PT/PTT Screening

Yesterday, 9-1-20, a colleague contacted George [me] because her physcian had ordered a PT and PTT as part of a pre-procedural workup. She asked what the PT/PTT accomplished, and both the physician and nurse practitioner offered no explanation. After considerable discussion, the PT/PTT order was canceled. I recalled a similar situation from 2011 when my […]

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Screening Assays

Sep 2 2020

george

Centrifuging for PPP

Hi, I used to work in special coag at VCU, it was over 10 years ago. When we were freezing specimens we had to double spin them at 3500 rpm for 15 minutes. Our quick-spin centrifuges for PT/PTT could cause the platelets to leak out their activation factors. Where I now work, we called Mayo […]

Specimen Management

D-dimer Reporting

Hemostasis laboratory directors are aware of the problems created by the variety of D-dimer result expressions. D-dimer reagent kit manufacturers have failed to harmonize results, in part because their reagent monoclonal antibodies possess variant specificities, and in part because some report results in “D-dimer units” [DDUs] and some in “fibrinogen equivalent units” [FEUs]. FEU values […]

Fibrinolysis

Sept, 2020 Quick Question: Fibrinolysis

Introducing our September, 2020 Quick Question, a laboratory service poll, “How do you measure fibrinolysis?” Please select your answer on the right or if you don’t see the answer you are looking for, please add your comment below.

Fibrinolysis

August, 2020 Quick Question on D-dimer Results

Our August, 2020 Quick Question asks, “What condition may account for a chronically elevated D-dimer?” We’ve had 59 respondents with a broad distribution of results: Plasma human anti-mouse antibody: 7% [4] Rheumatoid factor: 14% [8] Chronic low-grade inflammation: 24% [14] Venous thromboembolic disease: 17% [10] Disseminated intravascular coagulation: 34% [20] Other, please comment: 4% [3] […]

Fibrinolysis

Covid-Coag Conversation 9-15-20

You are invited to our Tuesday, September 15, 2020 webinar, Covid-Associated Coagulopathy: A Conversation about the Controversies and Confusion featuring pathology expert Andrew J. Goodwin, MD, University of Vermont Medical Center Laboratory Director. Click https://conta.cc/3aMDoNp for the eblast or bit.ly/COVID-Coag to go directly to the registration page. Covid-Coag is a PACE-accredited one-hour presentation, 5–6 PM […]

Arterial Thrombosis

PPP

George received a comment about platelet-poor plasma [PPP] from friend and colleague, Heather DeVries, Indiana University Health. Here is a paragraph from Fritsma GA. Laboratory evaluation of hemostasis, Chapter 41 in Keohane EM, Otto CN, Walenga JM. Rodak’s Hematology: Clinical Principles and Applications, 6th Edition, Elsevier, 2020. ISBN 978-0-323-53045-3: Platelet-Poor Plasma for Clot-Based Testing “Clot-based […]

Specimen Management

Mixing Studies

A note from colleague Kathy Robinson that deserves a thorough discussion… “I am updating our mixing study procedure and have some questions…” 1. What is the lower limit at which it is useless to perform studies for both PT & PTT [APTT]? There is no firm agreement about the limit. Some perform mixes whenever the […]

Bleeding Disorders

Markedly Elevated D-dimer in an Infant

A 4 month old girl was being prepped for surgery for a neural tube defect. All lab results were normal except her D-dimer result, which was greater than 20,000 ng/mL FEUs. The girl was in apparent good health, but the surgeon postponed surgery. The test was repeated after three days and the new D-dimer result […]

Fibrinolysis

WFH Guidelines: Third Edition

On August 4, 2020 the World Federation of Hemophilia announced the publication of the WFH Guidelines for the Management of Hemophilia, 3rd edition, 2020 [click for the publication]. The guidelines were developed by a team of experts from around the world and have been updated to reflect important developments in the management of hemophilia since […]

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Bleeding Disorders

All Posts

PT/PTT Screening

Centrifuging for PPP

D-dimer Reporting

Sept, 2020 Quick Question: Fibrinolysis

August, 2020 Quick Question on D-dimer Results

Covid-Coag Conversation 9-15-20

PPP

Mixing Studies

Markedly Elevated D-dimer in an Infant

WFH Guidelines: Third Edition

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question