Long bleeding times

  1. Hi everyone. Got a cool idea from transient dialysis patient the other night.. He uses Tums on his sites after the needles are pulled to stop the bleeding quickly.. Stopped in 5 minutes.. We have used it on several patients who would not stop bleeding after 35-40 minutes and they stopped in 5 minutes.. Don't really know how it works it just does.. If it ain't broke don't fix it...

    bobbi
    May the sun shine brightly on you and may the wind be always at your back....
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  2. 18 Comments

  3. by   misti_z
    That's interesting........any idea why? Beats me!
  4. by   3651bht
    The tums starts to dissolve with the heat of the body and a gel like substance mixes with the oozing blood and it clots it off.. Suppose we should be checking their Ca++ levels more often too. LOL

    May the sun shine brightly, in peace, on you and may the wind be always at your back...
  5. by   misti_z

    That's cool!!!
  6. by   nursefiggy
    hmmmm, you think Tums are sterile?
  7. by   jnette
    Originally posted by nursefiggy
    hmmmm, you think Tums are sterile?
    GOOD POINT ! That COULD be quite a no- no !!!

    We have used the little betadine swabs on some of our patients... seems to help stop the bleeding on many of them if placed beneath the gauze... but not on ALL patients.. it varies. Worth a try on your patients, though.
  8. by   rick3114
    Scenario varies from patient to patient.

    For patient on coumadin, you probably do not need to use heparin when they are on machine, and could squeak by with NS flushes, depending on PT/INR.

    Patients with accesses may also take baby ASA so you need to keep this in mind as well when bolusing large units of heparin.

    Try stopping the heparin hour before, sometimes 75 mins. before run is complete.

    Keep in mind true half life of variety of heparin you are using on a patient.

    In our Harvard teaching hospital unit we used to use Ferric subsulfate solution with gelfoam as a last resort for the patients who didn't respond well to merely a 2x2 and gelfoam. We trialed the potato starch in the squeeze bottle but that was ridiculous.

    A very old dialysis nurse used to use tea bags, saying the tannic acid promoted clotting and she would use this when the Ferric didn't work. I have never heard of using Tums, but think it is clever. Someone mentioned sterility of using the Tums, but when you have a bleeding patient who goes on and on bleeding for hours what do you do? Send to E.R. and use elastaplast in meantime? When you have worked an 11 or 13 hour day you want to go home and those pesky bleeders can ruin it for you on getting out on time!!!!!!
  9. by   Surgical Hrt RN
    i'm not a dialysis nurse.....but i got a theory! i work in an open heart icu. when our patients are bleeding the surgeons like us to give calcium gluconate to help with clotting. it works pretty good. tums are high in calcium.....so......maybe that's why it worked! who knows......sounds good to me! :chuckle
  10. by   jnette
    Quote from surgical hrt rn
    i'm not a dialysis nurse.....but i got a theory! i work in an open heart icu. when our patients are bleeding the surgeons like us to give calcium gluconate to help with clotting. it works pretty good. tums are high in calcium.....so......maybe that's why it worked! who knows......sounds good to me! :chuckle
    just how is the calcium gluconate used?

    gelfoam works pretty good, really. also the little 1x1 betadine wipes underneath the gauze.. seems to help on several of our pts.
  11. by   Surgical Hrt RN
    Quote from jnette
    just how is the calcium gluconate used?

    gelfoam works pretty good, really. also the little 1x1 betadine wipes underneath the gauze.. seems to help on several of our pts.
    we give the calcium gluconate iv. usually the bleeding slows within an hour. i know you guys don't have that long to wait. but, since calcium is in tums, i thought there might be a correlation. rule of thumb for us........if the patient's ionized calcium is < 1.1 we need to give one amp of calcium gluconate. hope this was what you were looking for in an answer. we use gelfoam also.....on sites that won't stop bleeding, for instance an arterial line.
  12. by   jnette
    Quote from surgical hrt rn
    we give the calcium gluconate iv. usually the bleeding slows within an hour. i know you guys don't have that long to wait. but, since calcium is in tums, i thought there might be a correlation. rule of thumb for us........if the patient's ionized calcium is < 1.1 we need to give one amp of calcium gluconate. hope this was what you were looking for in an answer.
    interesting. just wondered, because we do have to be careful with cal/phos issues, also.
  13. by   nurse dolly
    Quote from surgical hrt rn
    we give the calcium gluconate iv. usually the bleeding slows within an hour. i know you guys don't have that long to wait. but, since calcium is in tums, i thought there might be a correlation. rule of thumb for us........if the patient's ionized calcium is < 1.1 we need to give one amp of calcium gluconate. hope this was what you were looking for in an answer. we use gelfoam also.....on sites that won't stop bleeding, for instance an arterial line.
    we sometimes use the sticky stuff in the bottom of a tiger top lab tube ( you get it out with a q-tip!! it works very well when you have someone who keeps bleeding for a very long time. havent had to use this in a long time.
  14. by   Hellllllo Nurse
    Quote from nurse dolly
    We sometimes use the sticky stuff in the bottom of a tiger top lab tube ( you get it out with a Q-tip!! It works very well when you have someone who keeps bleeding for a very long time. Havent had to use this in a long time.
    Never heard of this one. And that stuff is sterile!


    I've heard of using Tums. I've been told it works. I've seen tea bags used, too. However, I'm sure the state frowns on this big time!

    We give a heparin bolus prior to starting tx, and no further heparin is given. The only exception is a 550 lb pt who gets 30,000 u of heparin per tx- 20,000 u bolus, and 2000u per hr, five hr tx.

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