Specimen Management

Impact of Sodium Citrate Levels on Coagulation Assays

Click here to see a poster describing the effects of varying citrate concentrations on clot-based assays: Rahman M, Bruhm M, Black KM, Sadeghi-Khomami A. Impact of sodium citrate levels in coagulation assays: A controlled ex-vivo study. Poster Presented at ISLH 2025. The findings will help us determine the effects of underfilling or overfilling blue-closure tubes […]

Specimen Management

Does Antiseptic Alcohol Cause Hemolysis?

Collectors routinely disinfect phlebotomy sites with isopropyl alcohol (IPA). We like to repeat a commonly held myth from the “data-free zone” that failure to allow the alcohol to dry before venipuncture causes patient discomfort, blood specimen hemolysis, and blood specimen dilution. The myth is addressed in the attached open access article, Sarmah D, Sharma B, […]

Specimen Management

Underfilled or Overfilled Coagulation Specimen Tubes

The CLSI H21 standard lists causes for coagulation specimen rejection, including hemolysis, icterus, lipemia, clotted specimens, underfilled tubes, and overfilled tubes. In most applications, underfilling is defined as a specimen comprising less than 90% of the stated volume. Most blue-closure tubes contain 0.3 mL of 3.2% sodium citrate and are calibrated to collect 2.7 mL […]

Specimen Management

How to Improve Lab Testing

From Heather DeVries: In the scope of the whole world, how do labs search for new ways to improve their laboratory testing? Would it just be typing in the search bar, or are there ways to find the latest information randomly while looking for other things? George replies, Heather, my surface-level response is to suggest […]

Specimen Management

More on CAP Specimen Requirements

In follow-up to my February 25, 2025 post, New CAP Survey Coag POC Requirements, I asked Dr. Andrew Goodwin, “Does CAP address courier specimen management? I see specimens collected at regional clinics that stand in a door-mounted specimen box for extended periods. I also wonder whether couriers have equipment maintaining coag specimen temperatures between 18 […]

New CAP Survey Coag POC Requirements

Click POC CAP Coag Requirements 1-25 to read about the CAP Survey updates to point-of-care specimen management featuring Andrew Goodwin, MD, medical director of the thrombosis and hemostasis laboratory, and Marian Rollins-Raval, MD, PhD; chief of the Division of Hematopathology and Genomic Medicine both at the University of Vermont Medical Center.

Specimen Management

Lab Monitoring For a Patient Transitioning From DOAC to Heparin

From Jessica Warner, MLS (ASCP)cm Technical Specialist Network Coagulation Service Lab Administration Kettering Health Hi George, Has there been much discussion on what sites are using for lab monitoring for patients transitioning from DOAC to heparin? We have strictly been using anti-Xa for heparin monitoring since 2015. We are a 13-site network with 8 hospitals […]

Anticoagulant Therapy

Platelet Clumping

I received this question on Friday, January 17, 2025: “Hello, where can I find guidance or literature on using sodium citrate tubes to mitigate platelet clumping?” Thank you for your question. This question was partially addressed in a March 11, 2024 post entitled Platelet Satellitism, however, I’ve attached two open-access articles that are helpful. First […]

Dec 2024 QQ: Whole Blood Clot Detection

Our December 2024 Quick Question, “How do you detect small clots in whole blood specimens?” drew 44 responses. Here are our results… Plastic dowel: 0 Observe plasma: 1 (2%) Wooden dowel (stick): 34 (78%) Tilt tube and observe: 8 (18%) We don’t check for clots: 1 (2%, I–Geo–added this vote, it does not represent a […]

Quick Question Archive

Clot Detection in Whole Blood Specimens

I (Geo) received this message on 11-27-24 from Dr. Ludwig Albornoz: After a simple search on Google, we landed on your website, regarding a practice of detecting and removing fibrin and or blood clots in clinical laboratory blood specimens by using a mechanical method, either plastic or wooden rods, which I introduced for use in […]

Specimen Management

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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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