New Call Parameter Added: Call prescriber if PTT is greater than 110 after 2 consecutive lab draws.
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Updated order seen in the Orders Tab:
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Updated - Nursing – Heparin Re-Order Protocol Careset
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Updated Reference Text:
Heparin Protocol
Heparin Weight-based Dosing Guideline for Initial Bolus (if ordered) and Drip Rate
 Heparin weight-based dosing is based on actual weight
Initial IV Heparin
Patient Weight
Initial Heparin Drip Rate
Bolus Dose
Less than 50 kg
4,000 units
750 units/hour
50-80 kg
4,500 units
1,000 units/hour
81-110 kg
5,000 units
1,200 units/hour
Greater than 110 kg
5,500 units
1,300 units/hour
Heparin Drip Titration
 Do not bolus or increase infusion rate 6 hours prior to known invasive procedure unless specifically ordered by
physician.
 *Call prescriber if PTT greater than 110 after 2 consecutive lab draws
PTT
IV Re-bolus
Dose
Less then 30 sec
30-40 sec
41-64 sec
65-110 sec
111-131 sec*
5,000 units
3,000 units
1,000 units
NO BOLUS
NO BOLUS
132-159 sec*
NO BOLUS
Greater than159 sec*
NO BOLUS
IV Drip Rate Adjustment
Increase drip by 200 units/hr
Increase drip by 100 units/hr
Increase drip by 50 units/hr
No change
Decrease drip by 50 units/hr
STOP HEPARIN DRIP – Restart in
one hour at 100 units less/hour
STOP HEPARIN DRIP – Restart in
one hour at 200 units less/hour
Next PTT Order
6 hours after adjustment
6 hours after adjustment
6 hours after adjustment
Daily PTT as ordered
6 hours after adjustment
6 hours after restart
6 hours after restart
Heparin High Intensity Monitoring
 Call ordering physician if at any time PTT falls below 65.
 The PTT should be checked every 6 hours x 4, then follow Heparin Re-order Protocol.
 Nurse to order the PTTs using the Heparin Re-order Care Set