Do you give Heparin at your 6am med pass?

  1. 0 We give Heparin at 6am and then the Lab comes in at 7am. Some of these blood tests are PT/INR. Is it OK to give Heparin at 6am and then have the lab do the PT/INR at 7am?
  2. Visit  Blackcat99 profile page

    About Blackcat99

    From 'Florida'; Joined Jan '04; Posts: 3,087; Likes: 1,012.

    11 Comments so far...

  3. Visit  Twinmom06 profile page
    2
    from what I was taught in my ICU rotation I just finished that 5000 units of subQ Heparin are not enough to affect PT/INR....its the drips that will show your changes....
    prnqday and Blackcat99 like this.
  4. Visit  LTCNS profile page
    0
    From my experience, most subq heparin given is 30,000 units and greater. That's because most patients in LTC who are getting subq heparin are post-op ortho and are on it for 7-10 days.

    Blackcat99, what is the dose?
  5. Visit  VANurse2010 profile page
    4
    Heparin affects PTT, not PT/INR. It won't make a difference. However, if the patient is on warfarin and getting their INR checked, why are they are on heparin in the first place?
    Forever Sunshine, psu_213, KelRN215, and 1 other like this.
  6. Visit  LTCNS profile page
    1
    Quote from VANurse2010
    Heparin affects PTT, not PT/INR. It won't make a difference. However, if the patient is on warfarin and getting their INR checked, why are they are on heparin in the first place?
    Good point. As far as getting heparin and warfarin, the doctors I have worked with have ordered warfarin to be held while the patient is on heparin.
    Blackcat99 likes this.
  7. Visit  morte profile page
    2
    have seen patients being "weaned" to warfarin from heparin....when PT/INR gets where they want it, the heparin is Dcd.
    Blackcat99 and Patchouli like this.
  8. Visit  turnforthenurseRN profile page
    5
    Quote from morte
    have seen patients being "weaned" to warfarin from heparin....when PT/INR gets where they want it, the heparin is Dcd.
    Or lovenox. It's not uncommon to see a patient on Coumadin and/or heparin/lovenox because it takes a few days for Coumadin to become therapeutic. Once it is, the heparin or lovenox is discontinued.
    al586, TX911, Stcroix, and 2 others like this.
  9. Visit  LTCNS profile page
    1
    It was Lovenox I was thinking about, not heparin. My bad!
    Blackcat99 likes this.
  10. Visit  SaoirseRN profile page
    1
    Yes I often see "bridging" (weaning) but only ever with a low molecular weight heparin (we use dalteparin and sometimes lovenox where I work), never with heparin.
    Blackcat99 likes this.
  11. Visit  morte profile page
    2
    Wellll, before they existed....
    Quote from SaoirseRN
    Yes I often see "bridging" (weaning) but only ever with a low molecular weight heparin (we use dalteparin and sometimes lovenox where I work), never with heparin.
    KelRN215 and Blackcat99 like this.
  12. Visit  Blackcat99 profile page
    0
    Thanks everyone. The dose is 5,000 daily.
  13. Visit  VANurse2010 profile page
    1
    I understand warfarin bridging, but I've only ever seen it with LMWH.
    Blackcat99 likes this.


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