Prothrombin Time & Activated PTT

Laboratory : Hematology

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Prothrombin Time & Activated PTT
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PTPTT MACG1

Specimen Type:

Blood

Tube Type:

Blue top (sodium citrate) tube

Collection Volume:

2.7 mL (minimum 1.8 mL) Must use appropriate sodium citrate tube base on volume of blood drawn (1.8 mL or 2.7 mL tube).

Cause for Rejection:

Specimen hemolyzed, clotted, diluted with IV fluid; contaminated with heparin; improperly filled; received > 1 hr after drawn

Storage:

Ambient

Availability:

Daily, 24 hours; STAT

Methodology:

Optical Light Scatter Detection Clotting Assay

Special Instructions:

Indicate clearly if a specimen has been drawn from an arterial line or from a line that has been rinsed with heparin. This information is absolutely essential to the laboratory personnel for proper handling of the specimen and the reporting of results. Please indicate if the patient is currently receiving anticoagulant therapy. If collected at an offsite location, send by a STAT Courier to Akron Children's at Mahoning Valley Hospital lab.

Lab/Phone:

330-746-9623

TAT:

4 hours

Additional Info:

Reference ranges: PT 12-14 secs; APTT < 41 secs

Synonyms:

PT & PTT; Protime & APTT