September QQ: DOAC Assay

Our September, 2017 Quick Question asks, How do you assay for direct oral anti-Xa antithrombotics such as rivaroxaban? The question, provided by friend and colleague, Dave McGlasson, also applies to apixaban, betrixaban, and edoxaban, all FDA-approved oral anti-Xa antithrombotics. What has never been approved is the chromogenic anti-Xa assay, despite release of calibrators and controls […]

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Anticoagulant Therapy

Aug 29 2017

george

August Quick Question: Fibrinolysis

Here are the results of our August, 2017 Quick Question with 68 total votes: How do you test for fibrinolysis? a. TEG or TEM: 9 (13%) b. D-dimer: 36 (53%) c. Plasminogen: 0 (0%) d. PAI-1: 1 (1%) e. D-dimer plus plasminogen: 10 (15%) f. D-dimer, plasminogen, and PAI-1: 6 (9%) f. We don’t test […]

Fibrinolysis

POC and Plasma-based PTs

From Jake Fray, MLS, Denver Health POC Coordinator via Joan Polancic, MLS, Denver Health School of Medical Laboratory Science. We are having major issues with our point of care Coaguchek devices not correlating with our main lab Stago results.The pharmacists that use the Coagucheks for their outpatient anti-coag testing are getting pretty upset that there […]

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Anticoagulant Therapy

Aug 20 2017

george

Hemostasis and Thrombosis Textbook

Congratulations to Drs. Emmanuel Favaloro and Guiseppe Lippi for their 2017 Humana Press publication, “Hemostasis and Thrombosis: Methods and Protocols.” Among other attributes, the text is a practical manual that provides laboratory assay principles and detailed protocols. George is proud to have collaborated with friend and colleague David L. McGlasson, San Antonio, on Chapter 26: […]

Events

RiaSTAP

Although the FDA approved CSL-Behring’s RiaSTAP, human plasma-derived fibrinogen concentrate in 2009, it seems most facilities continue to use cryoprecipitate to treat hypofibinogenemia, dysfibrinogenemia, and afibrinogenemia. Has your institution switched to RiaSTAP? Why, or why not? For the answer, see this reference provided by George’s UAB colleague, pathologist Lawrence A. Williams III: “After adjusting for […]

Bleeding Disorders

Medical Decision Points

Odetta Hanna from Sekisui Diagnostics asked, “Do you have a good resource to obtain the medical decision points for coagulation assays?” From George, yes, the text I find most helpful for clinical decision-making is Kitchens CS, Kessler CM, Konkie BA. Consultative Hemostasis and Thrombosis, Third Edition, 2013, Elsevier, Philadelphia. Also, if you pardon the self-promotion, […]

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Global Hemostasis Assays

Aug 12 2017

george

VWF Reference Interval

From Sharon Johnson, Sysmex America: Hi George: I was recently asked if guidelines or clinical recommendations had changed for VWF normal ranges based on blood group. In CLSI Guideline H-51A. 2002, it suggests laboratories establish their own reference ranges for VWF for “O” and “Non-O” blood groups, as patients with group “O” typically have much […]

Bleeding Disorders

Hemolysis and Heparin Assay

Frequent contributor Dave McGlasson called from the American Society for Clinical Laboratory Science annual meeting venue in San Diego. He has just heard this question from a colleague. “Can you use the chromogenic anti-Xa heparin assay when the specimen is hemolyzed or icteric?” Her concern arose from cases in which patients had been treated with […]

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Anticoagulant Therapy

Jul 29 2017

george

ASH Guidelines for Comment

The American Society for Hematology invites public comment on their Guidelines for VTE in Pediatric Patients and Guidelines for VTE in Non-Surgical Patients. Click or tap here if you would like to review or comment.

Thrombophilia

QQ for 7-17: Specimen Storage

Our July, 2017 Quick Question was, “How do you store plasma specimens when coagulation testing is delayed to beyond 48 hours?“ We totaled 86 responses, and here are the results: Controlled refrigerator at 1–6°C 9% (8) Controlled freezer at –20°C 33% (28) Household freezer at ~ –20°C 3% (3) Controlled freezer at –70°C 55% (47) […]

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Quick Question Archive

All Posts

September QQ: DOAC Assay

August Quick Question: Fibrinolysis

POC and Plasma-based PTs

Hemostasis and Thrombosis Textbook

RiaSTAP

Medical Decision Points

VWF Reference Interval

Hemolysis and Heparin Assay

ASH Guidelines for Comment

QQ for 7-17: Specimen Storage

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question