Platelet Clumps in Citrate Tube

Dear Fritsma Factor, I am a hematopathology fellow evaluating the following patient for thrombocytopenia. History and laboratory results are listed in detail below. We have encountered a situation where the patient develops platelet clumps within citrate tubes but not in EDTA. I have found only limited information regarding this phenomenon and was wondering if anyone […]

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Bleeding Disorders

Nov 13 2016

george

ASCLS Region III Triennial

Please join us this week in Birmingham, Alabama for the ASCLS Region III Trienniel conference at the University of Alabama at Birmingham. There are many excellent presentations in the area of hemostasis, transfusion management, and diagnostic errors. Click or tap here for complete information. George presents “Improving Acute Care with Coagulation Mixing Studies” on Thursday, November […]

Events

D-dimer Interference

With reference to our September 8, 2016 discussion entitled Still More on Xarelto and D-dimer, attached is information on another individual with whom I have been corresponding for several months whose D-dimer remains moderately to markedly elevated but whose lab results have demonstrated there is no human anti-mouse antibody or rheumatoid factor present. This person, […]

Fibrinolysis

Specimens with Hematocrit >55% Reprise

On September 12, 2016, Michelle Fahs MT (ASCP) asked about how to prepare tubes with the proper volume of anticoagulant for people whose hematocrit exceeds 55%. Here is a question from Sandy Odegaard asking about the correction formula’s derivation: Hi George, BD could not explain where the conversion factor for calculating the appropriate sodium citrate […]

Specimen Management

Whole Blood PTs

From: Brancaccio Mauro, ICD-Partners, Italy. Is it possible and correct to do the PT on the sangueblood? Hello, Bancaccio Mauro. If I translate correctly, I will take sangueblood to mean whole blood (with thanks to Dave McGlasson for his assistance). Yes, the PT has been established as a whole blood assay using point of care […]

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Anticoagulant Therapy

Oct 22 2016

george

Correction Factor for ACD Solution

On September 28, 2016, Julia Hill asked, “Is there a standard calculation for using ACD tubes?” Her comment was appended to a 2009 entry describing HELLP syndrome, so it may have been buried deep in our database. George assumes Julia’s question relates to platelet satellitosis, which results from the action of an immunoglobulin potentiated in […]

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Platelet Function Testing

Oct 6 2016

george

Acceptable Coagulation Test Specimens

From Lauren Ball: Do you suggest that most labs use a 4 hour rule for specimen acceptability? We offer PT, PTT, fibrinogen, D-dimer, and anti-Xa tests. PTTs and Anti-Xa tests may need to be performed within 2 hours but the manufacturer’s guidelines suggest that a specimen is good for up to 8 hours for tests […]

Specimen Management

Platelet Counts from Citrate Tubes

Here is some correspondence between Estelle Ninnemann at ACL Laboratories, and Dennis Ernst, at the Center for Phlebotomy Education, Inc. From Estelle, “In our laboratory, phlebotomists collect sodium citrate (blue top) tubes when a patient is known to have a history of platelet clumping. The sample is collected and sent with the lavender top tube […]

Specimen Management

Heparin and Cell-free DNA

Here’s a challenging question from the ASCLS Consumer web forum: “I’m currently on 40 mg of Lovenox daily during my pregnancy. Can that alter the cell-free DNA test in any way? I take my meds at 10 every morning, should i take the blood test after my shot is due? I’m getting different answers from […]

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Anticoagulant Therapy

Sep 30 2016

george

Whole Blood PTTs

From Kirk Guyer, Cascade Technologies: There are whole blood PTT (APTT) assays and there are citrated platelet poor plasma (PPP) PTT assays. What happens in a PPP PTT assay if there are platelets present? Does the PTT result shorten? Can platelets shorten the PTT result in a whole blood PTT assay? I ran a PTT […]

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Bleeding Disorders

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Platelet Clumps in Citrate Tube

ASCLS Region III Triennial

D-dimer Interference

Specimens with Hematocrit >55% Reprise

Whole Blood PTs

Correction Factor for ACD Solution

Acceptable Coagulation Test Specimens

Platelet Counts from Citrate Tubes

Heparin and Cell-free DNA

Whole Blood PTTs

George Fritsma MS MLS

Cheat Sheets from George

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