Difference between revisions of "Template:Low risk of bleeding"
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*Suprapubic catheter insertion | *Suprapubic catheter insertion | ||
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| − | ==Coagulation== | + | ===Coagulation=== |
This procedure counts as conferring a relatively low risk of clinically significant bleeding.<ref>The coagulation section follows local practice at: {{NU Hospital Group}}</ref> | This procedure counts as conferring a relatively low risk of clinically significant bleeding.<ref>The coagulation section follows local practice at: {{NU Hospital Group}}</ref> | ||
| − | ===Required lab test=== | + | ====Required lab test==== |
*Prothrombin time (PT or INR), within 24 hours for inpatients. Within 2 weeks for those with healthy liver. Within 1 week for those with liver disease and no additional acute disease since then. | *Prothrombin time (PT or INR), within 24 hours for inpatients. Within 2 weeks for those with healthy liver. Within 1 week for those with liver disease and no additional acute disease since then. | ||
| − | ===Lab interpretation=== | + | ====Lab interpretation==== |
*INR should be corrected if over 2.0 | *INR should be corrected if over 2.0 | ||
*If ''partial thromboplastin time'' (aPTT or APTT) has been taken, it should be corrected if over 1.5 times its normal upper limit. | *If ''partial thromboplastin time'' (aPTT or APTT) has been taken, it should be corrected if over 1.5 times its normal upper limit. | ||
*If ''platelet count'' has been performed, transfusion is indicated if it is below 50 x 10<sup>9</sup>/L (equals 50,000/µL). | *If ''platelet count'' has been performed, transfusion is indicated if it is below 50 x 10<sup>9</sup>/L (equals 50,000/µL). | ||
| − | ===Anticoagulant medication=== | + | ====Anticoagulant medication==== |
*Coumarin (warfarin): Normally stop 3-5 days before, in order to reach INR ≤ 2.0 | *Coumarin (warfarin): Normally stop 3-5 days before, in order to reach INR ≤ 2.0 | ||
*Low-molecular-weight heparin (LMWH): Stop 1 preceding dose | *Low-molecular-weight heparin (LMWH): Stop 1 preceding dose | ||
Revision as of 17:45, 20 September 2018
Contents
Example procedures
- Nephrostomy tube change
- Catheter insertion into plaura or peritoneum
- Superficial biopsies and drainage (neck, extremities and walls of thorax and abdomen
- Suprapubic catheter insertion
Coagulation
This procedure counts as conferring a relatively low risk of clinically significant bleeding.[1]
Required lab test
- Prothrombin time (PT or INR), within 24 hours for inpatients. Within 2 weeks for those with healthy liver. Within 1 week for those with liver disease and no additional acute disease since then.
Lab interpretation
- INR should be corrected if over 2.0
- If partial thromboplastin time (aPTT or APTT) has been taken, it should be corrected if over 1.5 times its normal upper limit.
- If platelet count has been performed, transfusion is indicated if it is below 50 x 109/L (equals 50,000/µL).
Anticoagulant medication
- Coumarin (warfarin): Normally stop 3-5 days before, in order to reach INR ≤ 2.0
- Low-molecular-weight heparin (LMWH): Stop 1 preceding dose
- Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa, Lixiana):
- Glomerular filtration rate over 30 ml/min: Stop 24 hours before
- Glomerular filtration rate less than 30 ml/min: Stop 48 hours before
- Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
- Dipyridamole (Persantine): Stop 48 hours before
- NSAIDs (including aspirin): No need to stop
References
- ↑ The coagulation section follows local practice at: NU Hospital Group, Sweden
