Non-weight-based heparin infusions

Esme12, ASN, BSN, RN · Mar 12, 2012

I am disappointed that the nurses are not being held to task and held responsible for their non compliance or that the facility cannot analyze why the protocol isn't working and fix whatever systems issues that exist.

However, we did non weight based heparin for years and the largest factor to the benefit the patient is obtaining and maintaining therapeutic anticoagulation. I cannot however find any evidence to upport that theory.

meandragonbrett · Mar 12, 2012

For what it's worth......I have never done weight based heparin gtts in any facility that I have worked.

brainkandy87 · Mar 13, 2012

Well, if we want to get technical about it, weight based heparin infusions are only done correctly probably 5% of the time. Why? Think about the weird numbers you get when doing the initial loading dose of heparin. Weird calculations like 4,362 or 4,789. How many times does our initial dose come to a figure that we can precisely measure with commonly available syringes? Not often. Even with a 1 ml syringe, you're still rounding up or down a little bit.

BUT that's the technical way to look at it. Most of my initial loading doses are between 4,000 to the maximum for our facility, 5,000. Non-weight based protocol wouldn't be a big issue, in my opinion.

ckh23, BSN, RN · Mar 13, 2012

At my facility we calculate the initial loading dose and initial rate according to weight and then we adjust according to PTT. I have used both weight based and non weight based at different facilities. It has been my experience that the weight based protocol seems to make people more coagulopathic initially and stay elevated for the first couple of adjustments.

Silverlight2010 · Mar 17, 2012

Ours are always weight based, we can't enter heparin gtt orders into our computer system without a weight. It won't let us. The upside is that everytime we make a change based on ptt results our system automatically gives us the new rate, and bolus needed, or time we need to hold the infusion for. We do have a written protocol we can verify against but I love ours, makes my life easy :)