Heparin in an emergency-to draw PTT or not?

[Shell5]

In a semi emergency situation and a surgeon asks you to give 5000u IVP and then hang 1000u/hr of Heparin, but did not order to to get a PTT, do you normally get one anyone? He did not order a heparin protocol? I am new to med surg and I hear several seasoned nurses saying different things. I am not sure. I think next time I will ask the dr. if he wants a PTT. However, it seemed to be an emergency situation.

[NurseyBaby'05, BSN, RN]

Yes! Yes! YES! Get that PTT drawn STAT. What if the doc made a mistake and you give the bolus and cause the patient to bleed out? You gave the med. Also, be sure your protocol is followed. You can have a stat lab back in a very short time. If the doctor gets mad, tough! There was an incident within the health system where I work where this exact scenario occured and the patient wound up going to Neuro ICU bleeding out into his brain. He eventually died. The nurse and doctor are both fired and now their licenses are on the line; if not already suspended or revoked.

[trixytop4]

I have to say that we have a protocol and before you give a bolus of heparin and then hang it you better have a baseline PT and PTT INR. You never know what might be going on with this patient. In an emergency we immediately start the IV and draw the blood and that includes the blue top tube. Cover you behind and be safe.