Activated Clotting Time ACT

Performed by POC Hemochron Jr. (Signature Elite)

ACT POC

ACT+ (ACT High range Elite)
ACT-LR (ACT Low range Elite)

Fresh Whole Blood
Specimens must be processed immediately after collection

Sample	Collection	Minimum Blood Volume	Preparation
Indwelling venous blood line	Syringe (no anticoagulant)	1.0 ml	Discontinue fluids drip. Obtain 5.0 ml blood and discard the first syringe. Obtain 1.0 ml blood with the second syringe to be used for testing. Do not obtain blood from heparinized access line, lock or indwelling heparin lock.
Extracorporeal blood line port	Syringe (no anticoagulant)	1.0 ml	Flush the blood access line by withdrawing and discarding 5.0 ml blood Obtain 1.0 ml blood with second syringe to be used for testing.
Venipuncture	Syringe (no anticoagulant)	1.0 ml	Obtain 1.0 ml blood with syringe to be used for testing. Use a 23 or larger gauge needle.

POCT: Test immediately

Unacceptable Sample Types

• Citrated tube (blue top) used for collection
• Sample collected into a pre-heparinized syringe
• Sample contamination with tissue thromboplastin
• Sample contamination with indwelling intravenous (I.V.) solutions
• Sample contamination with alcohol cleansing solution
• Samples with visible clotting or debris accumulation

24x7, POC

Provider Order is required for testing.
Specimens are processed via the POC system as "Unsolicited orders" with results posting to the patient Epic EMR. 

Expected Range (seconds)	ACT-LR	ACT +
Reference Range	89-169 sec	96-152 sec
Reportable Range	65-400 sec	68-1005 sec
Out of Range Low	<65 sec	<68 sec
Our of Range High	>400 sec	>1005 sec

 

The ACT-LR assay demonstrates a response to the anticoagulation effects of heparin at doses up to 2.5 units/mL of blood.  It is intended for use in monitoring low to moderate heparin doses frequently associated with procedures such as cardiac catheterization, Extracorporeal Membrane Oxygenation (ECMO), Hemodialysis, and Percutaneous Transluminal Coronary Angioplasty (PTCA).  The test is affected by aprotinin.

The ACT+ test demonstrates a dose response to heparin between 1.0 and 6.0 units/mL of blood by time increases relative to the increasing concentrations of heparin. It is intended for use in monitoring moderate to high heparin doses frequently associated with cardiopulmonary bypass surgery and angioplasty.  The ACT+ is not as sensitive to very low levels of heparin such as those encountered in critical care.  The test is unaffected by aprotinin due to the cuvettes containing kaolin and not Celite.