Collecting and Shipping Specimens for Coagulation from Laboratories outside Saskatoon
Due to the importance of sample integrity for coagulation testing, shipping of specimens for special coagulation is not recommended. The following instructions are to be used in situations where it is impossible to have the patient travel to Saskatoon.
- Referred in frozen specimens (except for D-Dimers) must be accompanied by a platelet count done on the plasma before freezing. Platelet count must be less than 10xe9/L.
- Specimen shall be drawn by phlebotomy. Line draws are not acceptable.
- Specimens must be collected into the plastic (glass is not acceptable) 3.2% (0.105M) sodium citrate tubes adhering to the 9:1 ratio of whole blood anticoagulant.
- Specimens must be processed and frozen at less than -20oC within three hours of collection.
- Platelet poor sodium citrate plasma must remain frozen at less than -20oC during storage. A freezer that undergoes automatic freeze/thaw cycles (frost-free) is not acceptable.
- Platelet poor sodium citrate plasma must remain frozen at less than -20oC during shipping. Specimen must be shipped with dry ice. Ice packs and gel packs are not acceptable.
- Specimens are stable for:
- 2 weeks at less than -20oC
- 12 months at less than -70oC
- Unacceptable specimens:
- specimens that do not adhere to the 9:1 ratio of whole blood to anticoagulant
- specimens that are hemolyzed, icteric, lipemic or clotted
- if the patient's hematocrit is greater than 0.55 the testing shall be cancelled and reordered when the patient's hematocrit is less than 0.55
- the specimen has not been processed and frozen at less than -20oC within 3 hours of collection
- the plasma has not been kept at less than -20oC for 2 weeks or -70°C for up to 12 months
- the plasma has not been tested to be platelet poor before freezing
- the plasma has not been shipped on dry ice
Procedure
| 1 | Collect specimen from patient via phlebotomy and mix gently immediately.
|
| 2 | Transport specimens to the laboratory as soon as possible. |
| 3 | Before centrifugation, check the whole blood specimen for gross clot formation by gentle inversion and observation. |
| 4 | - Centrifuge the capped specimen at a speed and time required to consistently produce platelet poor plasma (CLSI recommends 1500g for 15 minutes at room temperature)
- Transfer plasma to a non-activating plastic centrifuge tube labeled with the patient's information using a plastic pipette
- Recentrifuge this sample an additional 10 minutes
- Using a plastic pipette, aliquot the specimen to another non-activating plastic centrifuge tube labeled with the patient's information and the specimen type
- Perform a platelet count on the plasma aliquot to ensure the platelet count is less than 10x10e9/L. If it is not repeat the procedure to obtain a platelet count of less than 10x10e9/L.
Note: Record the results of the platelet counts and attach to the requisition and paperwork to send with specimen to Royal University Hospital |
| 5 | Make a copy of the original requisition as well include any pertinent patient information and send with the specimens being sent to Royal University Hospital. |
| 6 | Package specimens with enough dry ice to remain frozen during transport in a styrofoam container. Attach requisition, the platelet counts of the frozen sodium citrate plasma as well as any other relevant paperwork and ship to: St. Paul's Hospital
Laboratory - Specimen Management
1702 20th Street West
Saskatoon, SK, S7M 0Z9 They will accession the tests and forward the specimens to the RUH Hematology Laboratory. |
| 7 | Any inquiries regarding Special Coagulation Testing, phone Royal University Hospital Coagulation Division at
306-655-2178. |
If you choose to print this information, it is valid only on date of print.
Laboratory Controlled Document LSM-580 v3
