1. Platelet Function Testing Kit for each patient The packet contains everything needed We will now demonstrate how to perform the test

2. insulated pouch heating pad connecting 2way adaptors fixing solution aspirin test clopidogrel test baseline test Instruction leaflet Citrate blood collection tube Three platelet stimulant tubes

3. Activate the heating pad by clicking on the circular valve inside Warming the tubes

4. When activated the gel turns white and warms up immediately Warming the tubes

5. Place the heated pad inside one pocket of the insulation pouch Warming the tubes

6. Place the three stimulant tubes in the other pocket of the insulation pouch Warming the tubes

7. The stimulant tubes are now ready to use Warming the tubes

8. Venepuncture Select the green topped citrate monovette Blood should preferably be collected using one of the following venepuncture procedures Butterfly BD Vacutainer Sarstedt Multifly set

9. Butterfly you will also need the Sarstedt multi-adaptor valve Venepuncture

10. BD Vacutainer Safety-Lok you also need the Sarstedt multi-adaptor valve Venepuncture

11. the Sarstedt multi-adaptor valve Venepuncture

12. Sarstedt MultifySet already supplied with the adaptor for the monovette tube Venepuncture

13. Filled citrate anticoagulant tube Fill to the 10 ml line by pulling gently on the plunger (do not lock off the tube) Invert 3 times to mix the blood

14. Pull the plunger pulled back (do not lock off the tube) Add the blood from the syringe up to the 10 ml mark Screw on the green cap Invert 3 times to mix the blood If you have to use a needle and syringe If using a needle and syringe the tube will need to be opened by holding the monovette upright and unscrewing the green end taking care not to spill the anticoagulant inside. 10 ml mark Venepuncture

15. Filled citrate anticoagulant tube

16. Place the blood in the insulation pouch with the stimulant tubes until ready to perform the test

17. Mix the blood and attach one of the 2way adaptors Platelet stimulation

18. Attach each stimulant tube and add blood in turn Fill three stimulant tubes Platelet stimulation

19. To fill, pull back plunger until top of the plunger aligns with bottom arrow Blood should flow up to 4.5 ml mark Platelet stimulation

20. Place the stimulant tubes back in the pouch to keep warm Check the time and wait 5 minutes! Platelet stimulation

21. While waiting for the 5 minutes Discard the used citrate tube and adaptor valve

22. While waiting for 5 minutes Take the second 2way adaptor and attach to the Fixing Solution Tube

23. When 5 minutes is passed Attach each stimulant tube in turn to the 2way adaptor Pull back plunger all the way and fill the tubes with the fixing solution (liquid aligns with the 4.5 ml mark)

24. Completed stimulant tubes Invert to mix

25. Snap off the plungers on the stimulant tubes

26. Write patient details on the labels on each of the three stimulant tubes

27. Place the completed stimulant tubes in the padding for transportation

28. Place tubes inside the package and transfer pack to Nottingham Platelet function will be measured as platelet P-selectin expression