HELLO! This is Qingling! I was posted to the Haematology Lab for this whole period of attachment and there are like 6 sections of the lab which we'll be rotating every month. So for the first month, I was attached to the Coagulation Stat Lab. This is a 24hours routine lab and everyone in there are always very busy. The Stat Lab is quite small for the number of people working in there and there are 3 sections within the Stat Lab! One is the routine tests for coagulation, another is for urinalysis (I don't know why its not in the CCHEM lab but my supervisor says a few years ago, they changed it to allow the Haem Lab to do it) and another one belongs to the Routine Lab where they do the FBC testing. So basically, I was pinned down to the section where we do the routine testings for coagulation such as PT/APTT (commonly done in Stat Lab).

On the first two weeks, I've been using the SYSMEX automated blood coagulation analyzer CA-1500.



Picture from http://diagnostics.siemens.com/webapp/wcs/stores/servlet/ProductDisplay~q_catalogId~e_-111~a_catTree~e_100001,1015818~a_langId~e_-111~a_productId~e_182051~a_storeId~e_10001.htm



I feel that this is a great invention! It can do multiple tests such as PT, APTT, D-Dimer Assay, Factor Assays, Protein C Assay, Protein S assay etc. The turnaround time for the tests ordered is fast and it increases productivity rate! However in the Stat Lab, only PT and APTT tests are done. The rest of the tests are sent to the Special Coagulation Lab to do.



So basically when samples arrive, this is what I'll do!

1. Collect samples from the Reception Counter
2. Remove blood tube from biohazard bag
3. Check that the name tally with the request form
4. Ensure correct anticoagulant tube is used (citrated ; light blue)
5. Check that volume is sufficient
6. Assign a lab serial number on the request form and initial name next to it
7. Paste the respective barcode label with correct serial number and date on the blood tube
8. Before spinning, invert tube to look for big clot
9. Centrifuge @ 3000rpm for 3minutes. At the same time, log in request in LIS
10. After centrifuging, place them on the sample rack and put on machine's right rack pool ensuring that the barcode labels are facing the scanner in the machine when running.
11. Press START on the analyzer screen to run the test
12. Record the results on the request form
13. Update results in LIS
    

Therefore the principle of Prothrombin Time (PT) is to screen for abnormalities of factors involved in extrinsic pathway such as factor II, V, VII, X, prothrombin and fibrinogen whereas APTT is a screening test that measures clotting factor of intrinsic pathway such as VIII, IX, XI and XII. These can be easily done by using this automated analyzer to perform the tests! The most commonly ordered tests are PT and APTT. It makes work easier for us because manual PT/APTT is so time-consuming! Remember we did it during the Haem practical? Gosh, it's going to take us hours to complete all the tests ordered! Our lab only do it manually if the first result is out of range and when repeated, result is within the range.

Reference range for PT : 9.0 - 12.5sec
Reference range for APTT : 26.0 - 36.1 sec

The manual test is to confirm the result of the repeated test before recording it in the LIS. However, manual testing is rarely done in our lab!

And thats all for my first few weeks in the Stat Lab! I'll be in the Special Coagulation Lab this week and I'll be learning more other tests!

Till then!

-QINGLING- :D