It measures the time to cessation of bleeding after a standardized incision over the volar aspect of the forearm. However, the test is prone to problems related to quality control, reproducibility, sensitivity, and specificity. As an additional replacement for the bleeding time, especially when a functional (qualitative) abnormality of platelets is suspected by characteristic mucocutaneous bleeding or bruising, a global assay of platelet function can be appended to the panel of screening tests. With a few notable exceptions, normal results for all these screening tests of hemostasis essentially exclude any clinically significant systemic coagulopathy. A to C, Algorithms for clinical and laboratory approach to the diagnosis of a patient with a suspected systemic bleeding disorder (coagulopathy). This test provides a global assay of coagulation and fibrinolysis using pointof-care technology. It is a whole blood clotting test in which a small aliquot of blood is rotated in a cuvette, and the strength, elasticity, and dissolution of the forming clot are measured with a torsion wire or by optical detection. A1 Its impact on producing other favorable clinical end points remains open to study. Approach to evaluating patients with prolonged prothrombin time (pt) or activated partial thromboplastin time (aptt). If correction occurs with the inhibitor screen, individual coagulation factor levels should be assayed for a specific deficiency state. Specific assays should then be performed to determine whether there is a true inhibitor against a coagulation factor.
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