All Posts

Thawing Coag Specimens

I [Geo] received this question on 4-6-21 from Don Wahl, Core Laboratory Manager, Sanford USD Medical Center, Sioux Falls, SD. “Why do coagulation tests need to be quick- thawed at 37°C? If samples are thawed at room temperature what would be the effect on the coagulation testing?” Hello, Don, and thank you for your question. […]

Specimen Management

Coagulation Overview

In response to requests, we’ve posted our latest audio PowerPoint module, “Coagulation Overview.” Please visit our growing list of recently produced free modules under the menu heading, Educational Modules.

Coagulation Factors

April 2021 Quick Question: Andexanet Alfa

Our April Quick Question arises from discussions with Chad Siniard, MD., University of Alabama at Birmingham Division of Laboratory Medicine and hemostasis author and expert Dave McGlasson. Andexanet Alfa® is the FDA-approved reversal agent for rivaroxaban and apixaban that has become a standard ER treatment for potential anticoagulant overdose. A key consideration is the US […]

Anticoagulant Therapy

March 2021 Quick Question Response

Our March, 2021 Quick Question was a case study that netted 49 votes. A 2 YO experiences frequent joint bleeds. PT: 22s; PTT: 29s; fibrinogen 280 mg/dL. What do you do next? Assay factors VIII, IX, and XI. 10% [5] Assay factors II, V, and X, 14% [7] Assay factor VII, 70% [34, correct] Assay […]

Bleeding Disorders

Testing for von Willebrand Disease Subtype 2N

I [Geo] ran across this 2011 Versiti protocol for identifying von Willebrand disease subtype 2N, “Normandy,” sometimes nicknamed “Autosomal Hemophilia A.” This is a sophisticated phenotypic method for finding the ratio of von Willebrand factor concentration [antigen] to coagulation factor VIII activity. Click here for their von Willebrand Disease Subtype 2N Protocol.

Bleeding Disorders

Glass Tubes in Centrifuges

On September 4, 2010 Mary L. Turgeon provided a discussion of the effect of altitude on blood specimen collection using evacuated tubes. Today, Laura Lauzze added a comment on the subject, noting that they have found it necessary in her facility at 9000 feet to use glass tubes [click]. Her concern focuses on the risk […]

Specimen Management

D-dimer and DOACs

Here is a recent question from a colleague. “Dear George, A patient with a PE of unknown etiology, is now completing their 6th month of Eliquis therapy. When is the ideal time to check a D-dimer? Thank you.” Before answering, I [Geo] consulted with Dr. Larry Brace, who responds, “My opinion is that if the […]

Anticoagulant Therapy

VWD Subtype 2N

Today a colleague asked, do the bleeding symptoms associated with von Willebrand disease subtype 2N [Normandy, “autosomal hemophilia”] disappear during pregnancy? Hoping for some answers from our clinical participants.

Bleeding Disorders

Quick Question March 2021: 2 YO W/ Anatomic Bleeds

Our March, 2021 Quick Question is a case study involving a 2 YO who experiences frequent anatomic [joint and body cavity] bleeds. The lab results are PT: 22s; PTT: 29s; fibrinogen 280 mg/dL. What do you do next? Please choose your anwer on the right. You will need to endure the “Captch” function, we’ve had […]

Bleeding Disorders

Quick Question Feb 2021: Easy Bruising Case

Our February, 2021 Quick Question was a case study that drew 60 responses. A 25-YO woman who is 1 month post-partum experiences bruising and menorrhagia. She reports that her mother and brother both experience easy bruising and that her own bruising disappeared during her pregnancy. What condition could cause these symptoms? Acquired hemophilia: 12% [7] […]

Bleeding Disorders

Load more

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.

Cheat Sheets from George

Quick Question