Reference Lab Specimen Integrity

Hello George, I was referred to you by my current professor John Landis. I have a question regarding PT‘s being performed in a reference lab setting. The laboratory that I work for is essentially a reference lab in that we get samples from the surrounding areas and even different states. We typically receive our samples […]

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Specimen Management

Oct 26 2018

george

When to Label Tubes: Reprise

On January 1, 2018, I posted the outcomes of our December, 2017 Quick Question, “When is the correct time to label blood specimen tubes?” Subsequent to this posting, Dennis Ernst, Dave McGlasson, and I co-authored an editorial, “Labeling tubes before collection threatens patient safety,” in the February, 2018 issue of Annals of Blood. Below are […]

Specimen Management

Coag Test Utilization

While visiting the University of Texas Medical Branch campus in Galveston, George had the opportunity to become acquainted with Mayukh Sarkar, PhD, Medical Laboratory Scientist in the Division of Hematopathology, Laboratory Services. Dr. Sarkar recently published Sarkar MK, Botz CM, Laposata M. An assessment of overutilization and underutilization of laboratory tests by expert physicians in […]

Specimen Management

More on Platelet Clumping

From Heather DeVries, Indiana University Health, a follow-up to Dr. King’s April 26 pseudothrombocytopenia entry: Hi George, I recently read an article by Drs. Adcock Funk, Lippi, and Favaloro about quality standards in coagulation testing. The article cited a study indicating that sending PFA samples through a pneumatic tube system would not cause a preanalytical […]

Specimen Management

Cold Agglutinins

From Lissette, UCLA: We requested our hematology specimens to be sent with a warm pack for CBC/DIFF. Is it recommended to keep the sodium citrate tubes for coagulation testing on warm packs as well for patients with cold agglutinin? Is there a recommended method to workup these specimens for coagulation testing? Hello, and thank you […]

Specimen Management

Checking Platelet Poor Plasma

Hemostasis laboratories prepare platelet poor plasma (PPP), plasma with a platelet count below 10,000/uL for clot-based procedures. The CAP doesn’t specify how the laboratory validates their specimens to ensure they are PPP. Please summarize your protocol for our participants. Thank you. Added May 1, 2018: One facility validates all centrifuges, then “pulls” one random specimen […]

Specimen Management

Traumatic Venipuncture

From George: Long ago at a Temple University-sponsored meeting in Philadelphia, Dr. Dorothy Adcock provided data showing it was unnecessary to collect a “discard” tube ahead of a blue-closure hemostasis specimen. Conventional wisdom prior to hers and the work of others was that a discard tube was necessary to avoid contamination with “tissue thromboplastin,” which […]

Specimen Management

When to Label Tubes

Our December, 2017 Quick Question asked, “When is the correct time to label blood specimen tubes?” The question generated 124 votes, an exceptional total that illustrates the level of concern for this issue. The answers were: Prior to meeting the patient: 6 (5%) In the presence of the patient, before collecting the blood: 36 (29%) […]

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Quick Question Archive

Nov 28 2017

george

December Quick Question: Tube Labeling

Dennis Ernst, Center for Phlebotomy Education; Dave McGlasson; and George are preparing an opinion piece for Annals of Blood that describes blood specimen labeling standards. The European Federation of Clinical Chemistry and Laboratory Medicine Working Group on Preanalytical Phase specifies that blood specimens must be labeled prior to collection, whereas the Clinical Laboratory and Standards […]

Specimen Management

November Quick Question: Thrombophilia

Here are the results of our November, 2017 Quick Question, answered by 60 respondents: Question: When should you perform an antithrombin, protein C, and protein S profile? a. Soon after starting anticoagulant therapy: chosen by 0 respondents, 0% b. Just after a thrombotic event but before starting anticoagulant: chosen by 10 respondents, 17% c. Seven […]

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Quick Question Archive

Specimen Management

Reference Lab Specimen Integrity

When to Label Tubes: Reprise

Coag Test Utilization

More on Platelet Clumping

Cold Agglutinins

Checking Platelet Poor Plasma

Traumatic Venipuncture

When to Label Tubes

December Quick Question: Tube Labeling

November Quick Question: Thrombophilia

George Fritsma MS MLS

Cheat Sheets from George

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