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The test can be performed manually by staining the blood with new methylene blue and counting the percentage of red blood cells containing RNA under the microscope. The reticulocyte count is expressed as an absolute number or as a percentage of red blood cells.
The automated instruments count 32,000 white blood cells and statistically provide a more accurate differential count than a manual differential. All differentials will be analyzed on the instrument first. If the results fail the screening criteria, a manual differential will be performed.
In a manual differential, a stained blood smear is examined under a microscope and white blood cells are counted and classified based on their appearance. A manual differential is usually performed when the automated differential is flagged for review or when the healthcare provider requests it.
To determine the differential, a drop of blood is thinly spread over a glass slide, air dried, and stained with a Romanofsky stain, most commonly the Wright or May-Grunewald-Giemsa technique. Two hundred cells are then counted and classified.
In a manual differential, a stained blood smear is examined under a microscope and white blood cells are counted and classified based on their appearance. A manual differential is usually performed when the automated differential is flagged for review or when the healthcare provider requests it.
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Manual WBC counting It involves diluting blood with a Unopette system that contains a diluent that lyses the red cells to remove them from view. A hemocytometer is charged with the diluted blood, and nuclei are counted in the appropriate areas of the grid using a light microscope.

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