Hemoglobin derivatives is a blood test to detect and measure the percentage of abnormal hemoglobin derivatives that result from drugs such as nitroglycerin, or from poisoning by carbon monoxide.

Blood is drawn from a vein, usually on the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and an elastic band is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the band to fill with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

The samples are then sent to the lab where the percentage of total hemoglobin vs. derivatives is evaluated.

If your child is to have this test performed, it may be helpful to explain how the test will feel, and even demonstrate on a doll. Explain the reason for the test. Knowing the "how and why" may reduce the anxiety your child feels.

When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.

Hemoglobin is the substance in red blood cells that transports oxygen and carbon dioxide between the lungs and body tissues.

If certain chemicals or drugs are introduced into the blood stream, they can alter the hemoglobin so it no longer functions as a transport medium. Measuring abnormal hemoglobins can be helpful in diagnosing and monitoring exposure to these agents.

Carboxyhemoglobin is hemoglobin bound to carbon monoxide instead of oxygen or carbon dioxide. Carbon monoxide has a much higher affinity for hemoglobin than does oxygen (210 times more), and high percentages of carboxyhemoglobin in the blood impairs the normal transport of oxygen by the blood.

Sulfhemoglobin results from the union of hemoglobin with medications such as phenacetin or sulfonamides. This form of hemoglobin is unable to transport oxygen, and this condition is untreatable. The only solution is to wait until the affected red blood cells are destroyed as part of their normal life cycle.

Methemoglobin occurs when the iron that is part of hemoglobin is altered so that it does not carry oxygen well. Certain compounds introduced into the blood stream can cause this problem:

• Sulfonamides
• Chlorates
• Nitrates
• Nitrites
• Aniline
• Phenacetin

There is also a congenital form of this disorder caused by a deficiency of NADH cytochrome b5 reductase, and another form caused by hemoglobin M disease.