Specimen Management

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

Reducing Hemolysis Rate

Thanks to friend and colleague Dennis Ernst, Center for Phlebotomy Education, for illustrating a new technology, PIVO® from Velano Vascular, San Francisco, California, which enables blood collectors to obtain specimens from peripheral intravenous [PIV] devices saafely while reducing the incidence of hemolysis. Click here for an article describing the device on Dennis’s site.

Specimen Management

Specimen Collection: HCT over 55%

From Heidi Hobbs: Adjusting anticoagulant for hematocrits greater than 55% has been a hot topic lately. It is a challenge to ensure this is being done in all cases and we have some great things in the works. While doing some research, I ran across one lab that has a simplified adjustment table, where patients […]

Specimen Management

Cord Blood PTT

From Ann Helen: Can you trust results of PTT and factor VIII in umbilical cord blood? It seems as if it is usual to draw umbilical cord blood from newborns when the mother is a known carrier of Hemophilia A. Can you trust a high APTT and a low factor VIII in such a sample? […]

Bleeding Disorders

Platelet Clumping

Friend and Colleague Dennis Ernst, Center for Phlebotomy Education, shared this January 8, 2021 question with George: Hello Phlebotomy Today, We’ve come across a patient whose platelets clumped in EDTA and citrate tubes. We understand that ammonium oxalate may be used to provide an accurate platelet count. Do you know of a manufacturer of these […]

Specimen Management

In vitro detection and removal of DOACs from patient plasma specimens

Announcing a 9-30-20 open access publication [forgive the self-reference]: McGlasson DL, Fritsma, GA. In vitro detection and removal of direct oral anticoagulants from patient plasma specimens. Annals of Blood 2020:doi: 10.21037/aob-20-16. We describe a urine DOAC Dipstick and several competing “filter” devices that remove DOACs from plasma, enabling the operator to perform clot-based [PT and […]

Anticoagulant Therapy

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

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

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 […]

More on Covid Specimen Management

Please refer to our April 6, 2020 Covid discussion [click or tap] for a valuable 6 PM comment from Precision BioLogic friend and colleague, Ali Sadeghi-Khomami, who directs Precision’s research team, Ali has provided valuable specimen management information. Meanwhile, the following is a helpful follow-up on the topic of standard precautions, or what George still […]

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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