of the test strip, just enough to cover an aperture in the color scale
- Wait for about 30 seconds; then immediately read by comparing the blood stain with the color scale to find the best color match
- If the bloodstain matches one of the shades of red exactly, record the Hb value. If the color lies between two shades, record the mid-value. If in doubt between two shades, record the lower value
- Discard the test strip after use. Wipe the back surface of the scale at the end of each session, or if it becomes soiled during use
