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 […]

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Specimen Management

May 10 2018

george

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

Nov 2 2017

george

When to Label Tubes

On October 25, 2017, Heather DeVries, Indiana University Health, initiated a provocative discussion on the storage and transport of PTT specimens. Dr. Emmanuel Favaloro commented, providing some potential liberalization of the time limits imposed in the CLSI H21-A5 guideline. He also provided a reference, Lippi G, Salvagno GL, Montagnana M, Lima-Oliveira G, Guidi GC, Favaloro […]

Specimen Management

Applicator Sticks

This message came to George via Elaine Benoit, Precision BioLogic Inc. Good evening Mr George, I accidentally came across the site and I am very happy to have found you. First of all I apologize for English. I am passionate about in vitro haemostasis. In December 2013 I thought and applied a post-analytical sample clotting […]

Specimen Management

Storing Unspun PTT Specimens

From our colleague and frequent contributor Heather DeVries, Indiana University Health. Greetings George! One of our labs contacted me about PTT specimens coming from outpatient clinics, where they do not have centrifuges. Before coming into our system, this lab did a small study (30 specimens) to validate 24-hour stability of nonheparinized specimens for PTT testing. […]

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Specimen Management

Specimen Management

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

When to Label Tubes

Applicator Sticks

Storing Unspun PTT Specimens

George Fritsma MS MLS

Cheat Sheets from George

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Quick Question