This question arrived January 8 from Twyla Bader MT (ASCP), Heme/Coag Supervisor at St. Joseph Hospital, Bellingham WA:

We use Diagnostica Stago's  STA Compact analyzers and their LIA D-dimer reagent. Their package insert states there is no interference by hemolysis up to 5.0 g/L HGB. We did find a discrepancy between a hemolyzed sample and a nonhemolyzed recollection from the same patient with little time elapsed. We suspect it was due to a traumatic collection (indicated by hemolysis) that activated the coagulation cascade and resulted in D-dimer produced during the collection process in vitro. What do you  think, is it possible to have a considerable amount of D-dimer result from the collection process alone?

Kim Kinney of the Indiana University Medical Center (Clarian) lab writes:

 

We are getting ready to switch from the BioMerieux MDA to the Beckman Coulter TOPS and I was wondering how labs are now handling specimens that are hemolyzed, lipemic, or icteric. We have had the MDAs for six years and I will miss their ability to flag those specimens. 

Do labs visually check all specimens or just those that are abnormal?  We do still check all samples for clots and may have techs visually check at that time. Thanks for the help, Kim

We check all citrate specimens for clots by probing them with applicator sticks before centrifugation. Is this common practice? Are there alternatives?

Dan Heidemann, MT (ASCP), Oncology Alliance, Milwaukee, WI wrote this question to Medlab-L on Tuesday, December 4. He gave me permission to post it here:

Most people have heard of spontaneous platelet clumping in EDTA, but what if they also clump in a citrate (blue top) tube?  Thanks!

Donald R. Peven, MD, of Pontiac, MI extends the question of discard tubes to their use for factor assays. He writes...

CLSI Standard H-21A4 requires citrate volume adjustment when the hematocrit exceeds 55%.

Here are two informative specimen management links...

I sent out some announcements for our blog last week and received some nice responses from colleagues and former students. I heard from Francy Van Dyke who graduated from one of my earliest classes in Peoria, back when the Earth was forming (sorry, Francy). One of the facilities she works with prohibits...

Please review our previous thread on specimen collection and the comment on discard tubes. It seems that except for butterfly needles, when we use a discard...

Do we really follow specimen collection guidelines? The CLSI...