Another heparin protocol...

Nurses Safety

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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!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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

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.

Specializes in Legal, Ortho, Rehab.

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

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