Blood Bank, Compliance & Safety, General Information, Hemostasis/Coagulation, Referral/Sendouts, Test Utilization

Coagulation Blue Top Tube Shortage

Update 9/1/2021:

September 1, 2021

There continues to be a global shortage of sodium citrate (“blue top”) blood collection tubes used for coagulation testing as a result of unprecedented demand, in part due to COVID-19 surges, vaccine and treatment development. This was anticipated to last through August 2021, but now, due to continued unprecedented demands, there is no end date in sight. Please take this into consideration when ordering coagulation testing (i.e. Protime, aPTT, Fibrinogen, D-dimer, Lupus Screens, Factor Assays, Mixing Studies, von Willebrand testing, etc.).

Here are additional steps you can take to help:

• Eliminate collection of extra blue top tubes

• Discontinue standing orders for coagulation tests, when possible

• Avoid the use of coagulation tubes as discard tubes

• Please refrain from ordering Lupus Screens (LAB478) when patients are actively taking non vitamin K antagonists, including apixaban, dabigatran, and rivaroxaban. They have a significant impact on clot-based coagulation testing. It is best to carry these tests out prior to drug administration or during a trough setting.

ITM-1148595 and ITM-1148596 used at Spectrum Health have the potential to be impacted by this global shortage. Our supply chain is closely monitoring the situation and helping to ensure we continue to receive weekly allocations of the products.

Please also refer to the FDA Frequently Asked Questions (FAQ) on sodium citrate tubes: FDA: Sodium Citrate Tube FAQ or Sodium citrate Blood Specimen Collection Tube Conservation Strategies Letter

 

Original post 6/10/2021:

There is currently a national shortage of sodium citrate (“blue top”) blood collection tubes used for coagulation testing as a result of unprecedented demand, in part due to COVID-19 surges, vaccine and treatment development. This is anticipated to last through August 2021. Please take this into consideration when ordering coagulation testing (i.e. Protime, aPTT, Fibrinogen, D-dimer, Lupus Screens, Factor Assays, Mixing Studies, von Willebrand testing, etc.).

Here are additional steps you can take to help:

• Eliminate collection of extra blue top tubes

• Discontinue standing orders for coagulation tests, when possible

• Avoid the use of coagulation tubes as discard tubes

• Please refrain from ordering Lupus Screens ( LAB478) when patients are actively taking non vitamin K antagonists, including apixaban, dabigatran, and rivaroxaban. They have a significant impact on clot-based coagulation testing.  It is best to carry these tests out prior to drug administration or during a trough setting.

• Reduce cancelled specimens by making sure to collect specimens correctly by using the lab catalog for specimen collection instructions.

Thank you for your help during this exceptional time.

If you have any questions or concerns, please use the “Contact Us” link above.

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