This is a blood test that measures the amount of antithrombin III (AT III), a protein that helps prevent and regulate blood clotting.

Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and an elastic band is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the band to fill with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

For an infant or young child:

The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

The health care provider may limit certain medications shortly before the test to assure an accurate sample. Usually this will include monitoring drugs that may affect the amount of antithrombin in the bloodstream.

For infants and children:

The preparation you can provide for this procedure depends on your child's age, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

This test is indicated when there are repeated episodes of blood clots or when individuals do not respond to anticoagulant medications. It can help to determine the cause of hypercoagulation (increased blood coagulation).

The normal range is 0.20-0.45 mg/ml (milligrams per milliliter).

Lower-than-normal AT III may indicate an increased risk of clotting. Examples of disorders and/or conditions associated with increased blood clotting include:

• deep venous thrombosis
• pulmonary embolus (blood clot traveling to lung)
• phlebitis (vein inflammation)

• DIC (disseminated intravascular coagulation)
• other coagulation disorders
• liver disorders
• nephrotic syndrome

• use of anabolic steroids

• excessive bleeding
• fainting or feeling light-headed
• hematoma (blood accumulating under the skin)
• infection (a slight risk any time the skin is broken)
• multiple punctures to locate veins

Birth control pills can cause a slight decrease in AT III levels.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.