Using the PTT After Cardiac Catheterization

This question was forwarded by an American Society for Clinical Laboratory Science Consumer Web Forum volunteer: Our hospital currently uses activated clotting time (ACT) results during heart catheterizations to monitor heparin dosage. The ACT is also used as a guide for pulling the sheath. The nurse confirms that the ACT is less than a certain […]

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Anticoagulant Therapy

Apr 8 2014

george

THSNA Thu-Sat

Please join our sponsor Precision BioLogic Inc at Booth 106 in the Thrombosis and Hemostasis Summit of North America Biennial meeting this week, Thursday, April 10–Saturday, April 12, 2014 at the Chicago Sheraton. While there, please plan to visit our posters, McGlasson DL, Fritsma GA, #53: Do We Need To Normalize the Dilute Russell Viper Venom Time Screen/Confirm Ratio?, Thursday, […]

Events

Hyperglycemia and Prolonged PTT

From “BJ:” I recently cared for a 60 yr old type 2 diabetic in hyperglycemic hyperosmolar state. Initial serum glucose 960. The partial thromboplastin time (PTT) was initially 78 seconds without clear reason. The international normalized ratio (INR) was 1.4. The prothrombin time (PT) was not initially checked. I felt that the value was likely […]

Screening Assays

Specimen Management

From Joanna Carroll: I was recently told that samples should be double spun prior to long term freezing. Except in the case of heparin testing, I cannot find any evidence to support this. Also can you tell me if there are recommendations on how to handle samples for fibrinogen, D-dimer and unfractionated heparin anti-Xa assays? Our […]

Specimen Management

Inpatient Thrombophilia Testing

Another message from colleague and friend Kelly Townsend, Tricore Reference Laboratories, Albuquerque. Hi George, at one of our large teaching hospitals, we are working with the Internal Medicine department to establish “best practices” for ordering thrombophilia testing on inpatients. Has anyone out there successfully implemented guidelines they are willing to share? Any recent references would also be […]

Thrombophilia

Revalidating Sta-Clot LA

From Rose Markarian, Supervisor Hematology, Saint John’s Health Center, Santa Monica, CA: Hi George, We perform Stago’s confirmatory hexagonal phase Sta-Clot LA test for lupus inhibitor testing. We validated Stago’s recommended cut off value of ≤ 8.0 seconds several years ago when the test was implemented. Do we have to validate the cut off value with each new lot […]

Lupus Anticoagulant

Platelet Clumping

From Kelly Townsend at Tricore Labs: We have a patient whose platelets clump in every anticoagulant we’ve tried. He has normal prothrombin time, partial thromboplastin time, fibrinogen, and von Willebrand disease panel results, but oozes after even minor procedures. The clinicians want to evaluate platelet function, but we are hesitant because of his platelet clumping. Any suggestions for […]

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Platelet Function Testing

Mar 29 2014

george

How Long to Stop Infusion

From Kim Kinney at Indiana University Health: Hi George. We frequently get asked how long to stop an unfractionated heparin infusion before drawing for a partial thromboplastin time (PTT) from a central line or peripheral stick above the infusion site. We have always referred them to pharmacy. is there a standard practice used by nursing at other institutions […]

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Anticoagulant Therapy

Mar 28 2014

george

Discard Tubes for Heparin?

From Dennis Ernst, Center for Phlebotomy Education, Inc: I am chairing the CLSIDocument Development Committee on the venipuncture standard revision. At today’s web meeting the question came up about the necessity for discard tubes on heparinized patients. It’s been widely reported that discard tubes are not necessary, and haven’t been for some time. However, it came to our […]

Comments (2)

Anticoagulant Therapy

Mar 14 2014

george

Anti-Xa versus PTT

Hi George! Our HCO is wanting to change unfractionated heparin (UFH) monitoring to the anti-Xa test from the partial thromboplastin time (PTT). The research supports decreased lenghth of stay, quicker theurapeutic range achievement and improved patient safety monitoring with anti-Xa, as many patients may appear theurapeutic with the PTT but may actually be under or […]

Comments (3)

Anticoagulant Therapy

All Posts

Using the PTT After Cardiac Catheterization

THSNA Thu-Sat

Hyperglycemia and Prolonged PTT

Specimen Management

Inpatient Thrombophilia Testing

Revalidating Sta-Clot LA

Platelet Clumping

How Long to Stop Infusion

Discard Tubes for Heparin?

Anti-Xa versus PTT

George Fritsma MS MLS

Cheat Sheets from George

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