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

From radlines.org
Jump to navigation Jump to search
(→‎Required lab test: List format)
(Started)
Line 1: Line 1:
−
{|class="wikitable"
+
<noinclude>{{Top
−
|
+
|author1=[[User:Mikael Häggström|Mikael Häggström]]
−
===Coagulation: Low risk of bleeding===
+
|author2=
−
This procedure counts as conferring a relatively low risk of clinically significant bleeding{{#if:{{{when|}}}|&nbsp;{{{when}}}, and the following bleeding precautions refer to such cases|}}.<ref>The coagulation section follows local practice at: {{NU Hospital Group}}</ref>
+
}}</noinclude>
 +
===Coagulation: Moderate risk of bleeding===
 +
This procedure counts as conferring a moderate risk of clinically significant bleeding{{#if:{{{when|}}}|&nbsp;{{{when}}}, and the following bleeding precautions refer to such cases|}}.<ref>The coagulation section follows local practice at: {{NU Hospital Group}}</ref>
  
 
====Required lab test====
 
====Required lab test====
Line 11: Line 13:
  
 
====Lab interpretation====
 
====Lab interpretation====
−
*INR should be corrected if over 2.0
+
*INR should be corrected if over 1.5
 
*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 ≤ 1.5
 
*Low-molecular-weight heparin (LMWH): Stop 1 preceding dose
 
*Low-molecular-weight heparin (LMWH): Stop 1 preceding dose
 
*Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa, Lixiana):
 
*Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa, Lixiana):
−
:*Glomerular filtration rate over 30 ml/min: Stop 24 hours before
+
:*Glomerular filtration rate over 30 ml/min: Stop 2 days (48 hours) before
−
:*Glomerular filtration rate less than 30 ml/min: Stop 48 hours before
+
:*Glomerular filtration rate less than 30 ml/min: Stop 3 days (72 hours) before
 
*Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
 
*Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
−
*Dipyridamole (Persantine): Stop 48 hours before
+
*Dipyridamole (Persantine): Stop 2 days (48 hours) before
 
*NSAIDs (including aspirin): No need to stop
 
*NSAIDs (including aspirin): No need to stop
 
|}<noinclude>
 
|}<noinclude>
  
 
==Example procedures==
 
==Example procedures==
−
*Nephrostomy tube change
+
*Biopsy / drainage in the abdomen including liver biopsy and gallbladder drainage (not ascites drainage)
−
*Catheter insertion into plaura or peritoneum
+
*Biopsy / drainage in the thorax including lung biopsy (not pleural drainage)
−
*Superficial biopsies and drainage (neck, extremities and walls of thorax and abdomen
 
−
*Suprapubic catheter insertion
 
  
 
==References==
 
==References==
 
{{reflist}}
 
{{reflist}}
 
</noinclude>
 
</noinclude>

Revision as of 15:53, 10 April 2019

Author: Mikael Häggström [notes 1]

Coagulation: Moderate risk of bleeding

This procedure counts as conferring a moderate risk of clinically significant bleeding.[1]

Required lab test

Prothrombin time (PT or INR):

  • Inpatients: within 24 hours
  • Outpatients with a healthy liver: Within 2 weeks
  • Outpatients with liver disease and no additional acute disease since then: Within 1 week

Lab interpretation

  • INR should be corrected if over 1.5
  • 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 ≤ 1.5
  • 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 2 days (48 hours) before
  • Glomerular filtration rate less than 30 ml/min: Stop 3 days (72 hours) before
  • Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
  • Dipyridamole (Persantine): Stop 2 days (48 hours) before
  • NSAIDs (including aspirin): No need to stop

|}

Example procedures

  • Biopsy / drainage in the abdomen including liver biopsy and gallbladder drainage (not ascites drainage)
  • Biopsy / drainage in the thorax including lung biopsy (not pleural drainage)

References

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


Cite error: <ref> tags exist for a group named "notes", but no corresponding <references group="notes"/> tag was found, or a closing </ref> is missing

Retrieved from "https://radlines.org/index.php?title=Template:Low_risk_of_bleeding&oldid=3235"