? on drawing PT/INR | allnurses

? on drawing PT/INR

  1. 0 I have to draw a PT/INR and want to know if it needs to be done at a certain time of day or if there any other special things I need to know...have never done one before. I will be doing the stick, there's no line in place, will be done in the home.

    I did a search on the board but if there's something here on it, I didn't see it...

    Thanks!!
  2. Visit  Zookeeper44 profile page

    About Zookeeper44

    Zookeeper44 has '4' year(s) of experience and specializes in 'Psych'. From 'Eastanollee,GA'; 51 Years Old; Joined Mar '09; Posts: 64; Likes: 33.

    13 Comments so far...

  3. Visit  Five&Two Will Do profile page
    0
    Quote from Zookeeper44
    I have to draw a PT/INR and want to know if it needs to be done at a certain time of day or if there any other special things I need to know...have never done one before. I will be doing the stick, there's no line in place, will be done in the home.

    I did a search on the board but if there's something here on it, I didn't see it...

    Thanks!!
    Happy Thanksgiving! I imagine you are checking the INR due to coumadin therapy? You can check this anytime. Are you doing homehealth?
  4. Visit  mc3 profile page
    0
    I did them all the time when I worked in home health. Time of day wasn't a factor. If you're working today, I hope you get a chance to have some Thanksgiving dinner!
    mc3
  5. Visit  TheCommuter profile page
    3
    We check PT/INRs in the morning at my workplace. We give all Coumadin between 7:00pm and 8:00pm for consistency in the results, and we tend to check the PT/INRs at about 6:00am for the same reason.

    I should also mention that we use Coagucheck machines to check our PT/INRs. They look exactly like oversized glucometers, and we basically stick the patient's finger with a lancet, obtain a large drop of blood, transfer the blood onto the testing strip, and wait a few seconds for the result to appear.
  6. Visit  jnrsmommy profile page
    2
    Quote from TheCommuter
    We check PT/INRs in the morning at my workplace. We give all Coumadin between 7:00pm and 8:00pm for consistency in the results, and we tend to check the PT/INRs at about 6:00am for the same reason.

    I should also mention that we use Coagucheck machines to check our PT/INRs. They look exactly like oversized glucometers, and we basically stick the patient's finger with a lancet, obtain a large drop of blood, transfer the blood onto the testing strip, and wait a few seconds for the result to appear.
    Ooooh, I have never seen that machine before. Ours are still being sent out to the lab. Would be awesome to just do ourselves.
    pinkchris2000 and BunnySan27 like this.
  7. Visit  Christy1019 profile page
    2
    I dont know if this is facility specific or not, but in my ER when we draw coags it is the only specimen tube that MUST be filled completely w/blood. If you are also drawing other labs at that time, i believe the coags tube is supposed to be drawn second or third in order of tubes, with lactic acid/blood cultures/venous gas first, serum separator/serum level tubes second (red top for us), then coags (blue top) and then the rest, i forget what order.
    LaughingRN and tcvnurse like this.
  8. Visit  Zookeeper44 profile page
    0
    I am doing hospice, and no I am not working today, need to do the PT/INR tomorrow.

    So if the tube does not fill completely (which I don't think I've ever seen one do?) how do you get it filled...???
  9. Visit  Reno1978 profile page
    1
    The blue top tube should have enough suction in it to get it filled. The brand we use has a line on the tube that the blood has to reach. If you're doing a stick, if you can just draw 3mL into a syringe and then transfer the blood from the syringe into the tube, that'll work.
    Five&Two Will Do likes this.
  10. Visit  Christy1019 profile page
    0
    All blood tubes have negative pressure that creates suction to pull the blood into the tube, you can actually fill any of them all the way if you wanted to, but isnt required, with the exception of the lactic acid tube, and yes there is a line just below the blue part of the tube that is the "fill to" line
  11. Visit  Wave Watcher profile page
    3
    An easy way to remember order of blood draws.

    Yellow light, red light, green light, go
    Now all sterile draws first regardless. then...
    Yello tube (Yello)
    Light blue (Light)
    Red tube/tiger tops (Red light)
    Green tube (Green)
    Lavender tube (Light)
    Gray tube (Go)

    These are the most common rainbow colors used it seems.
    elprup, NRSKarenRN, and SneakySnake like this.
  12. Visit  tcvnurse profile page
    0
    Ditto what previous poster said about having the blue top tube filled to the label. Otherwise the nice folks at the lab will hand you the tube back and tell you to redraw. I used to use a expired tube to start the draw and THEN pop my blue top on there.

    I always tried to draw Pt/INRs in the morning and called them in to MD right away so I had half a chance of hearing back by the end of day. Good luck.
    Last edit by tcvnurse on Nov 24, '11 : Reason: spelling
  13. Visit  9livesRN profile page
    0
    I have done it 2 ways

    One: with the INR machine, like a glucometer but you need a nice fat dollop of blood otherwise you waste the strip, make sure you get it right on the target!

    Two: blood in a specimen tube, I find it easier to butterfly into a 3 ml syringe then stick the specimen tube!

    Timing wise, it doesn't matter, it depends on the client! You have to draw it early enough to send results and get the physician's response on the same day! Some times with home health we get it all set and the physician takes forever to respond..... But by having it drawn and read you can know if it is critical or not!
    Last edit by 9livesRN on Nov 24, '11
  14. Visit  seemerun profile page
    0
    I worked home health for quite awhile. Usually we used the machines but there were often times when we would need to do it by venipuncture. You do have to fill the tube all the way up and I always had problems with the vacutainers. They suction only pulled in about half way. You can attach a butterfly to the end a empty syringe and do it that way. Then you can be sure you get a big enough sample.


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