Difference between revisions of "Template:Low risk of bleeding"

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<noinclude>
 
===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
 
</noinclude>
 
 
===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>
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*Dipyridamole (Persantine): Stop 48 hours before
 
*Dipyridamole (Persantine): Stop 48 hours before
 
*NSAIDs (including aspirin): No need to stop<noinclude>
 
*NSAIDs (including aspirin): No need to stop<noinclude>
 +
==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
 +
 
==References==
 
==References==
 
{{reflist}}
 
{{reflist}}
 
</noinclude>
 
</noinclude>

Revision as of 11:45, 17 January 2019

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 a 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

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

References

  1. The coagulation section follows local practice at: NU Hospital Group, Sweden