Quick Guide to Hemostasis and Transfusion Medicine

Dr. George Fritsma manages www.fritsmafactor.com, “The Fritsma Factor, Your Interactive Hemostasis Resource,” an educational blog supported by Precision BioLogic Inc, Dartmouth, Nova Scotia. Dr. Fritsma also consults for the Laboratory Solutions Program for Developing Nations, supported by BioMedica Diagnostics, Inc., Windsor, Nova Scotia. He is a consultant for the Laboratory Medicine Division of the Pathology Department, University of Alabama at Birmingham School of Medicine, where he provides lectures for pathology residents and for hematology fellows. He is an adjunct Associate Professor for Michigan State and Rutgers University. George chairs the American Association for Clinical Chemistry Press Board and is a consulting editor for the Clinical Laboratory Science journal and is a member of the International Society on Thrombosis and Hemostasis and the International Society for Laboratory Hematology. Dr. Rance Chadwick Siniard is an Assistant Professor in Department of Pathology and Laboratory Medicine at the University of Alabama at Birmingham. He is the Director of Community Practice Pathology Program Transfusion Medicine and Director of Coagulation Laboratory, Laboratory Medicine, Clinical Pathology. His research interest is in hemostasis and thrombosis research. Brianna Miller is an Assistant Professor in the Medical Laboratory Sciences program at the University of Alabama at Birmingham. She holds a Master’s degree in Clinical Laboratory Science and an advanced certification as a Specialist in Blood Banking. After beginning her career at UAB Hospital in the Transfusion Medicine Service as a Medical Laboratory Scientist, she quickly moved into the position of Antibody Specialist. Eventually, she shifted to the academic side of UAB, advancing to an Assistant Professor. Mrs. Miller’s main disciplines of teaching include Transfusion Medicine and Hemostasis, but she also teaches various subjects in laboratory medicine to students in programs of Physician Assistants, Physical Therapy, Optometry, Biomedical Sciences, and Clinical Pathology Residents. Dr. Williams is currently an Assistant Professor in the Department of Pathology, Division of Laboratory Medicine and serves as the Medical Director of Hemostasis Laboratory at the University of Alabama at Birmingham. He is also the Director of Transfusion Medicine for the Community Pathology Practice Program, which encompasses 5 hospitals throughout Alabama. Dr. Williams received his BS with high honors in Biology from Longwood University and his MD with honors from Ross University. He completed residency training at East Carolina University and two fellowships – Transfusion Medicine at Yale University and Hematopathology at Virginia Commonwealth University. Dr. Williams is an award-winning teacher, known for his innovative teaching methods and his dedication to elevating students of all levels. His publications include original research articles, review articles, and books, including Quick Guide to Transfusion Medicine, 2nd edition. Nationally, he is known as an engaging and knowledgeable speaker and he serves on many committees committed to advancing the science of Transfusion Medicine, Apheresis, and Hemostasis.

• 1. Approach to bleeding patients1.1. Patient history, bleeding assessment test protocol1.2. Acquired versus congenital, isolated versus coagulopathy, systemic versus anatomic2. Approach to thrombosis patient2.1. Patient history2.2. Acquired versus congenital thrombosis2.3. Arterial versus venous thrombosis3. Blood specimen management4. Test utilization and indications5. Antithrombotic therapy5.1. Oral anticoagulants: warfarin and DOACs5.2. Parenteral anticoagulants: heparin types5.3. Direct thrombin inhibitors5.4. Antiplatelet therapeutics6. Platelets6.1. Normal platelet function6.2. Platelet disorders: thrombocytopenia and functional disorders6.3. Immune and thrombotic thrombocytopenic purpura6.4. Platelet function testing6.5. Viscoelastometry7. Coagulation7.1. Normal coagulation cascade7.2. Clot-based and chromogenic testing8. Bleeding disorders: diagnosis and management8.1. Acquired coagulopathies: liver disease, dietary deficiencies, kidney disease8.2. Trauma-induced coagulopathy8.3. Hemophilia: congenital single factor deficiencies8.4. Von Willebrand disease8.5. Disseminated intravascular coagulation8.6. Laboratory protocols8.7. Viscoelastometry9. Thrombophilia9.1. Congenital thrombosis risk factors9.2. Antiphospholipid syndrome9.3. Heparin-induced thrombocytopenia with thrombosis9.4. Thromboinflammation9.5. Laboratory protocols10. Transfusion safety11. Blood donation, processing, management11.1. Donor qualification, whole blood, plateletpheresis, plasmapheresis11.2. Directed donations12. Blood components: Red blood cells, leukocyte-reduction, CMV-negative products, irradiated products, plasma, cryoprecipitate, platelet concentrate, whole blood, coagulation factor concentrates13. Patient blood management: medical transfusion decisions, transfusion refusal13.1. Urgent blood need, group O whole blood13.2. Massive transfusion protocol13.3. Transfusion of neonates and neonatal immune thrombocytopenia13.4. Platelet concentrates13.5. Transfusion in autoimmune hemolytic anemia, sickle cell disease, IgA deficiency, etc13.6. Progenitor cell transplant14. Managing adverse transfusion effects: signs and symptoms—immediate and delayed, laboratory investigation, care15. Therapeutic apheresis: indications, types, technical and clinical considerations16. Features16.1. Glossary and abbreviations16.2. Table of tables16.3. Table of figures16.4. Table of equations16.5. Reference intervals and therapeutic targets16.6. Index16.7. References