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

Coagulation Blue Top Tube Shortage

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.

Chemistry, Compliance & Safety, General Information, Hematology, Hemostasis/Coagulation, Microbiology, Referral/Sendouts

CSF Priorities on QNS Specimens

When a Cerebrospinal fluid (CSF) specimen arrives into the laboratory and is deemed Quantity Not Sufficient (QNS) for ordered testing, the ordering provider is contacted to identify testing priorities. Occasionally, the laboratory is unable to secure these priorities.

If the lab is unable to secure priorities from the ordering provider within an hour of collection, the following will occur:

1. We will move forward with the Cell count with differential, Culture, and Protein/Glucose

2. The rest of the ordered testing will hold until we can clarify the priorities

Laboratory is partnering with Epic Beaker to discover if a prioritization of orders, upon CSF order entry, is possible.

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

Hemostasis/Coagulation, Referral/Sendouts

Supply Change Notification: 4.5 mL Blue Citrate Blood Tubes

Effective April 26th, 2021, Spectrum Health Laboratories will discontinue 4.5 mL blue citrate blood tubes. These are a vendor discontinued item. The replacement item will be the 2.7 mL blue citrate blood tubes.

Due to this change, there may be a difference in the number of tubes required to collect for the lab tests below. Please refer to the lab catalog for specimen collection requirements. Continue Reading

Advanced Technology Laboratory, General Information, Main lab

Update: COVID-19 Swab Supplies

If you are collecting COVID-19 swabs in your office or clinic, please order and collect using the saline swab kits (“liquid media” or “wet collection”) instead of the tube with no liquid media (“dry collection”).

• Liquid media swab kits will provide a faster turn-around time.

• Dry collection kits supplies are low.

Please refer to the COVID-19 PCR test in the Lab Catalog for the most up-to-date information on COVID-19 collection.

COVID-19 PCR Swab – LAB1230607

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General Information, Hemostasis/Coagulation

Update: Platelet Aggregation Studies

The Spectrum Health Regional Laboratory Coagulation Department will be going live with the Helena AggRam analyzer on February 3, 2021.  This analyzer uses platelet rich plasma to analyze human platelet aggregation which is measured by absorbance.  The following aggregating agents are used in these studies: Arachidonic Acid, ADP, Collagen, Epinephrine, and Ristocetin.

Patients for platelet aggregation studies should be resting, fasting, and non-smoking. Patients should avoid taking any prescription or over the counter medications known to affect platelet function for ten (10) days to two (2) weeks prior to the studies. For a list of medications known to have anti-platelet effects, click here. Continue Reading