Anticoagulation Reccs for Spinals/Epidurals

Question 1

Antiplatelets–aspirin/NSAIDs recommendation = ___

Answer 1

Aspirin/NSAIDs recommendation = none

Question 2

Antiplatelets–ticlodipine–d/c ___ days before

Answer 2

Ticlodipine d/c 14 days before

Question 3

Antiplatelets–clopidogrel–d/c ___ days before

Answer 3

Clopidogrel d/c 7 days before

Question 4

Antiplatelets–abciximab recommendation = ___

Answer 4

Abciximab recommendation = avoid

Question 5

Anticoagulants–warfarin d/c __-__ days before; __/__ (what lab tests?) prior to needle placement or catheter removal; INR < ___; monitor patient for __ hours post spinal, epidural, or removal of catheter

Answer 5

Warfarin d/c 4-5 days before; PT/INR prior to needle placement or catheter removal; INR < 1.5; monitor patient for 24 hours post spinal, epidural, or removal of catheter

Question 6

SubQ heparin–delay until ___

Answer 6

SubQ heparin–delay until after block

Question 7

IV heparin–delay until __ hour after block; remove catheter __-__ hours after last dose

Answer 7

IV heparin–delay until 1 hour after block; remove catheter 2-4 hours after last dose

Question 8

LMWH–lovenox PREOP–block __-__ hours after last dose; if high dose, delay block for __ hours

Answer 8

Lovenox PREOP–block 10-12 hours after last dose; if high dose, delay block for 24 hours

Question 9

Lovenox POSTOP–twice daily dose–delay 1st dose for ___ hours; ___ hour delay after catheter removal

Answer 9

Lovenox POSTOP–twice daily dose–delay 1st dose for 24 hours; 2 hour delay after catheter removal

Question 10

Lovenox POSTOP–once daily dose–1st dose __-__ hours postop; remove catheter __-__ hours after last dose and wait __ hours until next dose

Answer 10

Lovenox POSTOP–once daily dose–1st dose 6-8 hours postop; remove catheter 10-12 hour after last dose and wait 2 hours until next dose

Question 11

Herbal preparations–garlic, ginkgo, ginseng, ginger, feverfew, vitamin E–d/c __-__ days before surgery

Answer 11

Herbal preparations–d/c 5-7 days before surgery

Question 12

If patient is on subQ heparin > 4 days, check ___ (what lab value?)

Answer 12

If patient is on subQ heparin > 4 days, check platelet count

Question 13

If patient is on IV heparin, measure ___

Answer 13

If patient is on IV heparin, measure PTT