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PT Mixing Studies

From Dr. Manohar Pravin: I have a patient who presented with a history of painless gross hematuria with blood clots since 8 months. He had severe anemia and hepatosplenomegaly. His USG abdomen revealed only hepatosplenomegaly. CT abdomen and pelvis is normal. LFT, KFT, sickling test, CBC is normal. His PT and PTT are prolonged . How […]

TCoag KC1 Delta Coagulation Instrument

From Rob Lair, MLT Program Instructor, Medvance Institute, Nashville, TN Hello, I was reading a article from Dan Southern about the TCoag (formerly Trinity) KC1, and would very much like to receive a copy of the procedure he created for it. I am an instructor in the medical laboratory technician (MLT) program at Medvance Institutein Nashville, TN. The school has […]

ACD Tubes for Platelet Satellitosis

Donna Kaiser asks, “Is the use of acid-citrate-dextrose (ACD) tubes acceptable for patients who present with platelet satellitosis? We have several patients that continue to clump in sodium citrate tubes, mostly oncology patients. I have heard of using ACD as the anticoagulant to resolve the issue. If this is true, which ACD tube is acceptable and […]

More on Venoms

More on venom activity from Vilas Hiremath at United Labs: Dear George, I have spiked afibrinogenemia plasma with Russell viper (RV) and saw-scaled viper (Echis, SSV) crude venom. Prothrombin time (PT) and partial thromboplastin time (PTT) both failed to correct with RVV. The PT, but not the PTT, corrected to within the normal range with SSV. This […]

INRs: Report to One Decimal

We have been reporting INRs as only one decimal as 1.2 . We did this from the suggestions from CAP and their surveys. Also we have always rounded PTTs to a whole number. Should we be reporting 2 decimals on the INR and one on the PTTs? Thanks. Diane Thornton Section Supervisor Hematology St. John’s […]

Does HCT Affect Plavix Monitoring?

This is from Azevlab227: Good afternoon, George. I have a question for you and I’m hoping that other regular contributors to the site will have comments as well. I am currently using the VerifyNow P2Y12 for identifying those patients who are sensitive to the antiplatelet effect of Plavix or Prasugrel. There is a push to […]

Freezing Specimens

Pat Letendre’s Medlab-L list has had several posts lately about how to freeze serum or plasma specimens for long-term storage. Some have asked for specific guidelines, so I contacted members of the Precision BioLogic technical staff for advice. Precision BioLogic, as many coagulation specialists know, ships frozen pooled normal plasma, reference plasma, and single factor-depleted plasmas […]

Factor Activity Assays: Concentration or Function?

When performing factor activity assays, are you determining the concentration or the function? There has been some discussion lately on this and while we thought we knew, we’ve become confused. Thanks. Diane Thornton Section Supervisor Hematology St. John’s Regional Medical Center Laboratory Joplin, MO Hello, Diane, and thank you for your question. When you perform […]

Why is PT Stable 24 Hours?

From Madan Verma: Why are we allowed to add on a prothrombin time (PT) assay even 24 hours after collection? I was trying to find the factors’ half lives in vivo and wondering that factor VII has the shortest half life. Please explain. Can you please cite some literature regarding factor half lives? At http://uabcoag.net I found a summary, but […]

Bleeding Time Test

From “slacey:” I work as a phlebotomist and and occasionally have to perform a bleeding time test. This involves making a small incision, using a Surgicutt device, and recording the time it takes for the bleeding to stop. A blotting paper is used to determine when a platelet plug has formed and bleeding has stopped. My question […]

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

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