Prolonged PT (>16.

0 Working Instructions for the

seconds) Investigation of a Prolonged PT with a
Normal APTT. If the PT result is
grossly abnormal, unexpected or
suspicious, always confirm the validity
Check clinical of the sample and re-run for
details
confirmation before proceeding with
any additional tests.

Patient confirmed to
Patient confirmed to
Patient not on anticoagulants be on Rivaroxaban
be on a vitamin K (PT raised, APTT mildly
antagonist (i.e. warfarin prolonged or normal)
or sinthrome)
Report PT (&
Perform APTT) with comment
TT and fibrinogen stating patient is
Release the INR known to be on
rivaroxaban

Prolonged thrombin Normal TT and

time and/or reduced fibrinogen
fibrinogen

No further PT < 20 seconds

action APTT Normal
required No bleeding history
Add D-Dimer
if possible sepsis or
DIC
Unexplained prolonged
PT or bleeding history
(PT > 20.0 seconds)

Consider underlying No obvious

clinical condition e.g. clinical Perform
liver disease, vitamin K explanation for PT 50:50
deficiency, sepsis, DIC, the results
thrombolytic therapy, &
hypo/dysfibrinogenaemia.

PT 50:50 - PT 50:50 – Partial

Correction (back into or no correction
normal range)

Possible
Presence of underlying Possible factor deficiency inhibitor (Lupus
condition confirmed. (factor VII and mild or specific factor
deficiencies of II, V or X) inhibitor)

No further Double spin, Double spin,

action separate plasma separate plasma
required & refer to & refer to
Haemophilia Haemophilia