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Epic Code LAB1230585 TEG Global Hemostasis POC Thromboelastograph Coagulation Analysis

Important Note

There is currently a nationwide shortage of this tube. Please take steps to ensure specimen integrity to reduce recollection. Specimen Tube Shortage (link)

Dedicated specimen required.

  • Do not consolidate with other coagulation tests.
  • Specimens MUST BE HAND DELIVERED and clarify to the recipient that the item is a TEG
    • Butterworth Blood Bank
    • DO NOT USE PNEUMATIC TUBE SYSTEM
  • Inpatients may only be drawn at
    • 100 Michigan Street (Medical Center - Butterworth and Helen DeVos Children's Hospital)
  • Outpatient may only be drawn at
    • 35 Michigan Lab.

Global Hemostasis replaces tests "TEG Coagulation Analysis" [LAB2111574] and "TEG Coagulation Analysis -Heparinase" [LAB2111571]

Test Name Alias

TEG | Citrated Multichannel | Global Hemostasis 

Interface Order Alias

1230585

Quick Collect

WALK TO BB View lab catalog for collection instructions.

Clinical Information

The Global Hemostasis Assay provides a complete picture of a patient’s hemostasis status with a functional measurement of clotting factors, platelets, fibrinogen. The TEG 6S system is intended for in vitro diagnostic use to provide qualitative function and semi-quantitative indications of the hemostasis state of a whole blood sample.

  • CK = Citrated Kaolin
    • R: Reaction time. The amount of time between the start of the test and the beginning of coagulation.
    • K: The speed of formation of the clot from R time to a specific clot strength.
    • Angle: The speed of clot strengthening
    • MA: Maximum Amplitude. The ultimate strength of the clot.
  • CRT = Citrated Rapid Teg
  • CKH = Citrated Kaolin with Heparinase
  • CFF = Citrated Functional Fibrinogen MA

Ordering Instructions

For TEG Manager Access: Place a ServiceNow request and request “TEG Viewer”.

Collection Instructions

Specimen Collection: Blood

 

Container(s): 3.2% Na Citrate Tube (blue top)

Preferred Volume to Collect: 2.7 mL (Full tube)

Minimum Volume to Collect: 1.8 mL (Full tube)

Capillary collect ok? No

Microtainer acceptable: No

 

Collection Instructions:

Global Hemostasis Assay:

Provides a complete picture of a patient’s hemostasis status with a functional measurement of clotting factors, platelets, fibrinogen.

 

Venipuncture:

  • Use a 21-gauge needle or larger - a 21-gauge butterfly with tubing is OK.  Never use a smaller gauge needle.
  • Draw a discard tube (no additive or light-blue top marked “discard”) or discard syringe of 3-5 ml prior to collecting blood for TEG® analysis - required.
  • Completely fill a 2% Sodium Citrate Light Blue Top BD tube. 
  • Immediately gently invert the tube 5 times.

Arterial Line or Central Line:

Draw per the population appropriate Central Venous Catheter (CVC): Insertion, Maintenance, Utilization and Removal policy or Arterial Line: Insertion, Maintenance, Obtaining Samples, and Removal Policies.

  • Key Points:
    • Do not use heparinized syringes.
    • If closed blood sampling system is not in use, draw a discard tube (no additive or light-blue top marked “discard”) or discard syringe of 3-5 ml prior to collecting blood for TEG® analysis - required.
    • The amount of waste required is:
      • Adult- 5ml
      • Pediatric- 4ml
      • Neonatal- 2ml
    • Completely fill a 3.2% Sodium Citrate Light Blue Top tube.
    • Immediately gently invert the tube 5 times.

Specimen Transport:

  1. Walk all TEG specimens to the Blood Bank. 
  2. Do not use the pneumatic tube system.

When Collecting for Both Assays (Global Hemostasis & Platelet Mapping) draw order:

  1. 3.2% Sodium Citrate light-blue top tube marked discard (if from arterial line or central line closed blood sampling system is in use-skip this step).
  2. 3.2% Sodium Citrate light-blue top tube.
  3. Lithium Heparin Non-Gel Green top tube.

If there are questions regarding ordering and/or collection, please contact the Lab Call Center. If there are questions regarding interpretation please contact Dr. Peter Millward, Associate Medical Director, Blood Bank, or the Clinical Pathologist on call.

Rejection Criteria

  • Specimens that are under or over filled
  • Specimen sent in pneumatic tube system
  • Specimen has been thawed

Specimen Stability

Ambient: 4 hours

Laboratory Retention: 24 hours

Test Frequency

Available daily

Reference Range

Parameter Range Units
CK R 4.6 to 9.1 minutes
CK K 0.8 to 2.1 minutes
CK Angle 63 to 78 degrees
CK MA 52 to 69 mm
CRT 52 to 70 mm
CKH 4.3 to 8.3 minutes

 NOTE: Reference ranges not established for patients under 18 years old

 

 

Performing Department

Blood Bank

Performing Department Laboratory Location

Corewell Health Butterworth Laboratory, Grand Rapids, MI

Methodology

Coagulation analysis based on kinetic changes in whole blood

CPT

HC POC TEG COAGULATION TIME ACTIVATED [85347 (CPT®)]
HC POC TEG FIBRINOGEN ACTIVITY [85384 (CPT®)]
HC POC TEG PLATELET AGGREGATION IN VITRO EACH AGENT [85576 (CPT®)]

CDM Code

Unavailable

Epic Test ID

1230102207

LOINC

Currently Unavailable

Mayo Access Code

Currently Unavailable

Resources

PolicyTech #24255

Reviewed Date

2/1/2022

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