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Lab Dept:
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Coagulation
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Test Name:
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PROTAMINE CORRECTION (REPTILASE TIME)
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General Information
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Lab Order Codes:
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PCOR
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Synonyms:
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Reptilase Time; Heparin Neutralization; Snake Venom Thrombin Time
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CPT Codes:
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85635 – Reptilase test
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Test Includes:
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Reptilase time reported in seconds.
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Logistics
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Test Indications:
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Atroxin (Reptilase) is purified enzyme from Bothrops atrox venom which converts fibrinogen to fibrin directly, bypassing the conversion of prothrombin to thrombin and the action of thrombin on fibrinogen. Atroxin Time and Thrombin Time are rapid assay tests that measure this polymerization of fibrinogen to fibrin. Any interference with this conversion will be reflected in a prolongation in the clotting time of one or both of these assays. In patients receiving heparin, the Thrombin Time is found to be invariably prolonged, but the Reptilase Time is usually within normal limits. Thus the Reptilase Time can be very helpful in differentiating causes of long Thrombin Times, such as therapy, fibrinogen disorders (hypo-fibrinogenemia and dysfibrinogenemias) or inhibitors of thrombin or of the thrombin/fibrinogen reaction.
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Lab Testing Sections:
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Coagulation - Sendouts
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Referred to:
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Fairview University Medical Center (Test# REPT)
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-6280
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651-220-6550
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Test Availability:
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Daily, 24 hours. Test is performed as needed.
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Turnaround Time:
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6 hours
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Special Instructions:
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Indicate when specimen is drawn from a line or a heparin lock. Deliver immediately to the laboratory.
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Specimen
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Specimen Type:
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Whole blood
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Container:
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Light Blue top (Buffered Na Citrate 3.2%) tube
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Draw Volume:
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2.7 mL blood in a 3 mL tube (Minimum: 2.7 mL in a 3 mL tube).
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Processed Volume:
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Specimen will be processed by the reference lab facility.
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Collection:
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Do Not use the first 2 mL’s of blood collected.
Patients with hematocrit levels of >55% must have a special tube made to adjust for the hematocrit, contact laboratory for special tube.
Fill tube completely. Mix thoroughly by gentle inversion.
If the patient has a coagulation abnormality, apply direct pressure to the puncture site for 10 minutes; apply a pressure dressing. Instruct the patient to leave the bandage on for 12 hours.
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Special Processing:
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Lab Staff: Do Not centrifuge. Send to reference lab in original Vacutainer®.
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Patient Preparation:
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None
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Sample Rejection:
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Improper tube, Clotted samples, Underfilled tubes, Overfilled tubes, Mislabeled or unlabeled specimens
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Interpretive
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Reference Range:
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15.4 – 22.5 seconds
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Critical Values:
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N/A
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Limitations:
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N/A
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Methodology:
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Reptilase snake venom clotting time
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References:
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Fairview University Web Page http://labguide.fairview.org/diagnostic.asp
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Harmening DH (1997) Clinical Hematology and Fundamentals of Hemostasis
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Updates:
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5/25/2010: Tubing patient specimens is no longer prohibited.
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