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We check PTTs Q6hrs until we get 2 PTTs that are therapeutic. Then, they get checked every day. If the gtts need to be changed again...check 6 hrs after the change and ....need 2 more therapeutic PTTs until its every AM again. We have two different protocols to follow. Stroke and Cardiac. I think the therapeutic levels are different for each. Both initial gtts. are based on pt. wt.
Anne
Originally posted by KC CHICKWe check PTTs Q6hrs until we get 2 PTTs that are therapeutic. Then, they get checked every day. If the gtts need to be changed again...check 6 hrs after the change and ....need 2 more therapeutic PTTs until its every AM again. We have two different protocols to follow. Stroke and Cardiac. I think the therapeutic levels are different for each. Both initial gtts. are based on pt. wt.
Anne
Same here. If value >150 is obtained the gtt is off for 30min and another PTT drawn p the 30min then restart per the protocol.
Yup, we have a separate protocol and MAR for heparin gtt with the parameters on it. We write up the orders for the APTT draws "per heparin protocol" and can always put in a stat draw if we suspect any problems. The lab's usually real good about getting it back to us quickly too; can draw and get results within one hour.
Very important on a tele floor.
If someone has a minute could you please give me an example of values concerning monitoring aPTT levels on a patient receiving Heparin. I know the basics of the "normal range is between 20-45 seconds," and the "therapeutic level should be at 1.5-2.5 x the control"...but I'm having difficulty putting that into practice.
Thank you for any response. :nuke:
louiemed;
Here is a very good example of a best practice protocol sheet for weight based heparin. Check with your facility's protocol to make sure it's the same before using. I think it lays out the protocol in an easy-to-understand manner.
Does your facility use a protocol sheet? If not, they really should.
CTnuse
13 Posts
What is your protocol on monitoring APTTs on patients with heparin gtts?
Do you differentiate between standard nomagram and a modified nomagram.
I have seen too many people bleed or develop large hematomas because thier APTT has not been checked for more than 6 hours and it is way over limit.
Any imput would be greatly appreciated as I am trying to change our practice to make it safer.
Denise:)