I have just started at a new hospital and was very concerned with a heparin drip we were running. It was started at 2330 and no PTT/INR was taken again. Pt. had a peripheral IV and a single PICC. They started the heparin through the PICC and then Lab refused to try blood draws as said Pt was too hard a poke!!!!
I took over 8 hrs after heparin was started. Was told to switch Heparin to peripheral IV wait an hour, flush PICC with 60mls Saline then draw labs. Now my understanding is if a heparin drip is running in a Central line you CANNOT draw PT/PTT/INR as you will get skewed results!!!
Also the peripheral IV went bad so couldn't switch the lines. In the end we got a new peripheral IV switched heparin to peripheral, waited an hour then did as advised. Result was (greater than) 150. Hmmm I'm wondering how accurate that was? As it is it was over 12 hours before I could get the PTT/INR.
Then the Charge nurse wanted to run Antibiotics concurrent with the heparin. I didn't do that but surely THAT is dangerous.
Appreciate any thoughts!!!