Bleeding with Normal aPTT/PT
85240, 85250, 85270, 85291, 85384, 85245, 85246, 85410, 85415
To assist in the determination of a cause of bleeding in a patient with normal aPTT and PT.
Plasma (3.2% citrated), frozen
6 mL frozen citrated plasma (2 mL into each of three tubes)
Minimum: 3 mL frozen citrated plasma (1 mL into each of three tubes)
Blue-top (sodium citrate) tube
Do not draw from an arm with a heparin lock or heparinized catheter.
Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, “butterfly”), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tubes. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and (using a plastic transfer pipette) carefully remove two-thirds of the plasma without disturbing the cells. Deliver to a plastic transfer tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp No. 49482). The specimen should be frozen immediately and maintained frozen until tested.
Freeze plasma, refrigerate serum, and maintain whole blood and buccal swab kit at room temperature or refrigerate.
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