Hi, I just got home after what can only be described as the most draining shift I've ever had. I work on a telemetry cardiac PCU. Yesterday I had 4 patients that were all very busy. One patient I had was on a heparin drip. A baseline PTT was drawn at 6:30am and I started his drip at 8am. By 1500 his follow up PTT was drawn. However, because of my hectic day, I didn't get a chance to check the result until 1900 when I was giving report. It came back sub-therapeutic at 54.6 so he needed a bolus and rate change. The night RN signed it with me but now I'm wondering if I changed it too late and will possibly be in trouble for that 😔 Any insight is welcomed..
Sep 6, '17
Nah I wouldn't worry about it. Luckily the PTT came back slightly on the low side - it would be more worrisome if it came back critically high and wasn't noticed until four hours later.
Nov 22, '17
It's okay, that happens sometimes. No harm came to the patient, and you recognized it before you left for the day. Also, my facility uses anti-Xa to titrate heparin, not aPTT. I wonder if either one has benefit over the other.