Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Initial testing includes: prothrombin time (PT); activated partial thromboplastin time (APTT); dilute Russells viper venom time (DRVVT); thrombin time (bovine); fibrinogen; D-dimer; soluble fibrin monomer; antithrombin activity; protein C activity; protein S antigen, free; prothrombin G20210A mutation; activated protein resistance V; and, if appropriate, special coagulation interpretation.
If PT is > or =14 seconds, PT mix will be performed.
If APTT is >36 seconds, APTT mix will be performed.
If APTT mix is >36 seconds with no evidence of heparin in samples, platelet neutralization procedure will be performed.
If DRVVT ratio is > or =1.2, DRVVT mix and DRVVT confirmation will be performed.
If thrombin time is >23 seconds, reptilase time will be performed.
If protein S antigen, free is <65% for males and females > or =50 years of age and <50% for females <50 years of age, protein S antigen, total will be performed.
If protein C activity is <70% with no evidence for an acquired decrease in protein C activity, protein C antigen may be performed.
If antithrombin activity is <80% with no evidence of an acquired decrease in antithrombin activity, antithrombin antigen will be performed.
If activated protein C resistance (APC) ratio is <2.3 or baseline APC APTT is prolonged, factor V leiden (R506Q) mutation analysis will be performed.
If appropriate, protein S activity, coagulation factor assays, or Staclot LA will be performed at an additional charge to clarify significant abnormalities in the screening clotting times.
If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if inhibitor screen is positive.
See Thrombophilia Profile algorithm in Special Instructions.
Specimen Type Describes the specimen type needed for testing
Plasma Na Cit
Send specimens in the same shipping container.
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
See Coagulation Studies in Special Instructions.
Blood and plasma are required.
Specimen Type: Whole blood
Preferred: Yellow top (ACD)
Acceptable: EDTA, sodium citrate
Specimen Volume: 6 mL
1. Invert several times to mix blood.
2. Do not transfer blood to other containers.
3. Label specimen as whole blood.
Patient Preparation: 1. Patient should not be receiving Coumadin, heparin, direct thrombin inhibitors (argatroban, dabigatran), or direct factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban).
2. Specimen must be drawn prior to initiation of anticoagulants and thrombolytic therapy.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (citrate)
Submission Container/Tube: Polypropylene vials
Specimen Volume: 6 mL in 6 Polypropylene vials each containing 1 mL
1. Spin down, remove plasma, and spin plasma again.
2. Freeze specimens immediately at < or =-40 degrees C, if possible.
3. Label specimens as plasma.
1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
2. If priority specimen, mark request form, give reason, and request a call-back.
1. Coagulation Patient Information Sheet (Supply T675) in Special Instructions
2. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (Supply T576) is available in Special Instructions.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Whole Blood: 3 mL; Plasma: 5 mL in 5 polypropylene vials each containing 1 mL
Mild OK; Gross reject
Mild OK; Gross reject
Mild OK; Gross reject
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
|Plasma Na Cit||Frozen||14 days|
|Whole blood||Ambient (preferred)||7 days|