Laboratory Coagulation Testing Course

Lesson 1 • Primary Haemostasis and Platelet Role

Covers vascular injury response, platelet adhesion, activation, and aggregation. Provides the cellular foundation needed to interpret platelet function assay results.

Lesson 2 • Fibrinolysis and Clot Resolution

Describes plasminogen activation, fibrin degradation, and regulatory inhibitors. Connects fibrinolytic activity to fibrinogen assay interpretation.

Lesson 3 • Secondary Haemostasis and the Coagulation Cascade

Explains intrinsic, extrinsic, and common pathway factors and their interactions. Links cascade steps to the specific assays that measure each pathway.

Lesson 4 • Natural Anticoagulant Mechanisms

Reviews antithrombin, protein C, protein S, and TFPI pathways. Establishes why deficiencies in these proteins alter coagulation test results.

Lesson 1 • Haematocrit Correction for Polycythaemia and Anaemia

Teaches citrate volume adjustment for extreme haematocrit values. Uncorrected haematocrit causes falsely prolonged or shortened clotting times.

Lesson 2 • Specimen Rejection Criteria and Documentation

Defines rejection criteria including clots, haemolysis, lipaemia, and icterus. Proper documentation protects result integrity and supports quality audits.

Lesson 3 • Venipuncture Technique for Coagulation Samples

Details correct draw order, needle gauge, and tourniquet time for coagulation specimens. Poor technique is the leading cause of spurious coagulation results.

Lesson 4 • Specimen Transport, Storage, and Stability

Covers temperature requirements, centrifugation protocols, and time-to-analysis limits. Stability windows differ between PT, aPTT, and fibrinogen assays.

Lesson 1 • International Sensitivity Index and INR Calculation

Teaches ISI assignment, INR formula, and its role in standardising warfarin monitoring. INR calculation errors are a common and clinically significant laboratory mistake.

Lesson 2 • PT Assay Principle and Reagent Chemistry

Explains how thromboplastin and calcium initiate the extrinsic pathway in vitro. Understanding reagent chemistry is prerequisite to troubleshooting PT variability.

Lesson 3 • Performing the PT on Automated Analysers

Covers instrument setup, reagent loading, sample aspiration, and clot detection on automated platforms. Automation reduces variability but requires strict maintenance protocols.

Lesson 4 • PT Result Interpretation and Clinical Correlation

Links prolonged PT to factor deficiencies, liver disease, vitamin K deficiency, and anticoagulants. Accurate interpretation requires integrating clinical context with numeric results.

Lesson 1 • aPTT Assay Principle and Reagent Variables

Explains contact activation by phospholipid and activator reagents and their effect on sensitivity. Reagent choice directly determines heparin sensitivity and lupus anticoagulant detection.

Lesson 2 • Heparin Monitoring with aPTT

Covers therapeutic range establishment, anti-Xa correlation, and heparin dose adjustment using aPTT. Heparin monitoring is the most common clinical application of aPTT.

Lesson 3 • aPTT Mixing Studies: Design and Interpretation

Teaches 1:1 mixing study procedure, immediate and incubated correction criteria, and inhibitor vs. factor deficiency differentiation. Mixing studies are essential for prolonged aPTT workup.

Lesson 4 • aPTT Quality Control and Troubleshooting

Applies QC rules specific to aPTT and addresses common failure modes including reagent degradation and clotted samples. Systematic troubleshooting prevents patient result errors.

Lesson 1 • Fibrinogen Result Interpretation and Troubleshooting

Links fibrinogen levels to clinical conditions and addresses common analytical interferences. Accurate interpretation requires recognising acute-phase elevation masking true deficiency.

Lesson 2 • PT-Derived Fibrinogen Method

Covers the optical density-based PT-derived method, its advantages, and its limitations compared to Clauss. PT-derived values overestimate fibrinogen in dysfibrinogenaemia.

Lesson 3 • Clauss Fibrinogen Method

Explains the Clauss clotting rate principle, dilution scheme, and calibration curve construction. The Clauss method is the reference standard for fibrinogen quantification.

Lesson 4 • Immunological Fibrinogen Assays

Introduces immunoturbidimetric and immunonephelometric fibrinogen measurement for antigen quantification. Antigen-activity discordance identifies dysfibrinogenaemia.

Lesson 1 • Light Transmission Aggregometry

Covers LTA methodology, agonist panel selection, aggregation curve morphology, and result interpretation. LTA remains the gold standard for platelet function disorder diagnosis.

Lesson 2 • Platelet Function Testing Indications

Defines clinical indications including bleeding disorders, antiplatelet therapy monitoring, and surgical risk assessment. Appropriate test selection depends on the clinical question.

Lesson 3 • Impedance Aggregometry Methods

Introduces whole-blood impedance aggregometry platforms and their agonist-based test cartridges. Whole-blood methods reduce processing time and preserve platelet-leucocyte interactions.

Lesson 4 • Preanalytical Requirements for Platelet Assays

Details specimen handling, time-to-testing limits, and temperature requirements specific to platelet function testing. Platelet assays are uniquely sensitive to preanalytical errors.

Lesson 1 • Pattern Recognition in Coagulation Panels

Teaches systematic analysis of combined PT, aPTT, and fibrinogen results to identify pathway-specific defects. Pattern recognition is the core skill for coagulation panel interpretation.

Lesson 2 • Anticoagulant Drug Effects on Coagulation Tests

Maps warfarin, heparin, LMWH, and direct oral anticoagulants to their specific effects on PT, aPTT, and fibrinogen. Recognising drug effects prevents misdiagnosis of factor deficiencies.

Lesson 3 • Disseminated Intravascular Coagulation Diagnosis

Applies ISTH scoring criteria using PT, aPTT, fibrinogen, platelet count, and D-dimer. DIC diagnosis requires integrating multiple coagulation parameters with clinical findings.

Lesson 4 • Perioperative Coagulation Panel Interpretation

Applies coagulation panel results to preoperative risk stratification and intraoperative bleeding management. Perioperative interpretation requires rapid, action-oriented decision-making.

Lesson 1 • Internal Quality Control Programme Design

Designs a multi-level QC programme using commercial and in-house materials for all coagulation assays. A robust QC programme detects systematic and random error before patient results are released.

Lesson 2 • Method Validation for Coagulation Assays

Covers precision, accuracy, linearity, reference interval verification, and carryover studies for coagulation methods. Validation data must meet regulatory and accreditation requirements.

Lesson 3 • Reagent and Instrument Change Management

Establishes protocols for validating new reagent lots and instrument replacements without disrupting patient testing. Change management prevents undetected shifts in coagulation results.

Lesson 4 • Reference Interval Establishment and Verification

Teaches CLSI-aligned approaches to establishing and verifying reference intervals for PT, aPTT, and fibrinogen. Reference intervals must reflect the local patient population.