Thanks to Dennis Ernst, MT(ASCP), NCPT(NCCT), Director of the Center for Phlebotomy Education, for contacting BD and Greiner about the current sodium citrate tube shortage. Please refer to our May 17 post describing this issue and see comments from Dennis [which includes BD's recommendations], and from Bob Gosselin, who surveyed several colleagues and learned of several who are experiencing the shortage. Bob added the suggestion that we could return to yesteryear and prepare our own sodium citrate tubes.
While the shortage of blue-stopper tubes creates an administrative nuisance that could affect quality of care, now may be the time to enforce the American Society for Clinical Pathology Choosing Wisely 2013 Recommendation, "Avoid routine preoperative testing for low risk surgeries without a clinical indication," which specifically references the PT and PTT. While the PT and PTT are essential to a coagulation investigation based on indications such as unexplained hemorrhage or a family bleeding tendency, the tests lack sufficient predictive value when applied to an unselected population, and should not be ordered as part of a "rainbow draw."