Module HEME-06 · Version 1.0
Histograms, Scattergrams, and Analyzer Flags
Use declared Sysmex XN-series WDF/WNR and impedance evidence with CBC results, specimen inspection, and labeled smear review to make a validated local laboratory decision.
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Who this module is for
Medical laboratory scientists and hematology staff who review automated complete blood count results.
Learning objectives
- Declare the impedance, WDF, and WNR measurement paths and determine whether WNR has already provided an NRBC-corrected WBC.
- Use distribution, scattergram, specimen, and labeled smear evidence to trace RBC/platelet and photometric interference pathways.
- Apply a validated local rule to document a bounded release, repeat/alternate measurement, recollection, or escalation outcome without diagnosing from a plot or flag.
How completion works
Mark every required section done and answer every knowledge check in those sections correctly. The final save completes the module automatically.
Sources
10 sources
1. International Council for Standardization in Haematology. ICSH guidelines for the evaluation of blood cell analysers including those used for differential leucocyte and reticulocyte counting. Int J Lab Hematol. 2014;36(6):613-627.
Source note · consensus standard
2. Clinical and Laboratory Standards Institute. Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods. CLSI document H20, 3rd ed. 2026.
Source note · consensus standard
3. Centers for Medicare & Medicaid Services. State Operations Manual Appendix C: Survey Procedures and Interpretive Guidelines for Laboratories, including 42 CFR 493.1281 and 493.1289.
Source note · federal guidance
4. Sysmex Corporation. Fluorescence Flow Cytometry: WBC Differential Channel and XN-Series eBook.
Source note · manufacturer labeling
5. Gulati G, Uppal G, Gong J. Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution. Ann Lab Med. 2022;42(5):515-530.
Source note · peer-reviewed literature
6. College of American Pathologists. Hematology and Coagulation Checklist sample edition, items on WBC differential verification, blood film review, and RBC/PLT morphology.
Source note · accreditation standard
7. International Consensus Group for Hematology. Consensus Guidelines: Suggested Criteria for Action Following Automated CBC and WBC Differential Analysis.
Source note · consensus standard
8. Spectrum of Changes in RBC Indices and Histograms in Blood from Subjects with Cold Antibodies. PMID: 5198334.
Source note · peer-reviewed literature
9. U.S. Food and Drug Administration. 510(k) Premarket Notification K112605, Sysmex XN-Series Automated Hematology Analyzer configurations and XN-Series flagging/platelet application materials.
Source note · manufacturer labeling
10. Sysmex America. XN-L Series Flagging Guide and More Than Just a CBC: NRBC with Every Result.
Source note · manufacturer labeling