Abnormal Bleeding Profile
| Abnormal Bleeding Profile | | | |
| Number | | 116004 |
| CPT | | 85049; 85610; 85670; 85730 |
| Related Information | | Hemostasis and Thrombosis Appendix |
| Synonyms | | Bleeding Profile, Abnormal |
| Test Includes | | Platelet count; PT and aPTT; TT |
| Special Instructions | | If the patient's hematocrit exceeds 55%, the volume of citrate in the collection tube must be adjusted. Refer to Coagulation Collection Procedures for directions. |
| Specimen | | Whole blood and plasma, frozen |
| Volume | | 5 mL EDTA whole blood, one tube citrated whole blood (unopened), 3 mL citrated plasma, frozen |
| Minimum Volume | | 2 mL citrated plasma, frozen |
| Container | | Lavender-top (EDTA) tube, blue-top (sodium citrate) tube (do not open), and a frozen blue-top (sodium citrate) tube (do not open). |
Collection | | Blood should be collected in a blue-top tube containing
3.2% buffered sodium citrate.1 Evacuated
collection tubes must be filled to completion to ensure a
proper blood to anticoagulant ratio.2,3 The
sample should be mixed immediately by gentle inversion at
least six times to ensure adequate mixing of the
anticoagulant with the blood. A discard tube is not
required prior to collection of coagulation
samples.4,5 When noncitrate tubes are collected
for other tests, collect sterile and nonadditive (red top)
tubes prior to citrate (blue top) tubes. Any tube
containing an alternate anticoagulant should be collected
after the blue-top tube. Gel-barrier tubes and serum tubes
with clot initiators should also be collected after the
citrate tubes. Centrifuge and carefully remove the plasma
using a plastic transfer pipette, being careful not to
disturb the cells. Transfer the plasma into a LabCorp PP
transpak frozen purple tube with screw cap (LabCorp
No 49482). Freeze immediately and maintain
frozen until tested. To avoid delays in turnaround time
when requesting multiple tests on frozen samples, please
submit separate frozen specimens for each test requested.
Please print and use the Specimen
Collection Bulletin as a tube-filling guide. |
| Storage Instructions | | Maintain whole blood at room temperature. Freeze plasma. |
| Patient Preparation | | Avoid warfarin (Coumadin®) therapy for 2 weeks prior to the test. |
| Causes for Rejection | | Hemolysis; improper labeling; specimen not kept on ice; clotted specimen; specimen diluted with I.V. fluids; specimen contaminated with heparin |
| Methodology | | See individual tests. |
| Footnotes | | - Adcock DM, Kressin DC, and Marlar RA, “Effect of 3.2% vs 3.8% Sodium Citrate Concentration on Routine Coagulation Testing,” Am J Clin Pathol, 1997, 107(1):105-10.
- Reneke J, Etzell J, Leslie S, et al, “Prolonged Prothrombin Time and Activated Partial Thromboplastin Time Due to Underfilled Specimen Tubes With 109 mmol/L (3.2%) Citrate Anticoagulant,” Am J Clin Pathol, 1998, 109(6):754-7.
- “National Committee for Clinical Laboratory Standardization: Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline,” Third Edition, Villanova: NCCLS Document H21-A3:11(23), 1999.
- Gottfried EL and Adachi MM, “Prothrombin Time and Activated Partial Thromboplastin Time Can Be Performed on the First Tube,” Am J Clin Pathol, 1997, 107(6):681-3.
- McGlasson DL, More L, Best HA, et al, “Drawing Specimens for Coagulation Testing: Is a Second Tube Necessary?” Clin Lab Sci, 1999, 12(3):137-9
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