Here's the scenario: Patient's vitals signs pre-dialysis was fine and normotensive. So, charted bolus heparin was given. Upon putting the pt on the machine, BP was still normotensive so heparin infusion was started. After 2 hrs, patient's BP went to 200/180, asymptomatic, relaxed. Pt was known to have hypertension during dialysis always. I am fairly new to hemodialysis compared to the techs and nurses in my unit who are in this field for more than 7 years. Now there are 2 school of thoughts in our unit. The first (the one I was trained in) believes that stopping/clamping the heparin infusion of the hypertensive patient during dialysis will benefit the pt. It is to prevent cerebral hemorrhage in case the pt will have stroke. The second believes that since bolus has been given, there's no point of stopping the heparin infusion since it's already in the plasma regardless of the half life.
I cannot find a protocol in our unit. But if we follw the right intervention based on rationale, which do you think is right?
How about your practice or protocol in your unit. Replies in this topic is much appreciated.