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Test Code Billings Clinic: 2011 Abnormal Bleeding Panel

Important Note

For specimens being sent from reference clients outside of Billings:

Testing performed on Fibrinogen and Thrombin Time will be forwarded to Mayo Medical Laboratories for testing due to specimen stability constraints.

Performing Laboratory

Billings Clinic Laboratory: Coagulation

Useful For

Detection of the more common potential causes of abnormal bleeding.

Methodology

PT, PTT, Thrombin Time, Platelet Count: Optical

Fibrinogen: Modified Clauss

PFA: High-shear force dynamic flow

 

Specimen Requirements

Citrated whole blood, EDTA whole blood and sodium citrate plasma are required for this test.

 

Citrated Whole Blood for PFA

Collection Container/Tube: Draw a full, light blue-top (3.2% sodium citrate) tube, and send 3.5 mL of unprocessed sodium citrate whole blood.

Labeling and Transport Instructions:

  • Do not transport specimen in pneumatic tube.
  • Specimen must be hand delivered to laboratory, and test must be analyzed within 4 hours of draw.
  • Do not centrifuge.
  • Forward unprocessed whole blood promptly at ambient temperature only.
  • Reason for test is required on request form for processing.
  • Label specimen appropriately (citrated whole blood for PFA).

 

EDTA Whole Blood for Platelet Count

Collection Container/Tube: Draw blood in a lavender-top (EDTA) tube(s), and send 1 mL of unprocessed EDTA whole blood.

Labeling and Transport Instructions:

  • Do not centrifuge.
  • Forward unprocessed whole blood promptly at ambient temperature only.
  • Label specimen appropriately (EDTA whole blood for platelet count).
  • Specimen must arrive within 24 hours of draw.

 

Sodium Citrate Plasma for APTT, Fibrinogen, PT, and TT

Collection Container/Tube:  Draw blood in a light blue-top (3.2% sodium citrate) tube(s).

Collection Instructions:

  • Immediately after draw, gently invert tube(s) at least 6 times to mix well.
  • Spin down, remove plasma, spin plasma again, and send 4 mL of plasma divided into 4 plastic vials each containing 1 mL of citrate, platelet-poor plasma.
  • Double-centrifuged specimens are critical for accurate results as platelet contamination may cause spurious results.
  • Glass vial is not acceptable.
  • Freeze specimens immediately at -20° C.
  • Plasma containing Heparin (patients being treated with Heparin) MUST be centrifuged and plasma separated within 1 hour

Labeling and Transport Instructions:

  • Send specimens frozen.
  • Label specimens appropriately (plasma for APTT, fibrinogen, PT, and TT).

Reject Due To

  • Clotted specimen
  • Specimen received in a glass vial
  • Specimen received via the tube system (PFA only)
  • Coagulation specimens received refrigerated

Reference Values

See individual test listings.

Day(s) Test Set Up

Daily

Test Classification and CPT Coding

85049 - platelet count

85384 - fibrinogen activity

85576 - platelet aggregation

85610 - PT

85670 - TT

85730 - APTT

LOINC Code Information

Reporting Name LOINC Code
PFA-ADP 24472-3
PFA-EPI 24471-5
Fibrinogen 3255-7
Protime 5902-2
APTT 14979-9
Thrombin Time 3243-3
Platelet 777-3

 

Profile/Testing Information

Profile Information:
Activated Partial Thromboplastin Time (APTT) Platelet Function Assay (PFA)-100
Fibrinogen (Activity) Protime (PT)
Platelet Count Thrombin Time (TT)