why dont you monitor prophylactic SC heparin?

[bennett12]

I cant find the answer to this anywhere...

.why dont you monitor aPTT/CBC with prophylactic Subcutaneous unfractionated Heparin? thanks in advance.

[P_RN, ADN, RN]

A hard lesson to learn is that over time platelets can drop dangerously low on "regular old low dose heparin."

[himilayaneyes]

In the hospital that I worked out, most of our patients had a cbc drawn every morning. So all of our prophylactic sq heparin pts always had their platelets checked. There's always a possibility of HIT. The only thing I can think of as to why some facilities wouldn't do it is that they figure HIT is rare and that heparin has a very short half-life. Fortunately, it also has a reversal agent which would also make a facility feel more comfortable. But it should be standard to have a cbc everyday if their on lovenox or heparin sq.

[HamsterRN, ADN, RN]

We check CBC's on day 3 of DVT prophylaxis heparin therapy and every 3rd day after that if they don't already have CBC's ordered. I've been told the reason why we don't monitor PTT's on these patients is that while the PTT will rise from the patient's baseline, it won't necessarily rise out of the normal range, and there is no established goal range for ptt for the purpose of DVT prophylaxis; the studies it is based on looked at dosage levels and not ptt's.

[AtomicWoman]

In the hospital that I worked out, most of our patients had a cbc drawn every morning. So all of our prophylactic sq heparin pts always had their platelets checked. There's always a possibility of HIT. The only thing I can think of as to why some facilities wouldn't do it is that they figure HIT is rare and that heparin has a very short half-life. Fortunately, it also has a reversal agent which would also make a facility feel more comfortable. But it should be standard to have a cbc everyday if their on lovenox or heparin sq.

I work in acute rehab and just yesterday, we admitted a young man who developed HIT after ortho surgery. He had a brain bleed and now has cognitive deficits. That *definitely* made me think differently about prophylactic Heparin!

[Esme12, ASN, BSN, RN]

They should monitor it somewhat because bad things like HIT can happen. like CBC prior to iniciation of therapy and every 3 days there after as well as PT/PTT. No medicine should be ever considered benign.....they all have side effects.