Module 12

Cardiovascular Physiology:
Coagulation and Bleeding Time

At the end of this module, you are expected to:

1. Determine the coagulation time of blood by the slide method and by the capillary
tube method
2. Determine the bleeding time of blood

Introduction

The effectiveness of blood function depends on its circulation within a closed

system of vessels. The vessels might open because of disease or accident, and blood
loss can be prevented or minimized by hemostasis. Hemostasis is the mechanism that
leads to the cessation of bleeding from a blood vessel. The hemostatic process is
made up of complex series of biochemical reactions.

Materials

Lancets
Sterile cotton
70% alcohol
filter papers
glass slide
pins
capillary tube
Methods

A. Coagulation Time- Slide Method

1. Clean the finger with 70% alcohol and allow it to dry.

2. Puncture the fingertip with a sterile lancet. Do not use the first drop of blood since
it clots abnormally fast.
3. Note the time that the drop of blood to be used first appears at the finger
puncture. This time is used as the beginning of the experiment.
4. Place the drop of blood on a glass slide.
5. At ½ minute intervals slowly draw a straight pin through the blood and observe
the point of the pin.
6. Repeat step 5 until fine red threads can be detected on one end of the pin. This s
the endpoint. Sometimes the entire mass forms a gel, which is also considered
the endpoint.
7. The time the second drop of blood appears until the appearance of the first
thread is the coagulation time. Using this method of determination, the normal
range of coagulation time is from two to eight minutes.

B. Coagulation Time- Capillary Tube Method

1. Use the method in procedure A for obtaining the drop of blood to be used. The
drop of blood must be large.
2. Note the time the drop of blood to be used appears. This is used as the
beginning of the experiment.
3. Place one end of the capillary tube into the drop of blood (keep the other end of
the tube open). Hold the tube horizontally (do not let the tip touch the skin) and
allow the tube to fill by capillarity.
4. After exactly one minute (use a longer period of time if the blood took a long
period to coagulate in the slide method), carefully break off a small piece (about
 1 cm) of the capillary tube and determine whether a thread of coagulated blood is
visible between two pieces of tubing.
5. Repeat step 4 every 30 seconds until such a thread is obtained.

C. Bleeding Time

1. Puncture the finger as directed earlier. Secure a free flow of blood so that the first
drop on the filter paper will be one centimeter or more in diameter.
2. Note the time of appearance of the first drop of blood. Blot the blood with filter
paper every30 second until the bleeding stops.
3. Divide the total number of drops on the filter paper by two. This gives the
bleeding time in minutes.

Results

a. Record your results in the following data chart

Test Time Normal Range

Coagulation time-slide 6 minutes 2-8 minutes
Coagulation time- capillary 5 minutes 2-8 minutes
tube
Bleeding time 4 minutes 1-8 minutes

b. In the following table, indicate the function each substance performs in the
coagulation of blood.
Substance Function
Fibrinogen Fibrinogen is changed into fibrin, the
structural component of blood clots,
during the coagulation process. These
fibrin strands intertwine to create a
 mesh that holds plasma, platelets, and
blood cells in place until a stable blood
clot is formed.
Prothrombin The liver produces prothrombin, a
precursor protein that must be
activated in order to become thrombin,
an essential enzyme in the coagulation
cascade. Thrombin is a multifunctional
protein that contributes to coagulation
by promoting platelet aggregation,
activating other clotting factors, and
converting fibrinogen to fibrin.
Thromboplastin Factor VII is activated by
thromboplastin in conjunction with
calcium ions. This sets off a series of
enzymatic processes that result in the
production of thrombin from
prothrombin.
Calcium These are essential for the activation of
factors II (prothrombin), VII, IX, and X.
The binding of these substances to
phospholipid membranes of active
platelets or injured endothelial cells is
stabilized by calcium ions.

Discussion

1. Name and discuss two diseases or conditions in which coagulation time is

lengthened?
a. Liver Diseases - The liver is in charge of producing many of the proteins involved in
the blood clotting cascade, including fibrinogen and other clotting factors. When the liver
is injured or malfunctioning, it may produce insufficient amounts of these clotting
components, leading to longer coagulation times.
b, Hemophilia - is a genetic disorder marked by a lack or shortage of specific blood
clotting factors, especially Factor VIII (hemophilia A) or Factor IX (hemophilia B). Even
slight injuries can cause prolonged bleeding because the blood cannot clot correctly in
the absence of sufficient amounts of these clotting components. Hemophiliacs
sometimes have longer coagulation times because their blood doesn't contain the
elements needed to form stable clots.
2. How can the blood clotting time be shortened?
Giving the inadequate clotting factor might assist reduce the clotting time in
diseases like hemophilia or other clotting factor deficits. Usually, intravenous infusion of
concentrated clotting factor preparations is used to accomplish this( Clotting Factor
Replacement for Hemophilia, n.d.).
3. What is meant by coagulation?
The process that occurs when a clot forms. Since the creation of a clot is the
second step in stopping blood loss from a burst vessel, it is frequently referred to as
secondary hemostasis.

References

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%2Dclotting%20protein%20is%20available.

Toppr. (2022, September 5). What is the of thromboplastin- Explain-. Toppr Ask.

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Kandola, A. (2021, October 27). What to know about coagulation disorders.

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%20most%20common%20types%20are,%2C%20a%20blood%2Dclotting

%20protein.

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 Northwest, Ethiopia, 2022. Thrombosis Journal, 21(1).

https://doi.org/10.1186/s12959-023-00479-2

Clotting factor replacement for hemophilia. (n.d.).

https://myhealth.alberta.ca/Health/pages/conditions.aspx?

hwid=hw190139#:~:text=Clotting%20factors%20are%20replaced%20by,bleeding

%20episodes%20or%20prevent%20bleeding.

The Editors of Encyclopaedia Britannica. (2024, April 9). Coagulation | Definition,

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https://www.britannica.com/science/coagulation-of-blood#:~:text=coagulation

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Video References:
https://www.youtube.com/watch?v=digVjlk9VkY
https://www.youtube.com/watch?v=udo14VStFoc