INNOVANCE® PFA-200 System Sample Processing Online Training

Welcome to the INNOVANCE® PFA-200 Sample Processing Online Training course. The INNOVANCE® PFA-200 system is an analyzer and test cartridge system in which the process of platelet adhesion and aggregation following a vascular injury is simulated in vitro. In this course, you will learn about sample processing on the INNOVANCE® PFA-200 system. Select Next to continue. Demonstrate how to run patient samples Describe how to print stored data Evaluate and interpret test results List the sample collection requirements Upon successful completion of this course, you will be able to: Select Next to continue. The INNOVANCE® PFA-200 test process: Rapid evaluation of platelet function Single use test cartridges Activated by antagonists (such as ADP and Epinephrine) Activated platelets occlude the test cartridge aperture resulting in arrested blood flow Closure time is reported Tips for Running Patient Samples Learn about running patient samples. When complete, select the X in the upper-right corner to close the window and continue.   Below are tips to consider when running patient samples: Patient samples must be stored at room temperature. Samples are stable for up to 4 hours prior to testing. Make sure test cartridges have reached room temperature before using (approximately 15 minutes). To minimize the risk of trapping an air bubble in the test cartridge, place the tip of the pipette against an inside corner of the opening while you slowly pipette sample into the reservoir. Pneumatic tube transport of samples for platelet function tests may adversely affect results. Hand delivery is recommended to ensure platelet function test results are reliable. Why two cartridge types? Learn about cartridge types.   When complete, select the X in the upper-right corner to close the window and continue.   Question: Why does the INNOVANCE® PFA-200 system use two different types of test cartridges? Roll your mouse over the image on the left for the answer. First, use the sensitive Collagen/Epinephrine cartridge and report normal platelet function if the CT is within the normal range. If the CT is prolonged, also run the test with the Collagen/ADP cartridge. Note: Exposure to platelet inhibiting agents, such as Aspirin® and other acetyl salicylic acid-containing drugs will prolong the CT with the COL/EPI, but not the COL/ADP test cartridge.  If prolonged CTs are seen using both test cartridge systems, further studies should be performed to determine the cause of the platelet dysfunction, such as platelet dysfunction induced by intrinsic platelet defects or von Willebrand disease. Congratulations. You have completed the INNOVANCE® PFA-200 System Sample Processing Online Training course. Listed below are the key points that have been presented. Take time to review the material before you proceed to the final quiz.  List the sample collection requirements      Use a 21-gauge or larger needle to perform the venipuncture, and draw blood directly into an evacuated plastic or siliconized glass tube or syringe containing 3.2% (0.105M) or 3.8% (0.129M) buffered sodium citrate (1 part anticoagulant to 9 parts blood). A 23-gauge needle may be used for pediatric sample collection. Discard the sample if hemolyzed or if venous collapse or stoppage of blood flow occurs during collection. Gently invert the tube by hand 3 to 4 times to ensure proper mixing with anticoagulant. DO NOT place tubes on a rocker or rotator while waiting to be tested. Store samples undisturbed at room temperature. Samples are stable for up to 4 hours. DO NOT refrigerate or centrifuge samples. For the Collagen/Epinephrine (COL/EPI) test cartridge, it is recommended that testing NOT be performed until 10 minutes after blood collection to allow platelets to stabilize and reduce test variability inherent within the first 10 minutes post collection.                                                Demonstrate how to run patient samples Tips to consider when running patient samples: Patient samples must be stored at room temperature. Samples are stable for up to 4 hours prior to testing. Make sure test cartridges have reached room temperature before using (approximately 15 minutes). To minimize the risk of trapping an air bubble in the test cartridge, place the tip of the pipette against an inside corner of the opening while you slowly pipette sample into the reservoir. Pneumatic tube transport of samples for platelet function tests may adversely affect results. Hand delivery is recommended to ensure platelet function test results are reliable. Sample processing options include running:                             A single test on a patient sample A test in duplicate on a patient sample Two different tests on a patient sample A single test on two different patient samples To process samples, proceed as follows: To enter the sample ID: In the Run menu, tap Sample ID. A keyboard is displayed. Tap the keys required. Verify that the correct sample ID has been entered. Tap the enter key. The sample ID is set. To load samples: Peel off and discard the top foil seal of the test cartridge Place a test cartridge in position A (left position) of the cassette and push until it snaps securely in place. When running duplicates or two tests: Snap a second test cartridge into position B (right position). Resuspend the samples by gently inverting the collection tube 3 to 4 times by hand. Holding the cassette with the test cartridges on a flat surface, pipette 800μL of sample into the sample reservoir opening of the test cartridges. Dispense slowly along one of the inside corners. Place the cassette with the test cartridges into the incubation wells of the carousel so that the cassette is flush to the carousel surface. Do not apply pressure to the sample reservoir openings. To run tests: In the Run Menu screen, tap Start. Start changes to Stop. The tests start and can take up to 9min for a single test or 14min for two tests. Status messages, errors and results are displayed. When the test is finished, Stop changes to … (3 dots). The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS. … (3 dots) change to Clear. In the Run Menu screen, tap Clear. Cancelling Tests Tap Stop. The dialog Stop Testing is displayed. Tap Yes. Stop changes to … (3 dots). The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS. … (3 dots) change tom Clear. Removing Samples Wait until the carousel has moved to load position. Remove the cassette carefully from the carousel. Hold the cassette in one hand and gently pull the bottom of the test cartridge toward you until it unsnaps. Discard the test cartridges in a suitable biohazard waste container.   Describe how to print stored data   Sample results are printed when the analysis of the sample is complete. To reprint the results: In the Results menu, Tap the sample result you want to reprint. Tap the Result display box. Tap Print. The result and errors associated with the test are reprinted.                  Evaluate and interpret INNOVANCE® PFA-200 test results INNOVANCE® PFA-200 results:   Reported as a closure time (CT) in seconds Provides an indication of platelet function Should be compared to the laboratory established reference range Should always be evaluated in conjunction with clinical history and other laboratory findings   To interpret CT results, use the following chart as a guide, which shows that the INNOVANCE® PFA-200 system test allows you to differentiate between platelet dysfunction due to a platelet inhibiting factor (such as Aspirin® or other aspirin-containing medication) versus platelet dysfunction due to a platelet disorder.   Normal (n=176) ASA (n=120) Von Willebrand Disease (n=28) Glanzmann thrombasthenia   (n=4) Collagen/Epinephrine Normal Abnormal Abnormal Abnormal Collagen/ADP  Normal Normal Abnormal Abnormal   Interfering Substances and Test Limitations include: Platelet count Acetyl Salicylic Acid (ASA) ingestion (Aspirin®) Microthrombi Sedimentation rate Hematocrit Fatty acids and lipds Hemolysis Other medications Select Next to continue.     In the Results dialog, you can: Reprint results Create PDF files of results (if enabled by the Siemens service) Retransmit results to the LIS (if a LIS is connected) You can display the Results dialog: For the current test (before the test is cleared): in the Run menu For previous tests: in the Results menu Reviewing and Printing Results Learn how to review and print results. Slide NumberText BlocksCalloutsAudio ScriptImage File1When the INNOVANCE® PFA-200 System completes the analysis of the sample, the results will be printed out. The printout will display: Date and Time of the analysis Serial number, version and user ID Sample ID Patient ID, Patient Name, Patient Location (If entered) Test type Cartridge position (A or B) Closure time result (If tested in duplicate, each CT, a mean, %CV will be displayed) Printouts can be stored up to 5 years depending on your laboratory's storage procedure.  Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.Sample results are printed when the analysis of the sample is complete. The printout lists the date and time of the analysis, the serial number, version, user, Sample and Patient information, the test type, cartridge position, and closure time result. Because the printout is on thermal paper, they can be stored for up to five years. 2Current Test Results To display the dialog Results for the current test, follow one of the below procedures: In the Run menu: Tap A or B to select the required position. Tap Result. The Results dialog is displayed. In the Results menu: Select the sample result you want to view Tap Result. The Results dialog is displayed.   Select Next to continue.     Result information is displayed in the Run and Results menus. To display the Results dialog for the current test, on the Run menu tap "A" or "B" to select the required position, and then tap Result. Another way to access result information is by selecting the result to be viewed from the Results menu. Once the result is selected, tap Result. The Results dialog is then displayed.3Recent Tests To display the Results dialog for one of the most recent tests, proceed as follows: In the Results menu, tap Patient to select the required sample type. The corresponding tests are displayed on the left. Tap the arrow buttons to select the test. You can also tap the test you want displayed. Tap Select. The detail dialog for the test is displayed. Tap Result.  The Results dialog is displayed.  Select Next to continue. Recent test results, in list format, can be viewed under the Results menu. When the Results menu is displayed, tap either 'Patient' or 'QC' to display the respective closure times. The sample ID, date, time, cartridge type and closure time are displayed. If the Sample ID is tapped, the patient information and results are displayed. 4Older Tests Searches can be performed:  For patient samples: by any part of sample ID, patient ID or patient name For QC samples: by any part of sample ID or lot number   For additional information about searching for samples, refer to the INNOVANCE® PFA-200 System Instruction Manual.   Select Next to continue.   The INNOVANCE® PFA-200 system will store up to 1200 results. The Search function in the Results menu makes it easy to find the results. Patient samples can be searched by sample ID, patient ID or patient name. QC samples can be searched by sample ID or lot number.5 Reprint Results To reprint the results: In the Results menu, Tap the sample result you want to reprint. Tap the Result display box. Tap Print. The result and errors associated with the test are reprinted.   Select Next to continue.   There may be times when you will need to reprint the closure times of a specific sample. To do this, follow the steps listed.6Creating a PDF To save a PDF file of the results to a plugged in USB flash drive (if this feature is enabled by the Siemens service representative):  In the Results menu, tap the sample result Tap the Result display box. Tap Create PDF. The PDF file is saved to a plugged in USB flash drive. Note: Always follow your laboratory’s procedures for the proper storage and retention of printed and electronic test results and patient data. Select Next to continue.   Results can be saved on a USB flash drive if this feature is enabled by the Siemens service representative. Be sure to follow your laboratory's procedure for proper storage and retention of results. 7Retransmitting to LIS To retransmit the results to the LIS (if a LIS is connected):  In the Results menu, tap the sample result Tap the Result display box. Tap Retransmit.  The results will be retransmitted to the LIS.    When complete, select the X in the upper-right corner to close the window and continue.Although the results are automatically sent to an LIS, if an LIS is connected, there are times when retransmittal is needed. Follow the steps listed to retransmit results. The Test Results screen can be accessed by selecting the Test Results button in the Command Bar.  This screen allows the operator to perform several tasks, including reviewing the status of test orders and results, sending results to the LIS, pausing LIS communication, and ordering repeat tests. The software also has a search feature that provides the ability to quickly search for a tube based on Sample ID, Patient name, or Patient ID.  The search button is located in the status bar at the bottom of the screen. Select the links to learn about monitoring results and searching for tubes. Sample collection requirements: Use a 21-gauge or larger needle to perform the venipuncture, and draw blood directly into an evacuated plastic or siliconized glass tube or syringe containing 3.2% (0.105M) or 3.8% (0.129M) buffered sodium citrate (1 part anticoagulant to 9 parts blood). A 23-gauge needle may be used for pediatric sample collection. Discard the sample if hemolyzed or if venous collapse or stoppage of blood flow occurs during collection. Gently invert the tube by hand 3 to 4 times to ensure proper mixing with anticoagulant. DO NOT place tubes on a rocker or rotator while waiting to be tested. Store samples undisturbed at room temperature. Samples are stable for up to 4 hours. DO NOT refrigerate or centrifuge samples. For the Collagen/Epinephrine (COL/EPI) test cartridge, it is recommended that testing NOT be performed until 10 minutes after blood collection to allow platelets to stabilize and reduce test variability inherent within the first 10 minutes post collection.     Sample Collection Tips Learn more about sample collection.     To ensure that the closure time results for patient and control samples correlate with your laboratory's established normal reference range, use a consistent sample collection method (both sodium citrate concentration and venipuncture method) for drawing and handling reference range samples, patient samples, and donor control samples. When complete, select the X in the upper-right corner to close the window and continue. Sample processing options include running: A single test on a patient sample A test in duplicate on a patient sample Two different tests on a patient sample A single test on two different patient samples Processing a Single Test on a Single Sample Learn how to process a single test on a single sample. Checklist TitleChecklist TypeChecklist ContentOrdering the single test in the softwareSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessingSinglePatientTest_640x480/SIM_PFA200_SampleProcessingSinglePatientTest_640x480.swfHTML5 File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessingSinglePatientTest_HTML5_700x529/index.htmlPDF File:Loading the SampleHTML   Select the play arrow to begin the video.   Running the TestHTML After the cassette and cartridges are placed onto the carousel, it is time to start the tests. To run tests, proceed as follows: Start test In the Run Menu screen, Tap Start. Start changes to Stop. The tests start and can take up to 9min for a single test or 14min for two tests. Status messages, errors and results are displayed. When the test is finished, Stop changes to … (3 dots). The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS. … (3 dots) change to Clear. Clear test In the Run Menu screen, Tap Clear.  Information related to the test is cleared from the display. Clear changes to Start. When complete, select the X in the upper-right corner to close the window and continue. Running Duplicate Tests Learn how to run duplicate tests or two different tests on the same sample. Checklist TitleChecklist TypeChecklist ContentOrdering the testsSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessingSameSample2tests_640x480/SIM_PFA200_SampleProcessingSameSample2tests_640x480.swfHTML5 File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessingSameSample2tests_HTML5_700x529/index.htmlPDF File:Loading the SampleHTML To load the sample(s): Peel off and discard the top foil seal of the test cartridges Choose the respective cartridges for the tests ordered Place a test cartridge in position A (left position) of the cassette and push until it snaps securely in place. Snap a second test cartridge into position B (right position). Re-suspend the samples by gently inverting the collection tube 3 to 4 times by hand. Holding the cassette with the test cartridges on a flat surface, pipette 800μL of sample into the sample reservoir opening of the test cartridges.  Dispense slowly along one of the inside corners. Place the cassette with the test cartridges into the incubation wells of the carousel so that the cassette is flush to the carousel surface.  Running the TestHTML After the cassette and cartridges are placed onto the carousel, it is time to start the tests. To run tests, proceed as follows: Start test In the Run Menu screen, Tap Start Start changes to Stop. The tests start and can take up to 9min for a single test or 14min for two tests. Status messages, errors and results are displayed. When the test is finished, Stop changes to … (3 dots). The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS. … (3 dots) change to Clear. Clear test In the Run Menu screen, Tap Clear.  Information related to the test is cleared from the display. Clear changes to Start. When complete, select the X in the upper-right corner to close the window and continue. Running Two Tests with Different Sample IDs Learn how to run two tests with different sample IDs. Checklist TitleChecklist TypeChecklist ContentOrdering the TestsSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessing_2Sample2tests_640x480/SIM_PFA200_SampleProcessing_2Sample2tests_640x480.swfHTML5 File:/content/generator/Course_90002873/SIM_PFA200_SampleProcessing_2Sample2tests_HTML5_700x529/index.htmlPDF File:Loading the SamplesHTML To load the sample(s): Peel off and discard the top foil seal of the test cartridges Choose the respective cartridges for the tests ordered Place a test cartridge in position A (left position) of the cassette and push until it snaps securely in place. Snap a second test cartridge into position B (right position). Re-suspend the samples by gently inverting the collection tube 3 to 4 times by hand. Holding the cassette with the test cartridges on a flat surface, pipette 800μL of sample into the sample reservoir opening of the test cartridges.  Dispense slowly along one of the inside corners. Place the cassette with the test cartridges into the incubation wells of the carousel so that the cassette is flush to the carousel surface.  Running the TestHTML After the cassette and cartridges are placed onto the carousel, it is time to start the tests. To run tests, proceed as follows: Start test In the Run Menu screen, Tap Start. Start changes to Stop. The tests start and can take up to 9min for a single test or 14min for two tests. Status messages, errors and results are displayed. When the test is finished, Stop changes to … (3 dots). The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS. … (3 dots) change to Clear. Clear test In the Run Menu screen, Tap Clear.  Information related to the test is cleared from the display. Clear changes to Start. When complete, select the X in the upper-right corner to close the window and continue. You may need to cancel a test when: An incorrect sample is pipetted An incorrect cartridge type is used Canceling a Test Learn how to cancel a test. Checklist TitleChecklist TypeChecklist ContentStop TestHTML To cancel running tests: On the Run Menu screen, tap Stop.  The Stop Testing dialog is displayed. Tap Yes Select each checkbox to learn more about canceling tests.   Results and Errors Stored and PrintedHTML Stop changes to … (3 dots).The results and errors associated with the test are stored and printed. If a LIS is connected, the results and errors are transmitted to the LIS.    Clear TestHTML The three dots (…) change to Clear. On the Run Menu screen, tap Clear. Information related to the test is clearned fron the display. Clear changes to Start.  If QC samples have been measured, the sample type changes from QC to Patient and the button Cartridge Lot changes to Patient. Note: Do not reuse test cartridges of canceled tests. When complete, select the X in the upper-right corner to close the window and continue. Information for errors that occur on the system can be found in the Event Log. The event log is accessed by selecting Events from the Command Bar at the top of the screen.  The event log displays the event number, the date and time when the error occurred, and the error message. The archive limit for events is 90 days.  Context-sensitive Help is also available in the software.  To access the Help system, select the Help icon from the Status Bar at the bottom of the screen. Select the link to learn how to navigate the Event Log. After the analysis is complete, remove and discard the cartridges. WARNING: Infection by infectious samples Death or serious illness may result. Avoid contact with samples. Wear appropriate protective equipment. Handle the samples in accordance with good laboratory practices. Removing Samples Learn how to remove samples. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Carousel in Load Position Wait until the carousel has moved to the Load position before removing the cassette.  Select Next to continue.    Note: If audio does not automatically start, select the play arrow in the top left to begin.It is important to wait until the carousel is in the Load position before removing the cassette.2Remove Cassette Remove the cassette carefully from the carousel. Select Next to continue. Gently lift the cassette off of the carousel.3Remove Test Cartridges Hold the cassette in one hand and gently pull the bottom of the test cartridge toward you until it unsnaps. WARNING: Infection by infectious samples Death or serious illness may result.  Avoid contact with samples. Wear appropriate protective equipment. Handle the samples in accordance with good laboratory practices.  Select Next to continue.  To remove the cartridge from the cassette, hold the cassette in one hand and gently pull the bottom of the test cartridge toward you until it unsnaps.4Discard Test Cartridges Discard the test cartridges in a suitable biohazard waste container.   When complete, select the X in the upper-right corner to close the window and continue.Be sure to discard the test cartridges in a biohazard waste container. Sample errors are caused by instrument aspiration errors. When a sample error occurs, Samples on the Command Bar flashes red. The sample’s icon turns red at the Samples screen. On the Home screen, the drawer with red error tallies can be selected to navigate directly to the Samples screen that contains the error. Select the link to learn how to resolve sample errors. INNOVANCE® PFA-200 results: Reported as a closure time (CT) in seconds Provides an indication of platelet function Should be compared to the laboratory established reference range Should always be evaluated in conjunction with clinical history and other laboratory findings Interpreting CT Results Learn More about interpreting CT results.  The INNOVANCE® PFA-200 system closure time (CT) results provide an indication of platelet function. After performing an INNOVANCE® PFA-200 test, compare the CT results to the CT normal reference range established for your laboratory. Are the results for one or both test cartridges normal or abnormal? What does the test pattern indicate? To interpret CT results, use the following chart as a guide, which shows that the INNOVANCE® PFA-200 system test allows you to differentiate between platelet dysfunction due to a platelet inhibiting factor (such as Aspirin® or other aspirin-containing medication) versus platelet dysfunction due to a platelet disorder.   Normal (n=176) ASA (n=120) Von Willebrand Disease (n=28) Glanzmann thrombasthenia   (n=4) Collagen/Epinephrine Normal Abnormal Abnormal Abnormal Collagen/ADP  Normal Normal Abnormal Abnormal   Note: CT results above the laboratory established cut-off range may indicate the need for further diagnostic testing. CT results should always be evaluated in conjunction with clinical history and other laboratory findings (such as bleeding time and platelet aggregometry). If CT results do not agree with the clinical assessment, additional tests should be performed. When complete, select the X in the upper-right corner to close the window and continue.   Testing limitations and interferences Learn about testing limitations and interferences. Tab TitleTextPlatelet CountIn vivo platelet plug formation requires normal functioning platelets as well as adequate numbers of platelets. The same requirements are true to obtain normal CT results in the INNOVANCE® PFA-200 system. For this reason, patients with low platelet counts <150,000/mL (thrombocytopenia) can yield prolonged CT results that are higher than the laboratory’s established cut-off value.  Note: Correlations between INNOVANCE® PFA-200 system CT results and specimens with high platelet counts >500,000/mL have not been evaluated.ASAIngestion of acetyl salicylic acid (ASA), such as Aspirin®, affects platelet aggregation for up to eight days¹ by inhibiting the platelet-release reaction, which can lead to prolonged bleeding in some patients. The INNOVANCE® PFA-200 system detects ASA-induced platelet dysfunction. For example, studies have shown that 2 to 30 hours following ingestion of 325 mg of Aspirin®, 95% of normal patients will yield abnormal CTs using COL/EPI test cartridges. Of this group, 72 % will yield normal CTs using COL/ADP test cartridges. These studies show that the PFA-100® test system allows physicians to differentiate between ASA-induced platelet dysfunction versus platelet dysfunction due to platelet disorders, which could yield abnormal CTs for BOTH test cartridges. ¹ Wintrobe's Clinical Hematology, 10th Edition, (G.R. Lee, J. Foerster, J. Lukens, F. Paraskevas, J.P. Greer and G.M. Rodgers, eds), Williams & Wilkins, Baltimore, Chapter 70: 1807.MicrothrombiMicrothrombi in the sample or particulates introduced into the sample from the environment could adversely affect the INNOVANCE® PFA-200 test results and/or cause a cancellation of the test by the instrument due to the detection of a flow obstruction.  Sedimentation RateBlood samples with high sedimentation rates may experience settling in position B while waiting to be tested in sequence with position A. If settling occurs, the hemodynamic properties of the sample may be altered, potentially affecting CT results. For this reason, it is recommended that you run samples that exhibit high sedimentation properties as single tests (using only position A). To obtain duplicate CT measurements, run a single test in position A two times. Note: In a clinical setting, it may not always be possible to judge the sedimentation properties of an unknown sample. However, the origin of the sample (which department or floor it came from), diagnosis (e.g., disease state, presence of substantial hemodilution due to cardiopulmonary bypass or ECMO, etc.), and other available information (e.g., hematocrit values) may assist you in determining if sedimentation of the sample should be considered when performing INNOVANCE® PFA-200 tests.HematocritSeveral clinical studies have indicated an association between significant bleeding and anemia. The mechanism may be due to the inability of red blood cells to push platelets toward the periphery of a vessel to form an effective platelet plug. Because platelet plug formation is the mechanism measured by the INNOVANCE® PFA-200 system, patients with low hematocrit levels <35% can also yield prolonged CT results that are higher than the laborator's established cut-off value. Note: Correlations between the INNOVANCE® PFA-200 system CT results and specimens with high hematocrit levels >50% have not been evaluated.Fatty Acids/LipidsCertain fatty acids and lipids found in various human diets are known to inhibit platelet function. Physicians may wish to advise patients to refrain from fatty foods prior to testing. Note: Neutral lipids, such as cholesterol, generally have no effect on platelet function.HemolysisHemolyzed blood-free hemoglobin from red blood cell-lysis can interfere with the INNOVANCE® PFA-200 test results by decreasing the hematocrit and by releasing ADP (which can activate platelets).  Other MedicationsMany medications are known to affect platelet function. Be sure to review the medication history of the patient when evaluating CT results. To view or print a list of medications known to affect platelet function, please refer to the Medications that Induce temporary Platelet Dysfunction and medications containing Aspirin® job aids later in this course. INNOVANCE® PFA-200 Cartridge Type Normal Patient Aspirin® Ingestion von Willebrand Disease Glanzmann thrombasthenia   n=(176) n=(120) n=(28) n=(4) Collagen/Epinephrine Normal Abnormal Abnormal Abnormal Collagen/ADP Normal Normal Abnormal Abnormal