heparin gtt vs SubQ

[raindrop]

my unit will send a patient to the cath lab with the heparin gtt infusing. cath lab will stop the drip and discontinue the order before sending the patient back post cath.

so why is it acceptable for a patient to leave our unit to the CL with heparin infusing, but if someone has been getting subQ heparin, we aren't supposed to give it the morning of the procedure?? or lovenox for that matter.

[MendedHeart]

Higher weight molecular heparin is cleared from circulation faster than LWMH. SUBQ Heparin action is also delayed several hours.

[FurBabyMom, MSN, RN]

It has to do with the mechanism of delivery and the peak time of effectiveness for the route. SubQ meds absorb slower and peak later than IV meds. There is also a difference between lovenox and heparin SubQ. The goal for subq therapy is DVT prophylaxis, whereas they need a certain level of anticoagulation in the vessels to be able to do the cath procedure. Cardiac cath is a endovascular procedure, and thinking about how the procedure works should help too (if they didn't anticoagulate the blood, they would never be able to effectively cannulate the distal vessel to pass the sheath for the procedure, the insertion site (to the vessel) would begin to clot too easily).

It's common for cardiac and vascular patients to go to the OR on IV anticoagulants (cath lab, carotid endarterectomy etc). Some other surgery patients (colons, hysters, urology, or anything that could be a long case where the peak time for subQ med effectiveness is met during surgery) those patients have a higher risk of bleeding with pharmacologic DVT prophylaxis.

[Esme12, ASN, BSN, RN]

my unit will send a patient to the cath lab with the heparin gtt infusing. cath lab will stop the drip and discontinue the order before sending the patient back post cath.

so why is it acceptable for a patient to leave our unit to the CL with heparin infusing, but if someone has been getting subQ heparin, we aren't supposed to give it the morning of the procedure?? or lovenox for that matter.

Some patients need to have the heparin infusing due to the suspected/known blockages to try to prevent and embolytic event/MI prior to the scheduled intervention. Many cath lab patients get heparin bolus after arterial stick/sheath to prevent clotting.....the heparin is reversed with protamine at the end of the procedure when indicated.