Do you give Heparin at your 6am med pass?

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We give Heparin at 6am and then the Lab comes in at 7am. Some of these blood tests are PT/INR. Is it OK to give Heparin at 6am and then have the lab do the PT/INR at 7am?

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from what I was taught in my ICU rotation I just finished that 5000 units of subQ Heparin are not enough to affect PT/INR....its the drips that will show your changes....

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Specializes in Clinical Documentation Specialist, LTC.

From my experience, most subq heparin given is 30,000 units and greater. That's because most patients in LTC who are getting subq heparin are post-op ortho and are on it for 7-10 days.

Blackcat99, what is the dose?

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Heparin affects PTT, not PT/INR. It won't make a difference. However, if the patient is on warfarin and getting their INR checked, why are they are on heparin in the first place?

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Specializes in Clinical Documentation Specialist, LTC.
Heparin affects PTT, not PT/INR. It won't make a difference. However, if the patient is on warfarin and getting their INR checked, why are they are on heparin in the first place?

Good point. As far as getting heparin and warfarin, the doctors I have worked with have ordered warfarin to be held while the patient is on heparin.

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have seen patients being "weaned" to warfarin from heparin....when PT/INR gets where they want it, the heparin is Dcd.

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Specializes in ER, progressive care.
have seen patients being "weaned" to warfarin from heparin....when PT/INR gets where they want it, the heparin is Dcd.

Or lovenox. It's not uncommon to see a patient on Coumadin and/or heparin/lovenox because it takes a few days for Coumadin to become therapeutic. Once it is, the heparin or lovenox is discontinued.

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Specializes in Clinical Documentation Specialist, LTC.

It was Lovenox I was thinking about, not heparin. My bad!

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Yes I often see "bridging" (weaning) but only ever with a low molecular weight heparin (we use dalteparin and sometimes lovenox where I work), never with heparin.

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Wellll, before they existed....

Yes I often see "bridging" (weaning) but only ever with a low molecular weight heparin (we use dalteparin and sometimes lovenox where I work), never with heparin.
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Thanks everyone. The dose is 5,000 daily.

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I understand warfarin bridging, but I've only ever seen it with LMWH.

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