Plavix

["McLovin"]

What is everyone else out there doing about patients who are on plavix pre-procedure? At our facility we monitor the bleeding time. However it is quite time consuming and delays procedures.

[dianah, ASN]

I work in Cath Lab, not Radiology, but when we send pts for Cardiac Intervention, our sister facility ALWAYS wants 800mg Plavix given pre-procedure (don't know if they test for bleeding time, but somehow I think not; I think they just do the procedure and then leave the sheath in until APTT's are below 150, then pull the sheath [based only on the PTT]).

Now, the cardiac surgeons will wait to surgerize the pt until 5 days post-last Plavix dose!

Will have to check w/our Interventional Radiology folks, to see what they do.

I haven't heard any hue and cry over delaying procedures d/t waiting for bleeding times; my gut feeling is, the bleeding time numbers aren't a big concern.

The MDs are just aware the pt has Plavix on board when the procedure is done.

Again, though, will check and report back.

Is there any way you can do a point-of-care (POC) bleeding time (if your MDs require one when the pt is on Plavix)?

Perhaps it would be more efficient, preventing untimely delays (and you could perform it yourself, no need to collect blood, send it to lab, then wait for results. Or, no need to have the MD order it, have the ward nurse collect it, send it to Lab and then wait for results).