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Back to the ELT

In follow-up to Cassandra McGeachy’s August 7 question on the euglobulin lysis time (ELT), I’ve found two references for upgraded ELT methods that may be helpful.They are:

  • Cellai AP. Lami D, Magi A, et al. Assessment of fibrinolytic activity by measuring the lysis time of a tissue factor-induced clot: a feasibility evaluation. Clin Appl Thromb Hemost 2010;16:337–44.
  • Smith AA, Jacobson LJ, Miller BI, et al. A new euglobulin clot lysis assay for global fibrinolysis. Thrombos Research 2003:112:329–37.

Honolulu Oct 21–22

George presents “Monitoring the New Anticoagulants, Whatever Happened to the PT and PTT?” and “Managing Trauma-induced Coagulopathy,” for the 2014 ASCLS-HI Clinical Laboratory Symposium Update at the Ko’olan Conference Center near Honolulu, Hawaii, October 21 and 22 (well, someone has to do it!). Times for George’s talks are to be announced. We hope you can attend. Go to ASCLS-HI and click on 2014 ASCLS-HI Clinical Laboratory Symposium Update.

Drawing Above Heparin Line

We avoid collecting blood from an arm that has an intravenous line, however this practice seems to rely on conventional wisdom, not data. Here is a question from Dennis Ernst, Center for Phlebotomy Education about collecting above a heparin line:

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Euglobulin Lysis Time

From friend and colleague Cassandra McGeachy, Louisiana Coagulation Laboratory,

Hi George, I am looking for procedures available for performing the euglobulin lysis time (ELT). I am looking to update my present method if there are any options available.

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Ebola Precautions

George presented the first part of a three-part AACC webinar series, Quality Assurance in Hemostasis; What Makes Us Different? A question arose about Ebola virus specimen management. Though not specifically related to hemostasis, it seems appropriate to provide a link to the US Centers for Disease Control and Prevention (CDC) specimen precautions. What the CDC document does not address is potential instrument contamination. George suggested specimens identified as Ebola should be tested on isolated instruments. How do you manage infections specimens, and what do you recommend?

Factor VII Padua Mutation

As a followup to the July 30 Discordant PT Results, George presented this problem to a colleague in the booth of one of the major hemostasis materials distributors in the Clinical Laboratory Expo, thereby “spoiling his day.” Nevertheless, he had the answer by days’ end, confirming the response posted by Dr. Vadim Kostousov. This was further confirmed by Dr. Emmanuel Favaloro on July 3. Thanks to all who contributed to this interesting case.

AACC “Quick Takes” on Quality Assurance

Join George as he kicks off the American Association of Clinical Chemists (AACC) Quick Takes webinar series with “Quick Takes on Quality Assurance in Hemostasis.” George will present three 30-minute presentations on August 7, 14, and 21, 1–1:30 EDT. He will discuss:

  • Employing local calibration for prothrombin time/international normalized ratio (PT/INR) monitoring of Coumadin therapy.
  • Specimen management for coagulation and platelet aggregometry
  • Determining PTT sensitivity to factor VIII and IX deficiency
  • Developing an ex vivo “Brill-Edwards” curve to establish the partial thromboplastin time (PTT) heparin therapeutic range
  • Calculating clinical sensitivity and specificity and computing receiver-operator curves (ROC analysis)

Discordant PT Results

George is attending the annual AACC meeting at McCormick Place in Chicago. A colleague described a puzzling case in which a patient has a prolonged prothrombin time (PT) using a 1.3 ISI thromboplastin reagent (Stago) and a normal PT when using Dade (Siemens) Innovin. The findings are consistent on repeat split specimens, the PTT is normal, and the patient is not bleeding. Any ideas?

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