ACUTE MI -PT/INR results! I need explanation!

Editorial Team / Admin · Sep 3, 2008

I googled PT and protime and didn't come up with anything that makes sense of the values posted.

Is it possible there is/was an error (human or machine) error in obtaining/running them???

curious4life · Sep 3, 2008

I googled PT and protime and didn't come up with anything that makes sense of the values posted.
Is it possible there is/was an error (human or machine) error in obtaining/running them???

This is a school book question! At least I know Im not crazy LOL I looked at that for an hour good lord!! I think I am going crazy:no: Thank you for your support

allnurses Guide · Sep 3, 2008

I've never seen a PT of 0.6 - sounds very odd.

adria37 · Sep 4, 2008

That has to be a mistake IMHO to have a PT of .06 and INR of 1.8

INR = PT- test/PT-normal

Normal is roughly 1 and blood that takes twice as long to clot than "normal" would be 2. I would question the test.

adria37 · Sep 4, 2008

I don't believe a protime is not measured in seconds either :)

al7139, ASN, RN · Sep 4, 2008

Hi,

Hope this helps:

The PT (Prothrombin Time) is the amount of time needed to form a clot. It is measured in seconds. The INR (International Normalized Ratio) is a special mathematical calculation of the PT, used to monitor the effect of oral anticoagulants. For the patient getting PO therapy with Coumadin (Warfarin), the therapeutic range of the INR is 2.0 to 3.0. If the pt has a mechanical heart valve the therapeutic range of the INR is 2.5-3.5.

Although the test done includes BOTH the PT and INR, it is the INR that we use most often, because it is standardized across the world.

We monitor the PT/INR to determine the effect of anticoagulant therapy. If it is too low, ther is a risk for thrombus (clot) formation. If the level is too high, there is a risk for hemorrhage. In a normal person who does not need anticoagulants, the levels should be the PT is 10-14 seconds, and the INR should be 1.00-1.30.

In a pt with an MI, you would want the INR to be 2.0-3.0.

Hope this helps.

Amy

curious4life · Sep 4, 2008

Yes, very understandable thank you for that. The patient did have an acute MI.

gradRN2007, BSN, RN · Sep 13, 2008

probably was a clotted specimen or short, most likely clotted.

should of been asked for a redraw from your lab

EMT-Elvis · Sep 4, 2009

curiousforlife, what school do you go to? I am working on the same question now...

chademack · Sep 5, 2009

It would be great if you had the clinical experience to SEE what happens sometimes with blood. When you draw blood the specimen is a very viscous fliud. I have seen blood clot immediately in the tubes. When you draw a Pt/PTT/INR its in a blue tube is has a chemical additive in it. the reason you must fill the tube to a certain level is to get the correct ratio of 3.2% sodium citrate to blood specimen. This directly effects clotting time. If a specimen clots relatively quickly, then this can be indicative of a person having an MI cause by a blood clot. This is the exact reason we pump people full of anticoagulants in the cath lab.

Wmid · Feb 24, 2011

The INR is actually the patient's clotting time in seconds/the accepted reference of 12 seconds.

A bad draw resulting in hemolysis can throw this off - anything that stimulates platelet aggregation can throw it off. (Like leaving a tourniquet on for over 60 seconds.) A "short draw" will disrupt the delicate blood-to-Sodium Citrate anticoagulant ratio in the blue top tube used for these draws, which is why the lab often cannot accept a short tube for anticoag tests.

High hematocrits will also disrupt the result, by disrupting the 9:1 blood to anticoagulant ratio. The lab has to adjust the amount of sodium citrate in the tube for this: Sodium Citrate needed for accurate test = 1.85 x 10^3 x [100- (patient hematocrit percentage x 100)] x volume of patient's blood. So be nice when they ask for an additional draw!