Tuesday, March 30, 2010

Monitor Heparin During Surgery

Monitor Heparin During Surgery


Heparin is an anticoagulant used to prevent or treat excessive clotting within the body's blood vessels. The partial thromboplastin time (PTT) test, also called a "bleeding time" in the clinical lab, is a test used to monitor heparin therapy to make sure that not too much of it is being used. When people on heparin therapy undergo surgery, or if the surgery requires heparin (as is the case when a heart-lung machine is used), PTT tests are done throughout the surgery to make sure the patient will have the ability to clot and heal after surgery.


Instructions


Blood Collection


1. Collect a blood sample by using a blood collection kit, usually consisting of a syringe, needle assembly, cotton swab, and alcohol or iodine cleaning swab. If you are using a tube ("butterfly") needle assembly, empty about 1 milliliter of blood into a discard tube before filling the light blue top tube.


2. Make sure the light blue top tube is properly filled. For accurate blood coagulation time studies, a correct ratio of blood to sodium citrate must be in the tubes.


3. Apply pressure for an extended period of time to the site of the blood draw, if it was done through a venous phlebotomy. This is to make sure a clot forms and the site does not continue to bleed after the sample is taken. If a port or IV line was used, then no pressure is necessary.


Perfom the PTT Test


4. Calibrate and run quality control on the blood coagulation analyzer according to the analyzer's manufacturer instructions. Only then may you continue to the next step.


5. Insert the patient sample into the analyzer for testing. Make sure to follow procedures since any deviation may alter the results. Always use caution when opening the tube for testing (if necessary) and when operating the analyzer.


6. Report the results to the surgical staff immediately. It is of the essence that the surgical team be aware of the PTT results since the results dictate how heparin and other medications are used during the surgery. Any critically abnormal results should be reported immediately per your institution's standard operating procedure.







Tags: blood coagulation, blue tube, During Surgery, Heparin During, Heparin During Surgery, heparin therapy, light blue