POC: When to Validate High INRs

George received this question from an anticoagulation clinic coordinator last week: What value would you suggest to repeat a high fingerstick INR to a venous blood, >4.0, >5.0, etc. and why? Thank you. Here is the answer George provided: “Hello, and thank you for your question. Point of care (POC) instruments provide rapid PT/INR turnaround […]

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Validation

Apr 23 2012

george

Medical Laboratory Professionals Week April 22-28

Each April, Medical Laboratory Scientists worldwide celebrate Medical Laboratory Professionals Week. This year, Fritsma Factor celebrates our week, April 22–28, by offering 34 online audio modules that provide a complete overview of hemostasis. These modules, fully updated, include six new modules, Platelet Production, Platelet Structure, Platelet Function, and Platelet Function Testing I, II, and III. All 34 modules are […]

Events

ASCLS-Missouri Meeting April 17-19

The Missouri branch of the American Society for Clinical Laboratory Science holds its annual state meeting at the Millennium Hotel in St. Louis, April 17-19, 2012. George provides a presentation on Thursday, April 19, “Monitoring the New Anticoagulants, Whatever Happened to the PT and PTT?” from 1 to 2:30. Attached below is the PowerPoint handout. […]

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Anticoagulant Therapy

Apr 12 2012

george

Undiagnosed Thrombocytopenia

From an anonymous inquirer: I have been misdiagnosed for years. I have very large and oval-shaped platelets which my average count is 40,000. I also tell whoever is taking my complete blood count (CBC) to make sure it is a manual count because my platelets are too large for the machine. I have great coagulation […]

Bleeding Disorders

Dabigatran Clearance

Another post from Bob Gosselin (we hit the mother lode today!): GF: Re dabigatran clearing in 24 hours: This is not necessarily so, depending on the patient, as we have seen “dabi” levels (q12 drug) with trough before next dose of ~150ng/mL. So I would highly suggest using thrombin times for assessing the clearing of drug, as […]

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Anticoagulant Therapy

Apr 10 2012

george

POC INRs

From Bob Gosselin: Hey GF, re point of care (POC) international normalized ratios (INRs), assuming that you are collecting a citrated sample for testing, a high hematocrit (HCT) should not matter for a system that employs fingerstick whole blood, since there is no citrate:plasma ratio issue at hand with using whole blood. Viscosity may be an issue […]

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Anticoagulant Therapy

Apr 3 2012

george

More on LA Mixing Studies

I received this message from Dr. Rich Cambereri on March 8, and have been holding it pending additional data, but given our March 18, 2012 post from Vanessa Chan in Toronto, and subsequent responses from Herb Crown and Dr. Larry Brace, I’ve decided to use Dr. Cambereri to start a discussion about the use of mixing studies in the lupus anticoagulant (LA) profile: Hi […]

Lupus Anticoagulant

ACC

Here is a summary of the just-ended American College of Cardiology meeting in Chicago. It appears there was a lot of attention given to the new oral anticoagulants, especially to dabigatran (Pradaxa), which has been available since 2010 in the US. I’ve been seeing lawyer’s ads on TV recently, 1-800-BAD-DRUG, focusing on Pradaxa. Does Pradaxa deserve this […]

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Anticoagulant Therapy

Mar 25 2012

george

Monitoring Dabigatran with the ACT

George, We are a large public tertiary care hospital in West Tennessee. I am in the special coag lab. We are encountering some problems with patients coming in on dabigatran who need invasive stent procedures. Typically when the cardiologist uses heparin during the catheterization he orders an activated clotting time (ACT) post-procedure looking for a […]

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Anticoagulant Therapy

Mar 23 2012

george

How Many Use the Anti-Xa?

Hi George, I have visited your site a few times in the past and I own your pocket guide book, so I thought of you when I came up with this question. I read in ASCLS Today an article about monitoring heparin therapy using the chromogenic anti Xa assay instead of APTT. Is that standard […]

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Anticoagulant Therapy

All Posts

POC: When to Validate High INRs

Medical Laboratory Professionals Week April 22-28

ASCLS-Missouri Meeting April 17-19

Undiagnosed Thrombocytopenia

Dabigatran Clearance

POC INRs

More on LA Mixing Studies

ACC

Monitoring Dabigatran with the ACT

How Many Use the Anti-Xa?

George Fritsma MS MLS

Cheat Sheets from George

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