Template:Low risk of bleeding

Author: Mikael Häggström

Coagulation: Low risk of bleeding This procedure counts as conferring a relatively low risk of clinically significant bleeding. 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 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