PT/INR testing requirements
0 followers
0 Likes
Our Cath Lab Recovery department was performing PT/INR testing on all of their patients before their procedures. These are patients who stop their Coumadin or warfarin medication in order to have the procedure. We were then told that in order to use the PT cartridges, the patient needed to be currently taking their medication. This made the testing off-label. Is this correct? What are others doing in this situation?
Thank you for any input!
5 Replies
Reply
Subgroup Membership is required to post Replies
Join POCT Listserv now
Suggested Posts
| Topic | Replies | Likes | Views | Participants | Last Reply |
|---|---|---|---|---|---|
| iSTAT in NICU -chem 8, CG4 | 5 | 0 | 197 | ||
| Rotem Sigma Validation Help | 1 | 0 | 96 | ||
| Hemochron Sig Elite use outside of manufacturer temperature range | 2 | 0 | 153 |
That doesn't make any sense--they are coumadin patients. I think we need to get an answer from CAP. I'm going to send an email--I'll post what i find.
I emailed Jean Ball at CAP with the question: can we use our INR meters to test patients who have stopped taken their Coumadin for surgery or a procedure. Her response:
"Yes, as you are determining the effects (or lack thereof) of the Coumadin."
Kathleen, thank you for reaching out to Jean! Love her! This same debate ensues whenever the request to have INR available in the ER for TBI. I think of it the same way, in the case of TBI or Stroke, if they are unsure if the patient is on Coumadin they absolutely must test them to be sure before they administer TPA or they could kill the patient. So this is not "off-label" as they are in fact still testing for their "Coumadin level", aka INR. As long as it is below 1.7 then they are safe to proceed with TPA. The decision to give TPA must be made in the first 0-15 minutes from arrival in the ED preferably, so they don't have time to wait for lab.
Sent via Groupsite Mobile.
WE use the same reasoning why we order INR on patients who come to ER with stroke:
to make sure we can give TPA to a patient with history of Coumadin medication without inducing bleeding.
We do not screen coagulation status using INR in ER .
How do you ensure they don't use it on patients with unknown Coumadin usage?