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SPECIAL HEMOSTASIS LABORATORY

 LABORATORY POLICIES:

 Hours of Operation

The Special Hemostasis Laboratory is staffed Monday through Friday from 8:00 am to 5:00 pm, excluding national holidays. Laboratory technologists can be promptly reached during these hours by calling 732 235-7683.

Normal Ranges

Normal ranges listed on the results form are based on an adult population collected in 3.2% sodium citrate unless otherwise indicated.  Ranges are subject to changes due to changes in reagents, test methodologies, and/or instrumentation. Please refer to the final report for current normal ranges.

Interpretation

Interpretation of results will be included in the final report.  Optimal interpretation depends on providing the laboratory with clinical history and medications.

Billing

Referring institutions who draw blood and process samples for testing by the Special Hemostasis Laboratory will be billed directly by the Laboratory.

Patients who have samples drawn at the Robert Wood Johnson University Hospital outpatient laboratory will be billed by the hospital laboratory.  Please contact the hospital laboratory with questions about pricing and billing procedures.

STAT and ASAP Testing

STAT testing is available pending approval by the Special hemostasis Laboratory Director.  To inquire about STAT testing, please contact the Special Hemostasis Laboratory with the patient's name, clinical history, and name and telephone number of the referring physician.  The Laboratory Director may need to contact the patient's physician to discuss the necessity for STAT testing.  If ASAP testing is needed (i.e., prior to specific surgery date), please contact the Special Hemostasis Laboratory.

Adding/Cancelling Tests

Samples are stored at the laboratory for a minimum of six months; therefore additional assays can be performed upon request if adequate sample volume permits.  Cancellation of tests may be made while samples are in transit.  Regulations require written authorization for additions or deletions of assays.

Sample Collection

 Patients may be referred to the Robert Wood Johnson University Hospital outpatient department (Suite A)  for blood collection for any testing offered.  Bleeding time and platelet aggregation studies must be drawn on-site.  All other testing may be drawn and processed at a referring institution (See Sample Collection, Processing, and Shipping Information section).

 Reporting Test Results

 Routinely, a hard copy of results is mailed to the referring institution or physician.  If you would like results sent to additional persons or other addresses, please include this information on the test requisition form.  If the patient  has their blood sample drawn at Robert Wood Johnson University Hospital outpatient drawing station, the results will be mailed from Robert Wood Johnson University Hospital Laboratory (phone 732 937-8588).

 SPECIMEN COLLECTION, PROCESSING, AND SHIPPING PROCEDURES

 Coagulation tests are sensitive to methods of sample collection and processing.  Test results are dependent on the quality of the sample.  The drawing laboratory is responsible for adhering to collection and processing guidelines.

SPECIMEN COLLECTION

 Prior to obtaining a blood specimen from any patient, the identification of the patient must be verified by checking the patient’s wristband for name and hospital number.  If the blood is collected from an outpatient, ask for the patient’s name and/or identification card.

 Clean venipuncture is essential, therefore trauma should be avoided.  Contamination with tissue factor, activation of clotting factors and platelets, and hemolysis can occur from multiple sticks, slapping the vein, excessive pumping of the hand, air bubbles in the syringes, or from placing the tourniquet on too tightly or for too long a period of time.

 From a peripheral vein, draw 2-3 ml of blood for discard.  Then draw a 5ml size blue top tube containing 3.2%  Na citrate as the anticoagulant.  Mix thoroughly.  These tubes must be properly filled to achieve the proper ratio of blood to citrate.  If pediatric patients are drawn, a pediatric size tube may be used (2.7ml blood to 0.3ml of citrate is necessary).  For most individual testing, draw 1 blue top from which 4 tubes of 0.5cc citrated frozen plasma are required.  Additional or different requirements may be found in the “Special Requirements” section of the Panel Listing or the “Comments” section of the Individual Tests Listing.   Place tubes on ice.

 NOTE: The ratio of whole blood to anticoagulant should be 9:1.  If the patient’s hematocrit is below 20% or above 55%, the amount of anticoagulant used should be adjusted according to the following formula:

C = 1.85 x 103 x (100-H) x V where:  
 

C = volume of 3.2% sodium citrate in milliliters

H = hematocrit in percent

V = volume of whole blood in milliliters

 SPECIMEN SHIPPING

Send frozen samples on dry ice.  Samples must remain frozen during transport.  Call 732-235-7683 to notify SHL of shipment and tests requested.

 SPECIMEN PROCESSING

Tubes must be centrifuged within 30 minutes of collection.  Spin at 3000 rpm for 10 minutes 4oC.  From spun tubes, pool all the plasma into a clean plastic tube using a plastic transfer pipette.  Spin again at 3000 rpm at 4oC for 10 minutes.  Separate plasma carefully so as not to disturb the pellet and place into another clean plastic tube. 

Note:  All samples must be platelet free (<10,000/mm3)From this tube, aliquot into appropriately labelled cryo vials and freeze immediately at -20oor -70oC.  For individual tests,  four (4) 0.5ml frozen citrated plasma are required.  Tests with requirements other than four (4) 0.5ml frozen citrated plasma are noted in the comments section for that particular test.

 Each aliquot tube must be labeled with patient’s full name, draw date, time of draw, and patient ID number.  Samples will be frozen at -70oC, so please use labels that tolerate freezing.

 SPECIMEN REJECTION

Any specimens that are incorrectly collected or labeled or have thawed during transport cannot be processed.  Specimens that contain fibrin clots or are either hemolyzed, extremely lipemic or extremely icteric will also be rejected.  You will be notifed by telephone if samples are rejected. 

 TEST REQUISITION FORM

Federal regulations require the following information on all test requisition forms:  full patient name and ID#, date of birth (or age), sex, requesting hospital/lab and/or doctor (and phone number), date, time drawn, and specimen anticoagulant.

 PATIENT HISTORY

For accurate interpretation of test results, please complete questionnaire and send along with the specimen.

 

Send mail to martineu@umdnj.edu with questions or comments about this web site.
Last modified: August 03, 2005