retroperitoneal bleed | allnurses

retroperitoneal bleed

  1. 0 I have been taking care of a pt that had a retroperitoneal bleed secondary to Lovenox injection. This is the first time I have heard of this and was wondering how frequently you see this in your practice???
  2. Visit  rn4cicu profile page

    About rn4cicu

    Joined Dec '03; Posts: 41.

    21 Comments so far...

  3. Visit  athomas91 profile page
    0
    i assume this was post-op??
  4. Visit  rn4cicu profile page
    0
    no post op! pt was transferred from outlying facility with CP; pt started on Lovenox I guess in preparation for intervention that was going to be done here.
  5. Visit  kc ccurn profile page
    0
    gheez, how much Lovenox was he on? Usually if pt's are on a "maintenance" or preventative dose of lovenox it's only 1mg/kg sq bid. If they have a proven clot, like a DVT the dose is higher. What other meds was this guy on? any past history? I've seen plenty of retroperitoneal bleeds but not from Lovenox.
  6. Visit  Dinith88 profile page
    0
    I'm betting this retro-bleed would've happened regardless of what type of anticoagulation he/she was being given. The Lovenox surely made it worse, but it's not some side-effect unique to the drug.

    (hey KC, that 1mg/kg bid is a big dose for prophylaxis. We usually give 40mg sq qd for prevention(maybe more if patient weighs alot). The 1mg/kg/bid is more for chest pain/dvt)
    Last edit by Dinith88 on Jan 17, '04
  7. Visit  athomas91 profile page
    0
    i agree w/ the previous post...i have seen a ton of RP bleeds, but they were usually post cath etc....i would guess that there was another pathology re: the bleed and that the lovonox just made it more substantial...
  8. Visit  kc ccurn profile page
    0
    (hey KC, that 1mg/kg bid is a big dose for prophylaxis. We usually give 40mg sq qd for prevention(maybe more if patient weighs alot). The 1mg/kg/bid is more for chest pain/dvt)
    I think I was having a brain fart or something, our dose is 30mg. sorry:imbar
  9. Visit  allsorts profile page
    0
    Quote from athomas91
    i agree w/ the previous post...i have seen a ton of RP bleeds, but they were usually post cath etc....i would guess that there was another pathology re: the bleed and that the lovonox just made it more substantial...
    i would like your input on rp bleeds...we had a pat.post angioplasty,not on lovenox,not post cardiaccath,with AAA, PVD,who developed fatal rp bleed
  10. Visit  dianah profile page
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    re: allsorts' post: "post angioplasty" to me means post angiogram, which increases risk of rp bleed. Was a closure device used??
  11. Visit  allsorts profile page
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    Quote from dianah
    re: allsorts' post: "post angioplasty" to me means post angiogram, which increases risk of rp bleed. Was a closure device used??
    yes,perclose was used
  12. Visit  dianah profile page
    0
    Rp bleed IS one of the possible BIG BAD problems with closure devices. Any time one is used, I am automatically on guard, as it were, for a bleed. They are insidious and often when pt finally has s/sx, it's a HUGE bleed. Esp. if pt has had Lovenox or Plavix or IIB/IIIAs.
    I did a quick web search and came up with the following link that may be helpful:
    http://nsweb.nursingspectrum.com/ce/ce178.htm

    I'm sure there are other sites with good info. Rp is scary.
  13. Visit  allsorts profile page
    0
    Quote from dianah
    Rp bleed IS one of the possible BIG BAD problems with closure devices. Any time one is used, I am automatically on guard, as it were, for a bleed. They are insidious and often when pt finally has s/sx, it's a HUGE bleed. Esp. if pt has had Lovenox or Plavix or IIB/IIIAs.
    I did a quick web search and came up with the following link that may be helpful:
    http://nsweb.nursingspectrum.com/ce/ce178.htm

    I'm sure there are other sites with good info. Rp is scary.
    thanks for your input-i really appreciate it
  14. Visit  dianah profile page
    0
    Might be worth it to call the vendor rep. of the various closure devices your facility uses, to give an inservice to the nurses who care for pts post-device placement. Then you and others can ask questions directly.


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