Another heparin protocol...

[nyteshade]

Ok, my hospital has a very confusing heparin protocol. For example:

Patient weighs 86.4 kg

Initial rate started at 1000 units/hr (12 units/kg/hr) per pharmacy

The heparin bag is 25,000 units in 250 ml

So starting rate is 10 ml/hr

Now the fun begins:

aPTT is 40 sec

Protocol on MAR says:

If aPTT is 35-45 sec increase rate by 150 units/hr (2 units/kg/hr)

I got 12 ml/hr

I used this guide nursing.uchc.edu/.../Heparin%20Drip%20Calculation%20Reference.pdf

Or do you simply add 150 units to the 1000 units/hr for an answer of 11.5 ml/hr?

Thanks!

[Esme12, ASN, BSN, RN]

If your pump will infuse 11.5 then 11.5. If not then 12.

[nurseprnRN, BSN, RN]

Is there some reason you can't call the physician and clarify which is being prescribed-- a straight "increase by 150 units per hour" or "increase by 2 units/kg/hour," since they are different (and will be for anyone who doesn't weigh 75 kg :) )? Then work with your physician therapeutics committee and the pharmacy to standardize the order sheets for these changes.

[nyteshade, BSN]

Thanks guys! I've consulted with pharmacy, and will be working to get that changed.