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April 2021 Quick Question: Andexanet Alfa Response

Thanks to our 31 participants for answering the April, 2021 Quick Question, “What test do you employ to validate the need for andexanet alfa to reverse DOAC overdose?” Here are our responses: PT: 3% [1] PTT: 17% [5] Chromogenic anti-Xa: 77% [24] DOAC Dipstick: 3% [1] This question arose from a conversation with the director […]

Anticoagulant Therapy

Covid Coag: Thromboinflammation Talk

On Thursday, April 29, 7–8 CDT, George presents for the American Society for Clinical Laboratory Science–North Dakota via Zoom, “COVID-Coag: What the Heck is “Immuno-thrombo-inflammation?” Here is the updated six-per-page handout for my presentation.

Let’s Use “VITT”

ISTH has chosen the title, Vaccine-induced Immune Thrombotic Thrombocytopenia [VITT] for the adverse event we identified as VAPIT on 4/15/21. ISTH has drafted the attached Interim Guidance for Diagnosis and Treatment of VITT [click]. Watch Fritsma Factor regularly for updates to this document as events unfold.

What is VAPIT?

Since the April 14 meeting of the CDC‘s Advisory Committee on Immunization Practices [ACIP, click], information has become available about “Vaccine-Associated Prothrombotic Immune Thrombocytopenia” [VAPIT, or the ultimate name and acronym the scientific community ultimately settles on, if any]. Some vaccine adenovirus vectors may induce a rare autoimmune response that appears to associate with platelet […]

Dr. Elizabeth “Betsy” Van Cott

Just received this sad news forwarded by Bob Gosselin: Dear MGH Pathology colleagues, We are writing to share the terribly sad news that our dear colleague, Dr. Betsy Van Cott, passed away yesterday morning. Betsy was known, respected and cherished by so many of us—for her clinical skills, for her gentle demeanor, for her deep […]

Medical Laboratory Professionals Week

Help us celebrate Medical Laboratory Professionals Week, April 18–24. Be sure to thank you Medical Laboratory Profession for their service throughout the pandemic and on into 2021.

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

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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.

Cheat Sheets from George

Quick Question