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Articles tagged with: Blood/coagulation/hematology (see also Phlebotomy) –

Helping phlebotomists ease pediatric patient anxiety

June 2017—“It’s the most talked about pain kids experience, even more so than post-op surgical pain.” Julie Piazza, a certified child life specialist, is referring to needlestick pain from pediatric blood draws. As project manager for patient and family-centered care at C.S. Mott Children’s Hospital in the University of Michigan health system, now known as Michigan Medicine, Ann Arbor, Piazza has observed anxiety at both ends of the needle.

Life-threatening bleeding—what’s the right call?

June 2017—In the CAP16 session, “Your Turn: Management of the Bleeding Patient,” Theresa Nester, MD, reminded attendees who provide transfusion medicine consultation to assess the available information before calling the clinical team: patient history, drugs, coagulation test results, and products administered so far. “Your main role is to help determine why the patient is bleeding and the most appropriate treatment,” said Dr. Nester, medical director of integrated transfusion services at Bloodworks Northwest in Seattle.

Emergency hemorrhage panel gives surgeons what they need

June 2017—As an alternative to point-of-care testing, Wayne Chandler, MD, and colleagues developed and implemented a rapid emergency hemorrhage panel, or EHP, for trauma patients (Chandler WL, et al. Transfusion. 2010;50[12]:2547–2552). The panel tests are prothrombin time, hematocrit, fibrinogen, and platelet count. “By limiting EHPs to patients that were actively bleeding, EHPs accounted for only 8 of 243 coagulation samples per day,” he and colleagues wrote in their 2010 article.

Hemophilia management: Tips on monitoring modified replacement therapies

April 2017—Some modified recombinant factor VIII and IX products for hemophilia prophylaxis show significant reagent-dependent recovery in the one-stage assay, while recovery in the chromogenic assay appears to be more consistent, especially for modified recombinant factor IX. The variable results can lead to over- or underestimating the factor level, warn Stefan Tiefenbacher, PhD, of Colorado Coagulation, and Rajiv K. Pruthi, MBBS, of Mayo Clinic.

Lower HbA1c seen with sickle trait, but questions remain

March 2017—Perhaps unusually for news about clinical diagnostics research, an article in the Feb. 7 issue of JAMA created a mild stir with findings that HbA1c results in patients with sickle cell trait, the most common hemoglobin variant in the U.S., may systematically underestimate past glycemia (Lacy ME, et al. 317[5]:507–515).

Hemophilia diagnosis: how to test, what to know

March 2017—True, hemophilia is no longer commonly known as the “royal disease” (as it was when several generations of European rulers suffered from it). But in a January webinar, Dorothy M. Adcock, MD, gave some royally important suggestions regarding the laboratory diagnosis of hemophilia A and B.

Hemostasis testing guide now out in new edition

June 2016—The older we get, the faster time seems to pass. That’s why 2008 might not feel like all that long ago—until you consider that Obama had yet to take office, Donald Trump’s television appearances were limited largely to The Apprentice, and there was no “like” button on Facebook.

Nothing peripheral about assessing the ‘other’ cytopenias

April 2015—Think age is important only if you’re a Hollywood actress (unless you’re lucky enough to be Meryl Streep)? Think again. Specifically, Joan Etzell, MD, wants pathologists to think about age-adjusted reference ranges for thrombocytopenia and neutropenia. They’re intrinsic to the basic definitions of these diseases, she pointed out in a course on peripheral cytopenias at last year’s AACC meeting.

Pressing questions in POC glucose testing

April 2015—Sometimes major changes to a health care organization’s point-of-care testing system come from powerful regulatory agencies in Washington, DC. Or they may arise when a child with diabetes objects to frequent venipuncture. In either kind of case, experts say, pathologists and laboratory professionals must form strong relationships with clinicians and build structural foundations to help them meet these and other demands.

Study, strategy lift up POC critical value practices

February 2015—Too many point-of-care glucose test results in the critical high and low ranges may be nonreproducible and therefore should be repeated. That was the finding of a study published last year that said POC glucose results in the critical ranges should be considered to have a relatively high probability of signaling a potential preanalytic error.

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