HEMOGLOBIN TEST – FILTER PAPER [TALLQUIST] METHOD

Definition: Hemoglobin (Hb) – is the Red pigment in RBC and

Estimating the level of hemoglobin in blood by using hemoglobin testing paper
(Tallquist).
Hemoglobin test is defined as estimation of hemoglobin level in blood using
Tallquist method.

Principle :
1. The color of the blood corresponds to the amount of hemoglobin present.
2. The color chart has been developed to represent the color range of normal to
anemic blood on filter paper.
3. The degree of anemia can be visually assessed by matching the color of a
drop of blood on filter paper against a standardized color chart.

Test Characteristics:
Appropriate settings
Space requirements
Amount of blood sample
Preparation / processing time
Sample / test stability
: Most useful for screening in rural settings
: Well-lighted environment
: One drop of capillary blood
: 5 minutes
: 10 minutes

Purpose:
* To determine the amount of hemoglobin in blood.
* To monitor hemoglobin level for patients on treatment for anemia.
* To determine the level of hemoglobin in clients prone to anemia’s,
e.g., pregnant women and lactating mothers.

Needed Articles :
Equipments / Articles Purpose
 Tallquist paper (Filter That allows absorption and rapid drying of
paper) / Blotting paper blood drop.

 Hemoglobin scale That represents ranges of hemoglobin levels

(Dr.Tallquist scale) in standardized color comparison chart.

 Sterile lancet / Disposable

needle size – 28 or 30 gauge To obtain the sample (peripheral blood
sample)
 Alcohol swabs/ spirited
cotton swabs To get the sterile sample / To clean the
puncture site
  Paper bag

 Paper and pen To discard the waste properly

To record the findings

Pre procedure activity:

1. Explain the procedure to client and the family members.
2. Remove hand washing articles from the outer pocket and
3. Assemble the required articles in the working area.
4. Partially close the bag and
5. Do hand washing according to the steps.

Procedure:

Nursing actions Rational

1. Ask the client to be in
comfortable position (sitting / To make him / her comfortable
lying).

2. Clean thoroughly the middle Finger tips are highly vascular & proper
finger tip(preferably) with 70% cleaning reduces the risk of infection.
alcohol / spirit and allow to dry .

3. Obtain a drop of blood by To obtain the sample

pricking the finger tip with a
sterile lancet/ needle.

4. Wipe away the first drop of

To get the appropriate or most closely
blood with dry cotton ball.
result of the test.

5. Place a drop of blood on the It allows time for absorption of blood by

testing paper & wait for 30 the paper.
seconds.

6. Apply pressure over puncture site To stop the bleeding

with cotton ball until bleeding
stops.
 7. When the blood spot is no longer To get the result properly
shiny, hold the filter paper behind
the standardized chart so that the
blood spot is visible through the
hole in the chart. After the blood
is dropped onto the filter paper,
the reading must be performed
within 10 to 15 seconds.

8. Find the color on the chart that

Helps to ascertain the percentage of the
most closely matches the color of
hemoglobin.
the blood on the filter paper and
record the result. If the color of
the blood spot falls in between the
colors on the chart, use the lower
reading as the result.

9. Result interpretation :

10.Inform the client and record the Assure the client with result & help to
result in the family card. follow up care.

11. Clean & replace the articles and For appropriate disposal.
place the used lancet in a
puncture proof container & carry
it to health centre.

After care:
1. Record the reading and explain the result to the client and the family
members.
2. Do hand washing and replace the articles.
3. Give the used paper bag to the family member and ask them to burn it.

Suggestions for improving Test performance:

 Use only the filter paper provided with the chart. Other papers, such as
newsprint paper, will give inaccurate readings because they are not
calibrated with the chart.
  Filter paper that has become discolored or has developed brown spots
should not be used.
 Natural, direct lighting conditions are important for consistent color
matching.
 The color chart will be more durable if it is laminated (sealed in a plastic
covering).
 Observation of the client’s condition (clinical signs) will provide additional
information to help determine whether or not anemia is present.

Maintenance and storage:

 Do not leave the color charts in the sun for extended periods of time as they
may fade.
 Do not leave filter paper in the sun or in high humidity because the heat and
humidity will damage them.
 Store color charts and filter paper at room temperature (340 C).

Advantages:
1. Inexpensive
2. Rapid
3. Simple
4. No reagents required
5. Not require lysis or dilution of blood.
6. Portable
7. Electricity not required
8. Filter paper and color chart are durable if properly maintained and stored.

Disadvantages:
1. The chart is supplied with a limited quantity of filter paper. Other types of
paper cannot be substituted because they are not calibrated with the chart.
2. The scale may become contaminated with blood over time.
3. Lighting conditions influence interpretation of the result.
4. Size and thickness of blood spot, temperature and humidity all affect drying
time, which in turn affects color (result).