ACUTE MI -PT/INR results! I need explanation! | allnurses

ACUTE MI -PT/INR results! I need explanation!

  1. 0 PT/INR 0.6 seconds/1.8

    I understand anything over 1 is high for INR and the patient is at risk for bleeding but I cannot find and explanation for reduced PT other than I think the clot forms too rapidly. Am I on the right track. why does this information contradict
  2. 13 Comments so far...

  3. Visit  dianah profile page
    I googled PT and protime and didn't come up with anything that makes sense of the values posted.

    Is it possible there is/was an error (human or machine) error in obtaining/running them???
    MMARN and curious4life like this.
  4. Visit  curious4life profile page
    Quote from dianah
    I googled PT and protime and didn't come up with anything that makes sense of the values posted.

    Is it possible there is/was an error (human or machine) error in obtaining/running them???

    This is a school book question! At least I know Im not crazy LOL I looked at that for an hour good lord!! I think I am going crazy Thank you for your support
  5. Visit  ghillbert profile page
    I've never seen a PT of 0.6 - sounds very odd.
    CCL RN and curious4life like this.
  6. Visit  adria37 profile page
    That has to be a mistake IMHO to have a PT of .06 and INR of 1.8

    INR = PT- test/PT-normal

    Normal is roughly 1 and blood that takes twice as long to clot than "normal" would be 2. I would question the test.
    curious4life likes this.
  7. Visit  adria37 profile page
    I don't believe a protime is not measured in seconds either
    curious4life likes this.
  8. Visit  al7139 profile page
    Hope this helps:
    The PT (Prothrombin Time) is the amount of time needed to form a clot. It is measured in seconds. The INR (International Normalized Ratio) is a special mathematical calculation of the PT, used to monitor the effect of oral anticoagulants. For the patient getting PO therapy with Coumadin (Warfarin), the therapeutic range of the INR is 2.0 to 3.0. If the pt has a mechanical heart valve the therapeutic range of the INR is 2.5-3.5.
    Although the test done includes BOTH the PT and INR, it is the INR that we use most often, because it is standardized across the world.
    We monitor the PT/INR to determine the effect of anticoagulant therapy. If it is too low, ther is a risk for thrombus (clot) formation. If the level is too high, there is a risk for hemorrhage. In a normal person who does not need anticoagulants, the levels should be the PT is 10-14 seconds, and the INR should be 1.00-1.30.
    In a pt with an MI, you would want the INR to be 2.0-3.0.
    Hope this helps.
    onthemark, MMARN, CRIMSON, and 7 others like this.
  9. Visit  curious4life profile page
    Yes, very understandable thank you for that. The patient did have an acute MI.
  10. Visit  gradRN2007 profile page
    probably was a clotted specimen or short, most likely clotted.
    should of been asked for a redraw from your lab
  11. Visit  EMT-Elvis profile page
    curiousforlife, what school do you go to? I am working on the same question now...
  12. Visit  chademack profile page
    It would be great if you had the clinical experience to SEE what happens sometimes with blood. When you draw blood the specimen is a very viscous fliud. I have seen blood clot immediately in the tubes. When you draw a Pt/PTT/INR its in a blue tube is has a chemical additive in it. the reason you must fill the tube to a certain level is to get the correct ratio of 3.2% sodium citrate to blood specimen. This directly effects clotting time. If a specimen clots relatively quickly, then this can be indicative of a person having an MI cause by a blood clot. This is the exact reason we pump people full of anticoagulants in the cath lab.
    onthemark likes this.
  13. Visit  Wmid profile page
    The INR is actually the patient's clotting time in seconds/the accepted reference of 12 seconds.

    A bad draw resulting in hemolysis can throw this off - anything that stimulates platelet aggregation can throw it off. (Like leaving a tourniquet on for over 60 seconds.) A "short draw" will disrupt the delicate blood-to-Sodium Citrate anticoagulant ratio in the blue top tube used for these draws, which is why the lab often cannot accept a short tube for anticoag tests.

    High hematocrits will also disrupt the result, by disrupting the 9:1 blood to anticoagulant ratio. The lab has to adjust the amount of sodium citrate in the tube for this: Sodium Citrate needed for accurate test = 1.85 x 10^3 x [100- (patient hematocrit percentage x 100)] x volume of patient's blood. So be nice when they ask for an additional draw!
    nursej22 likes this.
  14. Visit  Skip219 profile page
    In the last thirteen years, I have seen one case of pts INR getting too low 1.7 and he threw a clot to a diagonal branch (had anterior MI). The usual route to an MI: the vulnerable plaque inside a coronary artery ruptures setting off the clotting cascade, and formation of a clot. Once its 90-100% blocked , the pt has an MI. In the cath labs that I have worked, the pts with INRs of 1.8 or less the cardiologists will cath them. Otherwise, they will postpone until their INR is in a safer range.
    CCL RN likes this.