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Quick Question Summary: Applicator Sticks

Here is a summary of our February Quick Question, “How do you examine coagulation specimens for clots?”

a. We run an applicator stick through each specimen before centrifuging: 10 (17%)
b. We run an applicator stick through specimens from certain units in our medical center: 2 (3%)
c. We examine the specimen visually before and after centrifuging: 14 (24%)
d. We place the centrifuged specimen on our instrument and respond to implausible results: 33 (56%)

This QQ generated seven comments. Some are concerned that using applicator sticks before spinning activates platelets and the coagulation system. Others doubted the effectiveness of visual inspection, particularly as many institutions place at least two labels on the tube, blocking any view of the specimen. Still others indicated their concern that we report plausible results from partially clotted specimens, thereby missing potential pathological results. Bill Chamlee of the Cleveland VA suggests checking for clots after the specimen has been centrifuged and assayed, then canceling results of those that are clotted. While laborious, this may be the most effective approach. It seems this would be a fertile issue for a clinical researcher.

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