Do you give Heparin at your 6am med pass?

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  1. by Feb 23
    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?
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    by Blackcat99 Feb 23 9:58 pm
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  3. 11 Comments so far...

  4. Feb 23 by
    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....
    crazy&cuteRN and Blackcat99 like this.
  5. Feb 23 by
    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?
  6. Feb 23 by
    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.
  7. Feb 23 by
    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.
  8. Feb 24 by
    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.
  9. Feb 24 by
    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.
  10. Feb 24 by
    It was Lovenox I was thinking about, not heparin. My bad!
    Blackcat99 likes this.
  11. Feb 24 by
    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.
  12. Feb 24 by
    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.