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Automated Ristocetin Cofactor

Here is a question I received early in January from Elpidio Pena. I apologize to Elpidio for letting this one slip through the cracks. George: our lab performs the ristocetin cofactor (VWF activity) assay using the traditional platelet aggregation method. We are planning to change instruments and one of the instruments we are considering performs […]

Therapeutic INR for Mechanical Heart Valves

Here are the results for last week’s Quick Question: What is your target INR therapeutic range for patients who have a mechanical heart valve? a. INR: 1.0-2.0: 2 (3.8%) b. INR: 2.0-3.0: 5 (9.6%) c. INR: 2.5-3.5: 40 (77.0%) d. INR: 3.0-4.0: 5 (9.6%) Unlike previous questions that functioned as surveys, this one has a […]

Screening for Heparin During LA Testing

Hi, George! I’m curious to know how other labs handle routine detection of heparin in samples for lupus anticoagulant testing. We currently run a PT and PTT on all samples right off the bat and then Hepzyme any that have high PTTs before proceeding with testing. As a quality management project, we are comparing other […]

Wilate von Willebrand Factor Cleared

Gerald Sapp, University of Alabama at Birmingham transfusion service manager told Margaret Fritsma, MA SBB (ASCP)–who then told me–that Octapharma USA announced their human plasma-derived biological, Wilate® von Willebrand factor/coagulation factor VIII complex was cleared by the FDA 12/4/09. Click these links for Octapharma’s Wilate brochure and package insert. Gerald wanted to know if anyone has experience with […]

Critical INR Values

I received this question from Emily Oakley at Windy Hill. Emily also posted this question to Pat LeTendre’s Medlab List last week: “How high should INRs be reported?” Emily, fortunately, this was the subject of a

Anti-Xa Kit and Equipment Distributors

Good evening Mr. George, My name is Lydie Edwige. I’m a post graduate student in China Pharmaceutical University (Nanjing), majoring in clinical pharmacy. I’m doing my internship in Gulou Hospital (Nanjing Drum Tower Hospital). I would like to do some research about the coagulation factor X using the measurement of FXa activity. I read your […]

Checking for Clots

Another note from Kim in Indianapolis at Clarian: We still routinely check each coag tube for a clot with applicator sticks. Our work load is to the point that this step is taking too much time. I would like to give this step up and have techs check after they are resulted but before verifying […]

IL Liquid Heparin Kit

From Kim Kinney at Clarian: George, We are excited about the all-liquid IL heparin kit. We have heard that it is now available. We are still running heparins on an MDA using the Stago kit. We make our own calibrators and QC from pharmacy heparin–a ton of work and not very stable. How do other […]

Medical Laboratory Science Wages and Vacancies

Happy 2010. Though 2008 and 2009 brought us a weakened economy, the opportunities in health care, and especially the medical laboratory science profession are expanding. I’ve attached a copy of the American Society for Clinical Pathology’s 2009 Laboratory Medicine wage-and-vacancy-survey-3-09, published in March, 2009. The data in this article remain accurate, and indeed, from the number of ads […]

Therapeutic Ranges for LMWH and Fondaparinux

From Pamela Owens at Tricore in Albuquerque: 1. What therapeutic ranges are folks using for the pentasaccharide fondaparinux (Arixtra)? How were the ranges determined? The ranges in the Arixtra package insert are extremely narrow. 2. Concerning the monitoring of low molecular weight heparin (LMWH): Are labs publishing separate therapeutic ranges for once-a-day dosing versus twice-a-day […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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