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Heparin Monitoring

aPTT: When we give an IV infusion of heparin, we use a blood test called the aPTT (activated partial thromboplastin time). This is a measure of bleeding time that’s done in a lab. We’re looking at something that’s 1.5-2.5 times the control.

So let’s make up something: If you work at a hospital that has a control of 10 seconds and we have a patient that’s on heparin, we’re looking for aPTT results of somewhere around 15-25 seconds. If the result comes back 37, that means there’s a high risk potential for bleeding. Every hospital has a protocol, so they may decrease the infusion rate or stop the infusion for 2 hours and start it at such and such a rate. If it comes back as a 12, that may be too low and another bolus dose will be given.

Bleeding: If the patient in the hospital is going to bleed, where will you monitor it from? The most common area where someone will be bleeding first is the GI tract. Make sure you don’t give anything intramuscularly (including heparin) to these patients because intramuscular is a very traumatic injection and it will create bleeding.

Recap

  • Activated Partial Thromoboplastin Time
  • 1 1/2 to 2 1/2 times control
  • Bleeding
  • No intramuscular injections

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