BKA following a hysterectomy, it really happened

[DutchgirlRN]

I have a patient who had surgery. We got a call to go out to her home and check her PT/INR twice a week for several weeks until her coumadin was adjusted. A few minutes later I get a call that her DC was cancelled and she was going back to surgery for an amputation! Her history was that she had a PE last year and has been on coumadin since. Her doc told her to quit taking her coumadin a week before her surgery. Her PT/INR was not checked before or after surgery. On the third day post op when she was supposed to go home her right foot started hurting and getting dark. She ended up with a below the knee amputation of her right leg. I understand stopping the coumadin before the surgery but not checking her blood (I thought clotting time PT and PTT were mandatory before OR?) and not restarting the coumadin after surgery? Any thoughts?

[DutchgirlRN, ASN, RN]

This is a very sad story with a very sad ending.

It is very sad but I'll tell you the patient sure isn't. She unbelieveably upbeat. Just days after being at home she was on crutches cooking dinner. She says once she gets her new leg she'll be right back to her old life, driving, working, etc. She went to every Christmas party she was invited to because she's determined not to let this change her life in anyway. I really admire her attitude and I believe she will accompolish everything that she goes after.

[DutchgirlRN, ASN, RN]

Please be careful about HIPAA issues here! It might not be all that difficult to figure out who/what hosp you're discussing. Thanks.

I see your point I'll be more careful with the details.