Specimen Management

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

Covid Specimen Storage

From friend and colleague, Heather DeVries, Indiana University Health: Hi, George. As I am sure you are aware, we are seeing some very high dimers now surrounding the COVID-19 pandemic. An email was sent from one of our sites to the entire system that they may want to save those samples for future validation studies […]

Specimen Management

HCT >55%

Click or tap this December, 2019 CAP Today “Best of Q&A” series answer to “Should a patient with a hematocrit greater than 55 percent be redrawn for correction always or only when prothrombin time and partial prothrombin time are elevated?” A shout out to Andrew Goodwin IV, MD, Department of Pathology, University of Vermont College […]

Specimen Management

Quick Question: Discard Tube?

Our December, 2019 Quick Question asks, “When collecting hemostasis specimens, when do you use a discard tube?” Results from 46 respondents: A. Just before every blue-closure tube: 6 (13%) B. Never, the discard tube is unnecessary: 2 (4%) C. Just after an additive tube to avoid carryover: 8 (18%) D. When collecting through an infusion […]

Quick Question Archive

December, 2019 Quick Question

Check our December, 2019 Quick Question on the right: “When collecting hemostasis specimens, when do you use a discard tube?” Please provide an answer based on your facility’s specimen management policy. If your answer doesn’t match the answers that are offered, please provide your comment below or send it to George at [email protected] for publication.

Quick Question Archive

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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