HAEMATOLOGY AND BLOOD TRANSFUSION
CONTROLLED DOCUMENT
Haematology and Blood Transfusion
Laboratory Handbook
Please note that this document is subject to the document control system of the Pathology
Department.
If you feel that this document is no longer fit for purpose please make laboratory
management aware and the document will be reviewed.
DOCUMENT REVIEW HISTORY
Review date
Reviewed by
Updated contact details to include all sites for
Barts Health
17/01/14
June 2015
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Summary of amendments
K Thompson
Format consistent with NHS and Barts Health
branding for display on the external website.
Implement change requests:
CR4953,CR4966,CR4981,CR4844
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 1 of 41
Contents
1
2
3
4
5
6
7
8
9
Introduction ............................................................................................................................ 3
Location, Address and Telephone Numbers ........................................................................ 3
Laboratory Hours ................................................................................................................... 4
Results, Enquiries and Clinical Advice ................................................................................. 4
Key Personnel ........................................................................................................................ 5
Laboratory Contact Numbers ................................................................................................ 8
Complaints and Compliments Procedure............................................................................. 8
Confidentiality ........................................................................................................................ 9
Processing Requests ........................................................................................................... 10
9.1
Specimen bottles/sample types .......................................................................................... 10
9.2
Sample labelling ................................................................................................................. 11
9.3
Sample Labelling for Blood Transfusion .............................................................................. 12
9.4
Sample rejection criteria ..................................................................................................... 12
9.5
High Risk Patients .............................................................................................................. 12
9.6
Urgent Tests ....................................................................................................................... 12
9.7
Sample Storage Policy and Add-on Requests .................................................................... 13
9.8
Requesting Cross-matches ................................................................................................. 13
9.9
Massive Haemorrhage Protocols (including MOH) .............................................................. 13
9.10 Requesting other Blood Components ................................................................................. 14
9.11 Blood Product Administration .............................................................................................. 14
9.12 Cold chain........................................................................................................................... 15
9.13 Transfusion Reactions ........................................................................................................ 15
9.14 Referral laboratories ........................................................................................................... 15
10
Specimen Transport ............................................................................................................. 16
11
Factors affecting tests ......................................................................................................... 16
12
Reports and Results............................................................................................................. 17
13
Test Repertoire ..................................................................................................................... 18
13.1 Test Combinations .............................................................................................................. 29
14
Haematology Reference ranges .......................................................................................... 30
14.1 Full Blood Count Parameters and Cell Counts .................................................................... 30
14.2 Haemostasis Reference Ranges ........................................................................................ 35
14.3 Red Cell Laboratory Reference Ranges.............................................................................. 41
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 2 of 41
1
Introduction
The Pathology specialties provide a comprehensive screening and diagnostic service. This
includes the availability of medical and scientific advice at all times. Members of each
specialty participate in audit, research, teaching, training and quality assurance schemes.
The Haematology department provides Haematology and Blood Transfusion services in
laboratories at the four hospitals of Barts Health NHS Trust. The department operates with a
Hub and Spoke model, with the majority of non-urgent and specialist work being performed
at The Royal London laboratory (hub). Urgent and in-patient work is performed at the spoke
sites at St Bartholomew’s Hospital, Newham University Hospital and Whipps Cross
University hospital.
The Haematology department at The Royal London provides general haematology services
and a number of specialist areas (haemophilia, sickle cell disease, thalassaemia, and
immune thrombocytopenia). The Royal London also provides general and referral blood
transfusion testing, and serves the Royal London Trauma unit, which is the busiest major
trauma centre in London.
St Bartholomew’s Hospital has a large haemato-oncology department that treats patients
with haematological malignancies (leukaemia, lymphoma, etc.) and with the recent
introduction of Barts Heart Centre has become the largest Cardiac centre in Europe.
The spoke laboratories provide services for urgent haematology and haemostasis testing
and general blood transfusion services.
CPA accreditation is currently held by the each of the four laboratories.
2
Location, Address and Telephone Numbers
Site
Address
Telephone Number
020 3416 5000
Royal London Hospital
Pathology and Pharmacy
Building
80 Newark Street
Whitechapel
London E1 2ES
St Bartholomew’s Hospital
West Smithfield
London
EC1A 7BE
020 3416 5000
020 7377 7000
Newham University Hospital
Glen Road
Plaistow
London
E13 8SL
020 3416 5000
020 7476 4000
Whipps Cross University
Hospital
Whipps Cross Road
Leytonstone
London
E11 1NR
020 3416 5000
020 8539 5522
Maps for each location can be found at our website http://www.bartshealth.nhs.uk/contact-us/
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 3 of 41
3
Laboratory Hours
Haematology and Blood Transfusion services are offered 24 hours per day at the Royal
London Hospital, St Bartholomew’s, Newham University Hospital and Whipps Cross
University Hospital. Only urgent tests can be processed outside of normal working hours.
4
Results, Enquiries and Clinical Advice
To obtain results via telephone, please use the contact numbers in the table below. Please
note we are unable to provide results directly to patients, please contact your relevant health
care provider. We are unable to provide Blood Group results over the telephone, these
results may be faxed to a safe-haven fax number.
Results and enquiries can be made during routine working hours (M-F 0900:-17:00).
GPs wishing to make a non-urgent enquiry may contact the GP referral email [email protected] for clinical advice. Emails to this address will receive a
response within 48 hours. For urgent referrals, please contact switchboard at the relevant
site and ask to speak to the Haematology Registrar.
For non-urgent haemato-oncology queries please contact [email protected]
Need information about blood tests? Lab tests online UK has been designed to help patients
better understand the many clinical lab tests, but is also used widely by healthcare
professionals as a source of information.
Laboratory Site
Royal London Hospital
Phone number for results
Main Switchboard 020 3416 5000
60341
60346 (GP’s only)
St Bartholomew’s Hospital
57242
Newham University Hospital
8733/8120
Whipps Cross University Hospital
5810
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 4 of 41
5
Key Personnel
Name
Position
Tony Halton
CSS Group Director
Simon Ashton
CSS Operations Director
[email protected]
Prof. Finbarr Cotter
Pathology Clinical Director
[email protected]
Nicole Gresham
Sarah Glover
Jacquie Wilson
Maureen Finneran
Dr Peter MacCallum
Mark Kowalczuk
Angela Heins
Paul Grist
Sean Platton
Anand Pancholi
Gareth HeywoodBeldon
Julia Lancut
Susan Hood
Dr Shubha Allard
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Associate Director
Pathology
Pathology Business
Manager
Administrator Pathology
Business Unit (PA to
Professor Cotter and
Nicole Gresham)
Senior Medical Secretary
– Clinical Haematology
Lead Clinician for Clinical
Haematology
Service Manager for
Clinical Haematology
Divisional manager –Blood
Sciences (Interim)
Lead Specialist
Biomedical ScientistHaematology and Blood
Transfusion
Principal Scientist
Haematology and
Haemophilia Centre
Chief Biomedical Scientist
Haematology and Blood
Transfusion (Newham)
Chief Biomedical Scientist
Haematology and Blood
Transfusion (Whipps
Cross)
Chief Biomedical Scientist
Blood Transfusion (Royal
London and St
Bartholomew’s)
Acting Chief Biomedical
Scientist Haematology and
Red Cell (Royal London)
Consultant Haematologist
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Email Address
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 5 of 41
Dr Laura Green
Consultant Haematologist
[email protected]
Dr Louise Bowles
Consultant Haematologist
[email protected]
Dr Charles Gutteridge
Consultant Haematologist
[email protected]
Dr Olivia Kreze
Consultant Haematologist
(Newham)
[email protected]
Professor John Pasi
Consultant Haematologist
[email protected]
Dr Tom Butler
Consultant Haematologist
[email protected]
Dr Dan Hart
Consultant Haematologist
[email protected]
Dr Upal Hossain
Consultant Haematologist
(Whipps Cross)
[email protected]
Dr Drew Provan
Consultant Haematologist
[email protected]
Dr Paul Telfer
Consultant Haematologist
[email protected]
Dr Banu Kaya
Consultant Haematologist
[email protected]
Dr Matthew Smith
Consultant Haematologist
[email protected]
Sarah Mills
Matron for Nusing in
Clinical Haematology
Angela Maddison
Transfusion Practitioner
[email protected]
Nidhi Sharma
Transfusion Practitioner
[email protected]
Josephine McCullagh
Transfusion Practitioner
[email protected]
k
Pascal Winter
Michelle Martin
Kate Forsyth
Aldine Thomas
Gaby Olatunde
Agnes Oyewole
Chipo Madangombe
Maxine Scott
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Lead Transfusion
Practitioner
Training Officer –
Haematology and BT
Senior CNS Haemophilia
(Royal London)
Senior CNS
Haemoglobinopathies
(Royal London)
Nurse Specialist
(Newham)
Anticoagulation CNS
(Whipps Cross)
Senior CNS
Anticoagulation (Newham)
Anticoagulation CNS
(Newham)
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 6 of 41
Erum Meraj
Abbi Morris
Wandai Maposia
Louise Taylor
Arlene Osias
Helena Tee
Dmitrij Bartosik
Guy Pickford
Rokey Jagne
Kate Ortiz
Ilyas Miah
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Anticoagulation
Administrator (Newham)
Senior CNS Haemophilia
(Royal London)
CNS Haemophilia (Royal
London)
Research Nurse Lead
(Royal London)
Research Nurse
Practitioner (Royal
London)
Research Coordinator
(Royal London)
Research Practitioner
(Royal London)
Senior CNS
Anticoagulation (Royal
London)
Anticoagulation CNS
(Royal London)
Home Visit Admin
practitioner
Home Visit Admin
practitioner
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 7 of 41
6
Laboratory Contact Numbers
Royal London
Haematology Laboratory
Haemostasis
Blood Transfusion
Red Cell Laboratory
020 3416 5000
60342
61049
60344
61116
Out of Hours BMS
St Bartholomew’s
Haematology Laboratory
Blood transfusion
Out of hours BMS
Newham University Hospital
Blood transfusion
Haematology Laboratory
Out of hours BMS
Whipps Cross University Hospital
Haematology
Transfusion
Out of hours BMS
Specialist Registrars (Royal London and St
Bartholomew’s)
Bleep 1422
020 7377 7000
57243
56130
Bleep 0098
020 7476 4000
8123
8273
Bleep 003
020 8539 5522
5888
5670
Bleep 168
61099
General Adult Haematology - Bleep
1243
Red Cell Disorders - Bleep 1241
Haemostasis/Thrombosis - Bleep
1155
Paediatric haematology - Bleep 1239
SIHMDS & laboratory – Bleep 0328
Haemato-Oncology – Bleep via
switchboard
Bleep 130
Bleep 247
Bleep 075
Bleep 076
Bleep 352
Specialist Registrar (St Bartholomew’s)
Specialist Registrars (Newham)
Specialist Registrars (Whipps Cross)
7 Complaints and Compliments Procedure
The Haematology and Blood Transfusion department manages complaints and compliments
through the Barts Health NHS Trust Corporate Complaints Policy.
The Patient Advice and Liaison Service (PALS) offer confidential advice, support and
information on health-related matters. They provide a point of contact for patients, their
families and their carers. PALS can give you information about the NHS complaints
procedure, including how to get independent help if you want to make a complaint. To
contact PALS, please phone 020 3594 2040 or email [email protected].
GPs and patients may notify the trust of a complaint or compliment by contacting the Central
Complaints Team via email [email protected].
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 8 of 41
8 Confidentiality
The Haematology and Blood Transfusion laboratories adhere to the Barts Health Trust
corporate Data Protection policy, which sets out the standards all staff must adopt in the
handling and management of information about people, to ensure compliance with the Data
Protection Act 1998 as amended by the Freedom of Information Act 2000 (section 68). The
role of our Caldicott Guardian is to ensure the highest levels of confidentiality and security for
patient identifiable information held in the NHS. The Trust’s Caldicott Guardian covers a
number of areas of concern, including keeping patients aware of what the NHS does with
their information, making sure that our staff are familiar with their responsibilities and good
practice, and ensuring that we have good security measures in place on our computer
systems so that patient information is not easily accessible by unauthorised users.
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 9 of 41
9
Processing Requests
9.1 Specimen bottles/sample types
The sample requirements for each test are specified in Section 13.
Figure 1: Microtainer EDTA for
Neonatal samples
Figure 2: Sodium Citrate 3.0mL
Figure 3: EDTA 4mL
Figure 4: EDTA 6mL
This pink top sample tube is primarily used for whole blood
tests such as Full Blood Count. The minimum sample
volume is 0.75mL. The sample bottle can also be used for
neonatal/paediatric blood transfusion testing. Please note
it may not be possible to complete all investigations with
this sample bottle size. See section 9.2 for details on
labelling.
This blue top sample tube is used primarily in
Haemostasis testing. It is essential that the tube is filled
only to the line (total volume 3.0mL). Under or over filled
samples are not able to be processed (see section 9.4). A
microtainer tube for neonatal/paediatric patients is also
available; this needs to be filled to the line, total volume is
1.3mL.
This purple top sample tube is used primarily for whole
blood tests such as Full Blood Count, but can be used for
plasma tests. The minimum sample volume is 2mL for
FBC and ESR requests.
This pink top sample bottle is primarily used for
Transfusion testing. The minimum sample volume is 3mL.
Please note, it may be necessary to provide further
samples where additional investigations are required. See
section 0 for details on labelling.
This yellow top sample bottle is used for serum tests. The
minimum sample volume is 2mL.
Figure 5: Serum Separating Tube
(SST) 6mL
This red top sample bottle is used for serum tests. The
minimum sample volume is 2mL.
Figure 6: Serum (clotted) tube 6mL
This universal container contains no additives and is used
for collection of urine and CSF samples.
Figure 7: Universal Container
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 10 of 41
9.2 Sample labelling
All requests for patients within the Trust should be made via CRS. If CRS is not available,
please follow the guidelines below.
All GP patient requests can be made via T-Quest.
Alternatively, please complete a pre-printed request form and send it to the relevant site
laboratory along with the sample(s) in a sealed specimen bag. Please follow the guidelines
below.
The printed barcoded label must be attached lengthwise down the tube so that the barcode
scanners can read the barcode and samples can be processed. Please do not wrap the
barcode label around the tube, the barcode scanners cannot read the label and this will delay
sample processing and the availability of results.
In the event of a major incident, an incident number may be used in place of an NHS or
Hospital number
Essential
Patient’s full name - spelled correctly or an
On
Sample
Container
Desirable
anonymised coded identifier
Date of Birth and/or Hospital or NHS number
Sample type
Date and Time
On
Request form
Patient’s full name - spelled correctly or an
Requester's bleep
anonymised coded identifier
number
Date of Birth
Clinical information
Patient’s sex
Time sample was
Hospital number or NHS number
collected
Patient’s location (Destination for report)
Identity of person that
The requesting doctor (Consultant or GP)
collected sample
Sample type
Date sample was collected
Urgency of sample
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 11 of 41
9.3 Sample Labelling for Blood Transfusion
Most errors associated with blood transfusion are due to clerical mistakes at the time of
collection of the Group and Screen sample, when the product is collected or at the time of
administration. To minimise this, the Blood Transfusion department operates a zerotolerance policy on inadequately or incorrectly labelled samples. Re-labelling of samples is
not permitted.
Samples for blood transfusion must be accompanied by a request form; the label must be
hand-written and include the following information:
Surname
Forename
DOB
NHS or Hospital Number
Date of collection
Phlebotomists signature
Samples that do not meet these criteria will be rejected. This is in compliance with 2009
Guideline on the Administration of Blood Components issued by British Committee for
Standards in Haematology.
9.4 Sample rejection criteria
It is the responsibility of the clinician requesting the test to ensure that the details on the
request form are accurate and complete.
It is the responsibility of the person taking the sample to ensure that the sample is correctly
labelled.
Samples may be rejected for the following reasons
Sample container broken or leaking
Incorrect sample received for requested test(s)
Insufficient samples
Grossly haemolysed or lipaemic samples
Old/ aged samples
Illegible labelling
Inadequately labelled or unlabelled samples
9.5 High Risk Patients
Samples from patients who may be suspected to have acquired viral haemorrhagic fever
must not be sent to the laboratory without prior discussion; this includes samples for all
routine testing. Under no circumstances must these samples be sent via the air chute.
Please contact the on-call Virology registrar via switchboard for more information.
9.6 Urgent Tests
The expected turn-around-time (TAT) for testing is described in Error! Reference source
ot found.. Samples from A&E are processed as urgent samples. If the clinical situation
requires urgent testing, please contact the relevant department to arrange for priority testing.
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 12 of 41
9.7 Sample Storage Policy and Add-on Requests
Plasma and whole blood samples are generally stored for 48 hours after the report has been
issued. Samples for coagulation testing are generally kept for 24-36 hours. Additional
requests may be made by contacting the relevant department within the laboratories;
however the sample may not be suitable for testing after some duration of time. The sample
validity time for requesting additional tests is described in section 13.
9.8 Requesting Cross-matches
Crossmatches can be made in advance for patients with planned elective surgery dates.
Please note that sample validity is dependent on a patient’s transfusion history. Please
contact the transfusion laboratory to determine if the sample will be valid for the required
date and time. This includes transfusions that have taken place outside of Barts Health.
Patient last transfused
3 to 14 days
15 to 28 days
29 days to 3 months
Samples to be taken
<24 hours before transfusion
<72 hours before transfusion
<One week before transfusion
Urgent crossmatches can be requested by telephone, please contact the transfusion
laboratory directly.
At the Royal London and St Bartholomew’s sites, remote issue blood is available. Blood is
available in specified fridges, and can be accessed for patient’s meeting the relevant
requirements.
Patients with antibodies or other special requirements may take longer to provide compatible
units. Please contact the transfusion laboratory to discuss patient’s requirements and the
timeframe for when blood may be made available.
9.9
Massive Haemorrhage Protocols (including MOH)
SBH
To activate Cardiac Code Red please contact the laboratory on extension 56130 or bleep
0098. State clearly patient’s hospital number, first and last name, patient’s DOB and location
of patient. Give your name, your contact/bleep number. Determine with the laboratory if a
group and screen is required. Request Pack A and/or Pack B.
Pack A contains 6 units Red Cells, 4 units FFP, 2 units Platelets
Pack B contains 6 units Red Cells, 4 units FFP, 2 units Platelets, 2 units Cryoprecipitate
Emergency (O Neg) blood is always available from any of the remote issue fridges
NUH
Contact the Blood Transfusion laboratory (8123 in normal working hours or Bleep 003
outside of normal working hours) and describe a massive haemorrhage or a Code Red. State
clearly patient’s hospital number, first and last name, patient’s DOB and location of patient.
Give your name, your contact/bleep number.
6 red cells, 4FFP, 1cryo and 1 platelet can be provided in the first instance, please state if all
these components are required. It will take 45 minutes to thaw the frozen products.
Emergency (O Neg) blood is available in theatres fridges and in the laboratory fridge.
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 13 of 41
WX
Contact the Blood Transfusion laboratory 5670 (normal working hours) or Bleep 168 (out of
hours) to activate a massive haemorrhage or Code Red. State clearly patient’s hospital
number, first and last name, patient’s DOB and location of patient. Give your name, your
contact/bleep number. Request Pack A or Pack B. It will take 20 minutes to thaw frozen
products.
Pack A contains: 4 units Red Cells, 4 units FFP
Pack B contains: 6 units of Red Cells, 4 FFP, 2 cryoprecipitate and 1 platelet.
2 units of emergency (O Neg) blood are available in the A&E blood fridge.
RLH
Contact the Blood Transfusion laboratory on Trauma phone-61108 to activate a massive
haemorrhage or Code Red. State clearly patient’s hospital number, first and last name,
patient’s DOB and location of patient. Give your name, your contact/bleep number. Request
pack A and/or Pack B
Pack A contains 4x AB FFP and 4 units of emergency (O Neg) Red Cells (available from any
remote issue fridge).
Pack B contains 6 units of Red Cells, 6 FFP, 2 cryoprecipitate and 1 platelet.
Pre thawed AB FFP is available at RLH for patients born before 1st January 1996; for
individuals born on or after 1st January 1996 Octaplas will be issued which will require 20
minutes thawing time.
9.10 Requesting other Blood Components
The following requests for blood products should be referred to the Haematology Registrar
for clinical advice and approval.
Requests for more than four 300mL units of FFP. The exceptions are trauma patients
and cardiac patients at LCH or SBH
All requests for Cryoprecipitate, except for trauma patients, cardiac patients at SBH and
neonates.
All requests for platelets in non-haematology patients, except for trauma patients, cardiac
patients at SBH and neonates.
It has been agreed that trauma patients, cardiac patients at LCH or SBH and neonates
should be given blood products as requested by the clinicians who are currently treating the
patient. Laboratory staff may refer any request that appears to be outside normal clinical
practice to the Haematology Registrar.
Human Albumin: Albumin is issued as requested.
9.11 Blood Product Administration
The type of blood product and the rate of transfusion must be clearly prescribed by medical
staff. Any discrepancy in the identity checks of the patient, the unit of blood, or the
compatibility report, must be reported to the Blood Transfusion laboratory and the blood must
not be transfused until the discrepancy has been resolved. The compatibility report must
remain attached to the patient's prescription chart during the transfusion and the traceability
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 14 of 41
label must be completed at the start of each unit and returned to the laboratory. The
compatibility report must be fixed in the patient's medical notes after the transfusion.
Each transfusion must be documented in the patient's health care record including the
following: Date of the transfusion
Clinical indication for the transfusion
Type of blood component or product used
Transfusion reactions and their management
Effectiveness of the transfusion
9.12 Cold chain
To comply with legislation, red cells must be stored in a refrigerator with the temperature
controlled at 4°C (+/-2°C). Units should only be removed within 30 minutes of transfusion. If a
transfusion is delayed on the ward for any reason, all units must be returned to a blood bank
refrigerator. If units have been removed from a refrigerator for more than 30 minutes, they
must be returned to the Transfusion Laboratory for disposal.
Platelets and Cryoprecipitate must never be refrigerated.
9.13 Transfusion Reactions
If the patient feels unwell or has a rise in temperature of >1oC, the transfusion must be
stopped immediately and the Blood Transfusion Laboratory and Haematology SpR notified.
9.14 Referral laboratories
Referral laboratories used by Barts Health:
Malaria Reference Laboratory
Malaria Reference Laboratory and
Diagnostic Parasite laboratory
Faculty of Infectious and Tropical
Diseases,
London School of Hygiene & Tropical
Medicine,
Keppel St
London, WC1E 7HT
University College London Hospitals
Haemoglobinopathy Genetics Centre
307 Euston Road
London NW1 3AD
Kings Path
Red Cell Protein Laboratory
Kings College Hospital
Denmark Hill
London SE5 9RS
Viapath
King's College Hospital
Bessemer Wing
Denmark Hill
London SE5 9RS
Royal Free London NHS Foundation Trust
Thrombosis and Haemostasis Laboratory
Pond St
London NW3 2QG
Viapath
Guy's Hospital
Great Maze Pond
London SE1 9RT
Great Ormond St
Haematology Camelia Botnar Laboratories
Great Ormond Street Hospital
Great Ormond Street, WC1N 3JH
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 15 of 41
International Blood Group Reference
Laboratory (IBGRL)
500 North Bristol Park,
Northway, Filton
Bristol BS34 7QH
NHSBT
75 Cranmer Terrace,
Tooting
London, SW17 0RB
Clinical Transplantation Laboratory
3rd Floor,
Pathology and Pharmacy Building
80 Newark St, London, E1 2ES
NHSBT
Colindale Avenue,
Colindale,
NW9 5BG
10 Specimen Transport
Blood and urine samples must be placed in sealed plastic specimen bags with a request
form, if not requesting electronically via CRS. Please keep the request form and sample in
separate sections of the specimen bag to avoid cross contamination in the event of a sample
leak.
Routine samples can be left at designated ward specimen collection points in the container
or specimen fridge as appropriate. Urgent samples can be delivered to the laboratory by the
air chute where available, or hand-delivered by porters. Please contact the porters to arrange
delivery of urgent samples. Samples are delivered from GP surgeries and phlebotomy
centres by scheduled courier deliveries, as well as from the spoke laboratories to the hub.
The following specimens MUST NOT be placed in the fridge:
Haematology and Biochemistry samples (unless specifically instructed otherwise)
CD4/CD8 subsets, cell markers and plasma viscosity
11 Factors affecting tests
Factors Affecting Test Performance
Test
Factor Affecting Test
Reported Parameters
Hb, RBC, PLT & WBC
Differential may be
available, depending on
degree of lipaemia
Gross lipaemia
INR, APTT ratio
Coagulation tests
Under filled or over filled samples
Full blood count
Coagulation Tests
Group and screen
Haemolysis
Unable to report results;
a laboratory comment will
be provided
Unable to report results;
a laboratory comment will
be provided
Unable to report results;
a laboratory comment will
be provided
Full Blood Count
Clotting Screen
Platelet function
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 16 of 41
12 Reports and Results
Inpatient and Outpatient pathology results are available to view on Millennium’s Flowsheet in
real time. They are also available on Cyberlab as a back-up.
Significantly abnormal results will be phoned to the ward or bleeped, if the contact number
has been provided
GP pathology results are delivered daily via GP Links. Results are also available on Cyberlab
for GPs that have access.
.
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 17 of 41
13
Test Repertoire
Test repertoire, testing location and special instructions
Test Name
Section
ADAMTS13 assay
Special
Haemostasis
Alpha-2-antiplasmin
Special
Haemostasis
Plasma
Citrate
Anti D Quantitation
Send Away
Whole blood
EDTA - 2x6mL
Pink
Anti Xa
Special
Haemostasis
Sample Type
Container Type
Special Instructions
Turn-Around
Time
Time limit for
add-on request
1 working day
(urgent)
5 working days
(routine)
4 hours if not
frozen, 3 months if
plasma frozen
Contact Haemostasis
Research laboratory at UCLH
Plasma
Citrate
2 days
State clearly name of
anticoagulant that patient is
receiving. Assays available for
UFH, LMWH, Orgaran and
Fondaparinux
4 hours (urgent)
5 working days
(routine)
4 hours if not
frozen, 3 months if
plasma frozen
Contact laboratory
3 days (Complex
antibodies may
require further
investigation at
external reference
laboratory)
2 days
Antibody Titration
Transfusion (RLH)
Whole blood
EDTA - 2x 6mL
Pink
Anti-c Quantitation
Send Away
Whole blood
EDTA - 2x6mL
Pink
5 working days
2 days
Antigen
Phenotyping
Transfusion (RLH)
Whole blood
EDTA - 6mL Pink
3 days
2 days
Antithrombin Activity
Special
haemostasis
Plasma
4x Citrate
1x EDTA-4mL
purple
4 hours (urgent) 5
working days
(routine)
7 days if not
frozen, 3 months if
plasma frozen
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Part of Thrombophilia screen
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 18 of 41
Test Name
Section
Antithrombin
antigen
Send Away
APC resistance
Special
Haemostasis
Apixaban assay
Special
haemostasis
APTT
Sample Type
Container Type
Turn-Around
Time
Special Instructions
6 weeks
4x Citrate
1x EDTA-4mL
purple
Part of Thrombophilia screen
10 working days
Plasma
Citrate
State clearly name of
anticoagulant that patient is
receiving
1 working day
(urgent)
5 working days
(routine)
Haemostasis
Plasma
Citrate
1 hour (urgent) 4
hours (routine)
APTT 50/50 mixing
studies
Haemostasis
Plasma
Citrate
1 hour (urgent) 4
hours (routine)
Argatroban assay
Special
haemostasis
Plasma
Citrate
State clearly name of
anticoagulant that patient is
receiving
BCR-ABL
Molecular
Whole blood
EDTA - 6mL
Purple
Sample should be received
less than 24 hours after
collection
Blood film
morphology
Haematology
Whole blood
EDTA - 4mL
Purple
Contact the laboratory to
indicate urgent samples.
Provide a date and time when
blood products required
Contact haematology registrar
Plasma
Blood Group and
Antibody Screen
Transfusion
Whole blood
EDTA- 6mL pink
1.3mL neonatal
pink top
Bone Marrow
Haematology
Bone Marrow
Aspirate/
trephine
Bone marrow
slides
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
1 working day
(urgent)
5 working days
(routine)
12 hours (urgent)
48 hours (routine)
Same day (Blood
group anomalies
or positive
antibody screens
may require further
investigations)
None
Karen Thompson
Paul Grist
Page 19 of 41
24 hours
Time limit for
add-on request
7 days if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
<24 hours
2 days
[Not applicable]
Test Name
Section
Sample Type
Container Type
Cell-free Foetal
DNA
Send Away
Whole blood
EDTA -6mL Pink
Citrated platelet
count
Haematology
Whole blood
Citrate
EDTA- 4mL
Purple
Collagen binding
assay
Send Away
Plasma
Citrate
CSF Cytospin
Haematology (RLH)
CSF
PLAIN - Universal
Cytochemistry
Turn-Around
Time
Time limit for
add-on request
5 working days
2 days
1 hour (urgent)
2 hours (routine)
<24 hours (not
centrifuged)
6 weeks
4 hours if not
frozen, 3 months if
plasma frozen
Special Instructions
Send both citrate and EDTA
samples together with clear
indication for citrated platelet
count. The citrate sample
cannot be shared with any
coagulation testing
Minimum 1mL sample required
6 hours
Contact laboratory
Citrate
State clearly name of
anticoagulant that patient is
receiving
1 working day
(urgent)
5 working days
(routine)
4 hours if not
frozen, 3 months if
plasma frozen
Whole blood
EDTA - 6mL Pink
Can be performed on 4mL
EDTA if necessary
Same day
2 days
Plasma
Citrate
1 hour (urgent)
4 hours (routine)
7 days if not
frozen, 3 months if
plasma frozen
3 days (Complex
antibodies may
require further
investigation at
external reference
laboratory)
2 days
1 week
<8 hours
Dabigatran assay
Special
Haemostasis
Plasma
DAT Screen
Transfusion
D-Dimer
Haemostasis
Elution Studies
Transfusion (RLH)
Whole blood
EDTA - 6mL pink
EPO
Red Cell Lab
Serum
SST – 5mL
Yellow
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Sample must be received in
the laboratory less than 8
hours after venesection
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 20 of 41
Test Name
Section
Sample Type
Container Type
Special Instructions
ESR
Haematology
Whole blood
EDTA - 4mL
Purple
Sample must be near full
Factor II
Special
Haemostasis
Plasma
Citrate
Factor IX
Special
Haemostasis
Plasma
Citrate
Factor V
Special
Haemostasis
Plasma
Citrate
Factor VII
Special
Haemostasis
Plasma
Citrate
Factor VIII
Special
Haemostasis
Plasma
Citrate
Factor VIII Binding
assay
Send Away
Plasma
Citrate
Factor VIII
chromogenic
Special
haemostasis
Plasma
Citrate
Factor X
Special
Haemostasis
Plasma
Citrate
Factor XI
Special
Haemostasis
Plasma
Citrate
Factor XII
Special
Haemostasis
Plasma
Citrate
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Turn-Around
Time
90 minutes
(urgent)
24 hours (routine)
4 hours (urgent)
2 working days
(routine)
4 hours (urgent)
1 working day
(routine)
4 hours (urgent)
2 working days
(routine)
4 hours (urgent)
2 working days
(routine)
2 hours (urgent)
1 working day
(routine)
6 weeks
2 hours (urgent)
1 working day
(routine)
4 hours (urgent)
2 working days
(routine)
4 hours (urgent)
2 working days
(routine)
4 hours (urgent)
2 working days
(routine)
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 21 of 41
Time limit for
add-on request
<24 hours
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
Section
Sample Type
Container Type
Factor XIII Assay
Special
Haemostasis
Plasma
Citrate
Fibrinogen
Haemostasis
Plasma
Citrate
1 hour (urgent)
4 hours (routine)
Fibrinogen Antigen
Send Away
Plasma
Citrate
6 weeks
Flow Cell Cytometry
for FMH
Send Away
Whole blood
EDTA - 6mL pink
5 working days
Fluid Cytospin
Haematology (RLH)
Fluid
PLAIN - Universal
Full blood count
(FBC)
Haematology
Whole blood
FVL
Molecular
Whole blood
G6PD Assay
Newham
Biochemistry
Whole blood
G6PD Screen
Red Cell Lab
Whole blood
Genotype
Send Away
Whole blood
EDTA - 6mL Pink
Haptoglobin
Red Cell Lab
Serum
SST - 5mL Yellow
HbH bodies
Red Cell Lab
Whole blood
EDTA - 4mL
Purple
Whole blood
EDTA - 4mL
Purple
HBO Screen
Red Cell Lab
Name
Q Pulse ID
Version
Date of Issue
Date of Review
EDTA - 4mL
Purple
EDTA - 4mL
Purple
EDTA - 4mL
Purple
EDTA - 4mL
Purple
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Special Instructions
Turn-Around
Time
4 hours (urgent)
5 working days
(routine)
Test Name
Time limit for
add-on request
4 hours if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
Minimum 1mL sample required
6 hours
Sample must be near full
1 hour (urgent)
2 hours (routine)
<24 hours
10 working days
7 days
<7 days (at 4°C)
Sample should be as fresh as
possible
Complete ethnic origin on
request form or submit FOQ
questionnaire with the sample
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 22 of 41
5 working days
2 days
1 week
<7 days (at 2-8°C)
72 hours
<24 hours
72 hours
<7 days (at 2-8°C)
Test Name
Section
Sample Type
Container Type
Heinz bodies
Red Cell Lab
Whole blood
EDTA - 4mL
Purple
HIT Screen
Special
Haemostasis
Serum
Clotted sample 6mL Red
HLA B27
Send Away
Whole blood
EDTA - 6mL
Purple
HMW Kininogen
Special
Haemostasis
Plasma
Citrate
Homocysteine
Special
Haemostasis
Plasma
IGH Rearrangement
Molecular
Whole blood
IM Screen
Haematology
Whole
blood/plasma
Immunophenotyping Immunophenotyping
Inhibitor Assay
Special
Haemostasis
Name
Q Pulse ID
Version
Date of Issue
Date of Review
EDTA- 4mL
purple
Special Instructions
Turn-Around
Time
1 day Please note:
if the patient is not
splenectomised
the sample may
need to be
incubated for 2448 hours
Discuss with Haematology
Registrar before requesting 4T score needed before
samples will be analysed
Send to laboratory
immediately, on ice, sample
must be separated within 1
hour of venesection if not sent
on ice.
Whole blood
Plasma
Citrate
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
<24 hours
2 working days
7 days if not
frozen, 3 months if
plasma frozen
10 working days
4 hours if not
frozen, 3 months if
plasma frozen
10 working days
<1 hour if not
received on ice. 8
hours if received
on ice
24 hours
<24 hours
1 working day
(urgent)
5 working days
(routine)
Same day (urgent)
3 working days
(routine)
7 days if not
frozen, 3 months if
plasma frozen
EDTA - 6mL
Purple
EDTA - 4mL
Purple
EDTA - 4mL
Purple
Time limit for
add-on request
None
Karen Thompson
Paul Grist
Page 23 of 41
Test Name
Section
Sample Type
Container Type
Inhibitor Screen
Special
Haemostasis
Plasma
Citrate
INR
Haemostasis
Plasma
Citrate
Iron Stain
Haematology
Bone Marrow
Aspirate
JAK2
Molecular
Whole blood
Kleihauer
Transfusion
Whole blood
EDTA - 4mL
Purple
EDTA - 6mL
Purple
EDTA – 6mL pink
from mother and
EDTA -4mL
purple cord blood
Lupus Screen
Special
Haemostasis
Plasma
Malaria Screen
Haematology
Whole blood
Methotrexate
Send Away
Serum
NBS Referral
Neonatal HBO
screen
Send Away
Red Cell Laboratory
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Whole blood
Whole blood
Special Instructions
1 hour (urgent)
4 hours (routine)
Discuss with haematology
registrar prior to test
1 week
Maternal and cord blood must
be received together
3 days
1 working day
(urgent)
5 working days
(routine)
2 hours (inpatient)
6 hours (GP)
3x Citrate
EDTA - 4mL
Purple
EDTA- 4 mL
purple or SST 5mL Yellow
EDTA- 2x6mL
pink
EDTA
Microcontainer
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Turn-Around
Time
Same day (urgent)
3 working days
(routine)
None
24 hours if not
frozen, 3 months if
plasma frozen
<6 hours
3 working days
Same day
5 working days
(complex antibody
investigations may
require more
extensive testing)
2 days
72 hours
<7 days
Only performed via liaison with
Haematology consultant. This
screen normally performed via
national screening laboratory
using the neonatal blood spot
card
Hard Copy Location
Author
Authoriser
Page
Time limit for
add-on request
7 days if not
frozen, 3 months if
plasma frozen
24 hours if not
frozen, 3 months if
plasma frozen
None
Karen Thompson
Paul Grist
Page 24 of 41
Test Name
Section
Sample Type
Container Type
Neutrophil alkaline
phosophatase
Neutrophil
Antibodies
O2 dissociation
Curve
Send Away
Whole blood
Send Away
Whole blood
P5N
Send Away
Whole blood
PFA-100 Assay
Special
Haemostasis
Plasma
2x Citrate
PIVKA proteins
Send Away
Plasma
Citrate
PK Assay
Send away
Whole blood
PK Screen
Send Away
Whole blood
Plasma Viscosity
Send Away
Plasma
EDTA - 4mL
Purple
Plasminogen
Special
Haemostasis
Plasma
Citrate
Platelet Function
Tests
Special
Haemostasis
Plasma
4x Citrate
Platelet Immunolgy
Send Away
Whole blood
EDTA-6mL pink
SST- 6mL Red
Platelet Nucleotides
Send Away
Plasma
2x Citrate
Turn-Around
Time
Special Instructions
Time limit for
add-on request
Contact laboratory
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Clotted sample 6mL Red
EDTA - 4mL
Purple
EDTA - 4mL
Purple
EDTA - 4mL
Purple
EDTA - 4mL
Purple
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Contact laboratory
5 working days
Contact laboratory
4 weeks
Can only be performed by prior
arrangement with laboratory
through Haematology Day Unit
Same day
[Not applicable]
6 weeks
4 hours if not
frozen, 3 months if
plasma frozen
Contact laboratory
2 weeks
Contact laboratory
2 weeks
4 days (at 4°C)
Do not refrigerate; sample
must be received in laboratory
within 12 hours of venesection
3 working days
Same day
10 working days
4 hours if not
frozen, 3 months if
plasma frozen
Same day
[Not applicable]
5 working days
2 days
Same day
[Not applicable]
Can only be performed by prior
arrangement with laboratory
through Haematology Day Unit
Please contact laboratory for
specific sample requirements.
Samples must reach the
referral laboratory within 3
days of venesection
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 25 of 41
Turn-Around
Time
Section
Sample Type
Container Type
Prekallikrein Assay
Special
Haemostasis
Plasma
Citrate
Protein C Activity
Special
Haemostasis
Plasma
4x Citrate
1x EDTA-4mL
purple
Protein C Antigen
Send Away
Plasma
Citrate
Protein S Antigen
(Total)
Send away
Plasma
Citrate
Protein S Free
Special
Haemostasis
Plasma
4x Citrate
1x EDTA-4mL
purple
Prothrombin Time
(PT/INR)
Haemostasis
Plasma
Citrate
1 hour (urgent)
4 hours (routine)
Prothrombin
Variant/Prothrombin
Gene Mutation
Molecular
Whole blood
EDTA - 4mL
Purple
10 working days
7 days
PT 50/50 mixing
studies
Haemostasis
Plasma
Citrate
1 hour (urgent)
4 hours (Routine)
4 hours if not
frozen, 3 months if
plasma frozen
Red Cell Folate
Red Cell Lab
Whole blood
5 days
7 days (at 4°C)
Reticulocytes
Haematology
Whole blood
1 hour (urgent)
2 hours (routine)
<24 hours
Rh Phenotype
Transfusion
Whole blood
EDTA - 6mL Pink
Same day
2 days
Ristocetin
Sensitivity
Special
Haemostasis
Plasma
4 x Citrate -
Same day
[Not applicable]
Name
Q Pulse ID
Version
Date of Issue
Date of Review
EDTA - 4mL
Purple
EDTA - 4mL
Purple
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Special Instructions
Time limit for
add-on request
4 hours if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
7 days if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
Test Name
10 working days
Part of Thrombophilia screen
4 hours (urgent)
5 working days
(routine)
Part of Thrombophilia screen
4 hours (urgent)
5 working days
(routine)
Minimum 2mLs sample
required
Can only be performed by prior
arrangement with laboratory
through Haematology Day Unit
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 26 of 41
Test Name
Section
Sample Type
Container Type
Special Instructions
Rivaroxaban assay
Special
Haemostasis
Plasma
Citrate
State clearly name of
anticoagulant that patient is
receiving
Serum Transferrin
Receptor
Send Away
Please check EPR to
determine if sickle status is
already known. Send sample 3
days in advance of planned
surgery. Provide details of
when surgery will take place.
Sickle Cell screen
Haematology
Whole blood
EDTA – 4mL
purple
T Cell Receptor B
Molecular
Whole blood
EDTA - 6mL
Purple
Thrombin
generation
Special
haemostasis
Plasma
Citrate
Thrombin Time
Haemostasis
Plasma
Citrate
Urinary
Haemosiderin
Haematology
Urine
PLAIN - Universal
Vitamin K epoxide
Send Away
Plasma
Citrate
vW collagen binding
assays
Send Away
Plasma
Citrate
VWF Antigen
Special
Haemostasis
Plasma
Citrate
VWF Activity
Special
Haemostasis
Plasma
Citrate
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Turn-Around
Time
1 working day
(urgent)
5 working days
(routine)
1 hour (urgent)
24 hours (routine)
Time limit for
add-on request
4 hours if not
frozen, 3 months if
plasma frozen
<7 days
1 hour (urgent)
4 hours (routine)
6 weeks
Hard Copy Location
Author
Authoriser
Page
4 hours if not
frozen, 3 months if
plasma frozen
24 hours if not
frozen, 3 months if
plasma frozen
1 week
[Not applicable]
2 hours (urgent)
1 working day
(routine)
1 working day
(urgent)
5 working days
(routine)
7 days if not
frozen, 3 months if
plasma frozen
None
Karen Thompson
Paul Grist
Page 27 of 41
4 hours if not
frozen, 3 months if
plasma frozen
Section
Sample Type
Container Type
VWF Multimers
Send Away
Plasma
Citrate
6 weeks
Warfarin Plasma
Conc
Send Away
Plasma
Citrate
6 weeks
Zinc protoporphyrin
Red Cell Lab
Whole blood
EDTA - 4mL
Purple
1 week
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Special Instructions
Turn-Around
Time
Test Name
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 28 of 41
Time limit for
add-on request
4 hours if not
frozen, 3 months if
plasma frozen
4 hours if not
frozen, 3 months if
plasma frozen
7 days (at 4°C)
13.1 Test Combinations
Test Name
Section
Sample
Type
Container
Type
Special Instructions
Turn-Around
Time
Coagulation Screen (PT/INR/APTT) +/Fibrinogen, D-Dimer, Thrombin Time
Haemostasis (all sites)
Plasma
1 x Citrate
Sample must be filled to
the line for the citrate
samples.
1 hour (urgent)
4 hours (routine)
Plasma and
whole blood
4 x Citrate and
1 x 4ml EDTA
Sample must be filled to
the line for the citrate
samples.
10 working days
Plasma
3 x Citrate
Plasma
3 x Citrate
Platelet Function
Plasma
Additional 4 x
Citrate
Platelet Nucleotides
Plasma
Additional 2 x
Citrate
PFA-100,
Plasma
Additional 2 x
Citrate
Thrombophilia Screen (PT/INR, APTT,
TT, fibrinogen, antithrombin, protein S,
protein C, APC resistance, lupus
anticoagulant, factor V Leiden,
prothrombin gene mutation)
Lupus Anticoagulant screen (PT/INR,
APTT, TT, lupus anticoagulant)
Von Willebrand Screen (PT/INR, APTT,
TT, fibrinogen, factor VIII, von Willebrand
antigen, von Willebrand activity)
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haemostasis
(Royal London).
Samples can be sent via
laboratories at other sites
– samples will be frozen
and sent to Royal London
for processing
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
Sample must be filled to
the line for the citrate
samples.
Sample must be filled to
the line for the citrate
samples.
Sample must be filled to
the line for the citrate
samples.
Sample must be filled to
the line for the citrate
samples.
Sample must be filled to
the line for the citrate
samples.
None
Karen Thompson
Paul Grist
Page 29 of 41
5 working days
5 working days
5 working days
5 working days
5 working days
14 Haematology Reference ranges
14.1 Full Blood Count Parameters and Cell Counts
Result
Result
below
above
Lower Upper Reporting
which
which
Full Name
Age
Limit
Limit
Units
result
result
requires
requires
review
review
th
Routine tests * reference ranges taken from Practical Haematology, Dacie and Lewis, 11 Edition (2012)
<3d
10.0
26.0
x109/L
<7d
7.0
23.0
x109/L
All results require review
<14d
6.0
22.0
x109/L
<1m
6.0
22.0
x109/L
<2m
5.0
19.0
x109/L
White blood cell count*
<3m
5.0
15.0
x109/L
<4m
6.0
18.0
x109/L
<1
6.0
16.0
x109/L
3.0
30.0
<6
5.0
15.0
x109/L
<12
5.0
13.0
x109/L
>12
4.0
10.0
x109/L
<3d
5.00
7.00
x1012/L
<7d
4.00
6.60
x1012/L
All results require review
<14d
3.90
6.30
x1012/L
<1m
3.60
6.20
x1012/L
<2m
3.00
5.40
x1012/L
<3m
3.10
4.30
x1012/L
Red blood cell count*
<4m
4.10
5.30
x1012/L
<1
3.90
5.10
x1012/L
No results require review
<6
4.00
5.20
x1012/L
<12
4.00
5.20
x1012/L
>12 
4.50
5.50
x1012/L
>12 
3.80
4.80
x1012/L
<3d
14.0
22.0
g/dL
<7d
15.0
21.0
g/dL
All results require review
<14d
13.5
21.5
g/dL
<1m
12.5
20.5
g/dL
<2m
11.5
16.5
g/dL
90
180
<3m
9.4
13.0
g/dL
90
145
Haemoglobin level*
<4m
11.1
14.1
g/dL
90
156
<1
11.1
14.1
g/dL
90
156
<6
11.0
14.0
g/dL
90
155
<12
11.5
15.5
g/dL
90
170
>12 
13.0
17.0
g/dL
90
185
>12 
12.0
15.0
g/dL
90
165
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 30 of 41
Result
Result
below
above
Lower Upper Reporting
which
which
Full Name
Age
Limit
Limit
Units
result
result
requires
requires
review
review
th
Routine tests * reference ranges taken from Practical Haematology, Dacie and Lewis, 11 Edition (2012)
<3d
0.45
0.75
<7d
0.45
0.67
All results require review
<14d
0.52
0.66
<1m
0.31
0.71
<2m
0.33
0.53
<3m
0.28
0.42
Haematocrit*
<4m
0.30
0.40
<1
0.30
0.38
No results require review
<6
0.34
0.40
<12
0.35
0.45
>12 
0.40
0.50
>12 
0.36
0.46
<3d
100.0 120.0
fL
<7d
92.0
118.0
fL
All results require review
<14d
88.0
126.0
fL
<1m
86.0
124.0
fL
<2m
92.0
116.0
fL
87.0
121.0
Mean cell volume*
<3m
87.0
103.0
fL
82.0
108.0
<4m
68.0
84.0
fL
65.0
89.0
<1
72.0
84.0
fL
67.0
89.0
<6
75.0
87.0
fL
70.0
92.0
<12
77.0
95.0
fL
72.0
100.0
>12
83.0
101.0
fL
78.0
106.0
<3d
31.0
37.0
pg
<7d
31.0
37.0
pg
All results require review
<14d
31.0
37.0
pg
<1m
31.0
37.0
pg
<2m
30.0
36.0
pg
Mean cell haemoglobin*
<3m
27.0
33.0
pg
<4m
24.0
30.0
pg
<1
25.0
29.0
pg
No results require review
<6
24.0
30.0
pg
<12
25.0
33.0
pg
>12
27.0
32.0
pg
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 31 of 41
Result
Result
below
above
Lower Upper Reporting
which
which
Full Name
Age
Limit
Limit
Units
result
result
requires
requires
review
review
th
Routine tests * reference ranges taken from Practical Haematology, Dacie and Lewis, 11 Edition (2012)
<3d
30.0
36.0
g/dL
<7d
29.0
37.0
g/dL
All results require review
<14d
28.0
38.0
g/dL
<1m
28.0
38.0
g/dL
<2m
29.0
37.0
g/dL
265
395
Mean cell haemoglobin concentration*
<3m
28.5
35.5
g/dL
260
380
<4m
30.0
36.0
g/dL
275
385
<1
32.0
36.0
g/dL
295
385
<6
31.0
37.0
g/dL
285
395
<12
31.0
37.0
g/dL
285
395
>12
31.5
34.5
g/dL
290
370
Red cell distribution width*
>12
11.6
14.0
%
0
20
9
<3d
100
450
x10 /L
<7d
210
500
x109/L
All results require review
<14d
160
500
x109/L
<1m
170
500
x109/L
<2m
200
500
x109/L
Platelet count*
<3m
210
650
x109/L
<4m
200
550
x109/L
<1
200
550
x109/L
120
600
9
<6
200
490
x10 /L
<12
170
450
x109/L
>12
150
410
x109/L
<3d
4.0
14.0
x109/L
<7d
3.0
5.0
x109/L
All results require review
<14d
3.0
6.0
x109/L
<1m
3.0
7.0
x109/L
<2m
3.0
9.0
x109/L
2.5
20.0
9
Neutrophil count*
<3m
1.0
5.0
x10 /L
1.0
20.0
<4m
1.0
6.0
x109/L
1.0
20.0
9
<1
1.0
7.0
x10 /L
1.0
20.0
<6
1.5
8.0
x109/L
1.0
20.0
9
<12
2.0
8.0
x10 /L
1.5
20.0
>12
2.0
7.0
x109/L
1.5
20.0
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 32 of 41
Result
Result
below
above
Lower Upper Reporting
which
which
Full Name
Age
Limit
Limit
Units
result
result
requires
requires
review
review
th
Routine tests * reference ranges taken from Practical Haematology, Dacie and Lewis, 11 Edition (2012)
<3d
3.0
8.0
x109/L
<7d
2.0
8.0
x109/L
All results require review
<14d
3.0
9.0
x109/L
<1m
3.0
9.0
x109/L
<2m
3.0
16.0
x109/L
0
18.0
9
Lymphocyte count*
<3m
4.0
10.0
x10 /L
0
12.0
<4m
4.0
12.0
x109/L
0
14.0
9
<1
3.5
11.0
x10 /L
0
13.0
<6
6.0
9.0
x109/L
0
11.0
<12
1.0
5.0
x109/L
0
7.0
9
>12
1.0
3.0
x10 /L
0
5.0
<3d
0.5
2.0
x109/L
<7d
0.5
1.0
x109/L
All results require review
<14d
0.1
1.7
x109/L
<1m
0.1
1.7
x109/L
<2m
0.3
1.0
x109/L
0
1.5
9
Monocyte count*
<3m
0.4
1.2
x10 /L
0
1.7
<4m
0.2
1.2
x109/L
0
1.7
9
<1
0.2
1.0
x10 /L
0
1.5
<6
0.2
1.0
x109/L
0
1.5
9
<12
0.2
1.0
x10 /L
0
1.5
>12
0.2
1.0
x109/L
0
1.5
9
<3d
0.1
1.0
x10 /L
<7d
0.1
2.0
x109/L
All results require review
<14d
0.1
0.8
x109/L
<1m
0.1
0.9
x109/L
<2m
0.2
1.0
x109/L
0
2.0
Eosinophil count*
<3m
0.1
1.0
x109/L
0
2.0
9
<4m
0.1
1.0
x10 /L
0
2.0
<1
0.1
1.0
x109/L
0
2.0
9
<6
0.1
1.0
x10 /L
0
2.0
<12
0.1
1.0
x109/L
0
2.0
9
>12
0.0
0.5
x10 /L
0
1.5
Basophil count*
>12
0
0.1
x109/L
0
0.3
9
Nucleated red blood cell count
All
0
0.2
x10 /L
0
0.2
Blasts
All
0
0
%
All results require review
Promyleocytes
All
0
0
%
All results require review
Metamyelocytes
All
0
0
%
All results require review
Myelocytes
All
0
0
%
All results require review
Atypical Lymphocytes
All
0
0
%
All results require review
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 33 of 41
Result
Result
below
above
Lower Upper Reporting
which
which
Full Name
Age
Limit
Limit
Units
result
result
requires
requires
review
review
th
Routine tests * reference ranges taken from Practical Haematology, Dacie and Lewis, 11 Edition (2012)
17-50 
1
10
mm/hr
<60 
1
12
mm/hr
<70 
1
14
mm/hr
>70 
1
30
mm/hr
Erythrocyte sedimentation rate*
No results require review
17-50 
1
12
mm/hr
<60 
1
19
mm/hr
<70 
1
20
mm/hr
>70 
1
35
mm/hr
<3d
120.0 400.0
x109/L
<7d
50.0
350.0
x109/L
<14d
50.0
100.0
x109/L
<1m
50.0
100.0
x109/L
<2m
20.0
60.0
x109/L
<3m
30.0
50.0
x109/L
Reticulocytes*
No results require review
<4m
40.0
100.0
x109/L
<1
30.0
100.0
x109/L
<6
30.0
100.0
x109/L
<12
30.0
100.0
x109/L
>12
50.0
100.0
x109/L
>12
0.5
2.5
%
CSF Red Cell Count
All
0
0
x106/L
All results require review
CSF White Cell Count
All
0
0
x106/L
All results require review
9
Fluid Red Cell Count
All
0
0
x10 /L
All results require review
Fluid White Cell Count
All
0
0
x109/L
All results require review
-1
Plasma Viscosity
All
1.5
1.72
mPA s
All results require review
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 34 of 41
14.2 Haemostasis Reference Ranges
Full Name
Age
Lower Limit
Upper Limit
Units
Result below
which result
requires
review
Result above
which result
requires
review
Routine Haemostasis
Reference range for tests marked * may change with each batch of reagent
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >6m locally derived.
<1d
8.8
13.8
Seconds
<5d
8.3
13.3
Seconds
<1m
8.1
12.5
Seconds
All results require review
PT*
<3m
8.4
12.4
Seconds
<6m
9.3
12.1
Seconds
>6m
9.4
12.2
Seconds
14.0
<1d
0.8
1.3
<5d
0.8
1.2
<1m
0.8
1.2
All results require review
INR
<3m
0.8
1.1
<6m
0.9
1.1
>6m
0.9
1.1
0.7
4.9
<1d
8.8
13.8
Seconds
<5d
8.3
13.3
Seconds
<1m
8.1
12.5
Seconds
PT 50/50*
All results require review
<3m
8.4
12.4
Seconds
<6m
9.3
12.1
Seconds
>6m
9.4
12.2
Seconds
<1d
24
42
Seconds
<5d
20
46
Seconds
<1m
20
43
Seconds
All results require review
APTT*
<3m
19
39
Seconds
<6m
22
33
Seconds
>6m
21
31
Seconds
31
<1d
0.9
1.6
<5d
0.8
1.8
<1m
0.8
1.7
APTT ratio
No results require review
<3m
0.7
1.5
<6m
0.8
1.3
>6m
0.8
1.2
<1d
24
42
Seconds
<5d
20
46
Seconds
<1m
20
43
Seconds
APTT 50/50*
All results require review
<3m
19
39
Seconds
<6m
22
33
Seconds
>6m
21
31
Seconds
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 35 of 41
Full Name
Age
Lower Limit
Upper Limit
Units
Result below
which result
requires
review
Result above
which result
requires
review
Routine Haemostasis
Reference range for tests marked * may change with each batch of reagent
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >6m locally derived.
<1d
11
16
Seconds
<5d
10
17
Seconds
<1m
11
17
Seconds
TT*
No results require review
<3m
12
17
Seconds
<6m
11
18
Seconds
>6m
11
18
Seconds
<1d
0.7
1.1
<5d
0.7
1.2
<1m
0.8
1.2
TT ratio
No results require review
<3m
0.8
1.2
<6m
0.8
1.2
>6m
0.8
1.2
<1d
1.67
3.99
g/L
<5d
1.62
4.62
g/L
<1m
1.62
3.78
g/L
All results require review
Clauss fibrinogen
<3m
1.07
3.79
g/L
<6m
1.15
3.87
g/L
>6m
1.56
4.00
g/L
1.00
10.00
Fibrinogen antigen
All
1.50
4.50
g/L
All results require review
D-dimer
All
0
0.44
mg/L FEU
No results require review
Full Name
Age
Lower Limit
DRVVT
DRVVT + PNP
DRVVT + PNP correction
DRVVT 50/50
DRVVT 50/50 + PNP
DRVVT EVM + PNP
correction
Dilute APTT
Dilute APTT + PNP
Dilute APTT + PNP
correction
Dilute APTT EVM
Dilute APTT EVM + PNP
Dilute APTT EVM + PNP
correction
All
All
All
All
All
0.74
0.85
0
0.82
0.82
All
0
10
%
All
All
0.83
0.84
1.15
1.06
Ratio
Ratio
All
0
10
%
All
All
0.89
0.91
1.10
1.05
Ratio
Ratio
All
0
10
%
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Upper Limit
Units
Result below
which result
will fail
Result above
which result
will fail
Lupus anticoagulant tests
1.10
Ratio
1.06
Ratio
10
%
1.06
Ratio
1.02
Ratio
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
No results require review
None
Karen Thompson
Paul Grist
Page 36 of 41
Full Name
Age
Lower Limit
Upper Limit
Units
Result below
which result
will fail
Result above
which result
will fail
Lupus anticoagulant tests
Lupus interpretation summarises findings of above tests, as required by ISTH and BCSH guidelines
Thrombophilia opinion summarises interpretation of test results by
Chief Biomedical Scientist or Haematology Clinicians
Full Name
Age
Lower
Limit
Upper
Limit
Units
Result below
which result will
fail
Result above
which result will
fail
Thrombophilia tests
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >16y locally derived. Thrombophilia
opinion summarises interpretation of test results by Chief Biomedical Scientist or Haematology Clinicians
<1d
39
87
iu/dL
<5d
41
93
iu/dL
<1m
48
108
iu/dL
<3m
73
121
iu/dL
Antithrombin
<1
76
130
iu/dL
No results require review
activity
<6
82
139
iu/dL
<10
90
131
iu/dL
<17
77
132
iu/dL
>16
81
119
iu/dL
Antithrombin
All
83
124
iu/dL
All results require review
antigen
<1d
17
53
iu/dL
<5d
20
64
iu/dL
<1m
21
65
iu/dL
<3m
28
80
iu/dL
<6m
37
81
iu/dL
Protein C activity
No results require review
<5
40
92
iu/dL
<10
45
93
iu/dL
55
111
iu/dL
16
>16
72
162
iu/dL
Protein C antigen
All
65
108
iu/dL
All results require review
<1d
12
60
iu/dL
<5d
22
78
iu/dL
<1m
33
93
iu/dL
<3m
54
118
iu/dL
<6m
54
119
iu/dL
Free Protein S
No results require review
antigen
<5y
54
118
iu/dL
<10y
41
114
iu/dL
52
92
iu/dL
16y
>16y
68
139
iu/dL
>16y
60
114
iu/dL
Total Protein S
All
67
140
iu/dL
All results require review
antigen
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 37 of 41
Full Name
Age
Lower
Limit
Upper
Limit
Units
Result below
which result will
fail
Result above
which result will
fail
Thrombophilia tests
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >16y locally derived. Thrombophilia
opinion summarises interpretation of test results by Chief Biomedical Scientist or Haematology Clinicians
APC resistance
>16
0.80
ratio
No results require review
Anti-Xa
All
IU/mL
No results require review
<1d
42
89
iu/dL
10
200
<5d
47
99
iu/dL
10
200
<1m
42
91
iu/dL
10
200
Plasminogen
<3m
59
108
iu/dL
10
200
<6m
74
128
iu/dL
10
200
>6m
83
143
iu/dL
10
200
Homocysteine
All
5.00
15.00
mmol/L
No results require review
Full Name
Age
Lower Limit
Upper Limit
Units
Result below
which result
will fail
Result above
which result
will fail
Haemophilia tests
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >6m locally derived.
<1d
50.0
178.0
<5d
50.0
154.0
<1m
50.0
157.0
Factor VIII
iu/dL
10
200
<3m
50.0
125.0
<6m
50.0
109.0
>6m
52.0
153.0
<1d
50.0
178.0
<5d
50.0
154.0
<1m
50.0
157.0
Factor VIII
iu/dL
10
200
(chromogenic)
<3m
50.0
125.0
<6m
50.0
109.0
>6m
51.0
160.0
<1d
15.0
91.0
<5d
15.0
91.0
<1m
21.0
81.0
Factor IX
iu/dL
10
200
<3m
21.0
113.0
<6m
36.0
136.0
>6m
58.0
138.0
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 38 of 41
Full Name
Age
Lower Limit
Upper Limit
Units
Result below
which result
will fail
Result above
which result
will fail
Haemophilia tests
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >6m locally derived.
<1d
10.0
66.0
<5d
23.0
87.0
<1m
27.0
79.0
Factor XI
iu/dL
10
200
<3m
41.0
97.0
<6m
38.0
134.0
>6m
58.0
148.0
<1d
13.0
93.0
<5d
11.0
83.0
<1m
17.0
81.0
Factor XII
iu/dL
10
200
<3m
25.0
109.0
<6m
39.0
115.0
>6m
52.0
164.0
<1d
26.0
70.0
<5d
33.0
93.0
<1m
34.0
102.0
Factor II
iu/dL
10
200
<3m
45.0
105.0
<6m
60.0
116.0
>6m
70.0
146.0
<1d
36.0
108.0
<5d
45.0
145.0
<1m
62.0
134.0
Factor V
iu/dL
10
200
<3m
48.0
132.0
<6m
55.0
127.0
>6m
62.0
150.0
<1d
28.0
104.0
<5d
35.0
143.0
<1m
42.0
138.0
Factor VII
iu/dL
10
200
<3m
39.0
143.0
<6m
47.0
127.0
>6m
67.0
143.0
<1d
12.0
68.0
<5d
19.0
79.0
<1m
31.0
87.0
Factor X
iu/dL
10
200
<3m
35.0
107.0
<6m
38.0
118.0
>6m
60.0
152.0
<1d
27.0
131.0
<5d
44.0
144.0
<1m
39.0
147.0
Factor XIII
iu/dL
10
200
<3m
36.0
172.0
<6m
46.0
162.0
>6m
55.0
155.0
vW:Ag
<1d
50.0
287.0
iu/dL
15
200
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 39 of 41
Full Name
Age
Lower Limit
Upper Limit
Result below
which result
will fail
Units
Result above
which result
will fail
Haemophilia tests
Paediatric reference ranges are taken from “Development of the human coagulation system in the full-term
infant.” M Andrew et al. Blood (1987); 70: 165-172. Reference ranges for >6m locally derived.
<5d
50.0
254.0
<1m
50.0
246.0
<3m
50.0
206.0
<6m
50.0
197.0
>6m
50.0
156.0
vW:RCo
All
41.0
161.0
iu/dL
10
200
vW:CBA
All
50
150
iu/dL
All results require review
<1d
6.0
102.0
<5d
18.0
130.0
<1m
33.0
121.0
High Molecular
u/dL
All results require review
Weight Kininogen
<3m
18.0
146.0
<6m
36.0
128.0
>6m
48.0
136.0
<1d
5.0
69.0
<5d
20.0
76.0
<1m
23.0
91.0
Prekallikrein
u/dL
All results require review
<3m
41.0
105.0
<6m
56.0
116.0
>6m
62.0
162.0
<1d
55.0
115.0
<5d
70.0
130.0
<1m
76.0
124.0
iu/dL
10
200
2-antiplasmin
<3m
76.0
140.0
<6m
83.0
139.0
>6m
68.0
136.0
Inhibitor activity
All
0
0.6
NBu/mL
All results require review
Haemophilia opinion summarises interpretation of test results by Haematology Clinicians
Full Name
Age
Lower
Limit
ADP 5µM
ADP 3µM
ADP 1µM
Arachidonic acid
Adrenaline
Collagen
Ristocetin
Platelet
nucleotides
Nucleotide ATP
Nucleotide ADP
All
All
All
All
All
All
All
43
27
5
75
29
80
83
All
0.60
1.39
åmol/plt
All results require review
All
All
0.30
0.22
0.88
0.59
åmol/plt
åmol/plt
All results require review
All results require review
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Upper
Result below which
Result above which
Units
Limit
result will fail
result will fail
Platelet function tests
98
%
All results require review
89
%
All results require review
30
%
All results require review
96
%
All results require review
95
%
All results require review
95
%
All results require review
95
%
All results require review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
Hard Copy Location
Author
Authoriser
Page
None
Karen Thompson
Paul Grist
Page 40 of 41
Upper
Result below which
Result above which
Units
Limit
result will fail
result will fail
Platelet function tests
ATP:ADP ratio
All
0.86
2.26
All results require review
Haemophilia opinion summarises interpretation of test results by Haematology Clinicians
Full Name
Age
Lower
Limit
14.3 Red Cell Laboratory Reference Ranges
Lower
Limit
Upper
Limit
Full Name
Age
Vitamin B12
Serum Folate
Red Cell Folate
Haemoglobin A2
Haemoglobin F
Haemoglobin A
Haemoglobin S
Haemoglobin E
Haemoglobin C
Haemoglobin D
Other haemoglobins
Glucose-6-phosphate dehydrogenase
Pyruvate Kinase
Haptoglobin
Methaemoglobin
Erythropoietin
All
All
All
All
All
All
All
All
All
All
All
All
All
All
All
All
Red cell tests
191
900
3.8
20
140
836
1.8
3.3
0
1
80
100
0
0
0
0
0
0
0
0
0
0
4.6
13.5
11
21
90
380
0
1
5
25
Zinc protoporphyrin
All
30
Name
Q Pulse ID
Version
Date of Issue
Date of Review
Haematology Laboratory Handbook
HAEM-QDOC1
3
14th October 2015
14th October 2017
80
Reporting
Units
ng/L
g/L
g/L
%
%
%
%
%
%
%
%
u/g (Hb)
u/g (Hb)
mg/dL
%
iu/mL
mol/L
RBC
Hard Copy Location
Author
Authoriser
Page
Result
below
which
result
requires
review
Result
above
which
result
requires
review
180
2100
0
199
101
1500
1.8
3.4
0
5
80
100
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
All results require review
None
Karen Thompson
Paul Grist
Page 41 of 41