Suspected Heparin Induced Thrombocytopenia (HIT) [30400758]
Height______________________________________________
Weight_____________________________________________
Allergies____________________________________________
- If HIT suspected, DISCONTINUE ALL FORMS OF HEPARIN
- Patients on warfarin (Coumadin) therapy at the time of HIT diagnosis, discontinue warfarin therapy and reverse INR with one of the
Phytonadione (Vitamin K) regimens in the Medication section below.
- For alternative therapeutic anticoagulation treatment, choose one of the following:
1. Argatroban Physician Order Set #637. Avoid in patients with severe hepatic impairment (Child Pugh Grade C)
2. Bivalirudin Orders and Dosing Protocol for Heparin-Induced Thrombocytopenia (HIT) Physician Order #913
General
Nursing Interventions
[X] Monitor for thrombosis and bleeding
Routine, Until discontinued, Starting today
Physician Consults
[]
Reason for Consult? _____________REQUIRED
RN/Secretary to contact the consulting provider? Yes/No REQUIRED
Hematology
Labs
Antibody Testing
[X] HIT Antibody by ELISA
Once, Starting today
Hematology
[X] CBC, no diff (hemogram)
Daily, Starting today
Medications
INR Reversal (Single Response)
Reminder: Discontinue Warfarin or ANY form of Heparin
()
()
phytonadione (MEPHYTON) tablet 5 mg
phytonadione ((AQUA-MEPHYTON) IVPB
10 mg, Oral, Once, For 1 Doses, Routine
10 mg, IntraVENous, for 30 Minutes, Once as needed, For 1
Doses
PRN Comment______________________REQUIRED
If patient NPO or if rapid reversal is needed due to bleeding or
upcoming surgery/procedure
Routine
Date:______Time:_______Printed Name of Ordering Provider: ______________________________________________
Provider Signature:__________________________________________________________
Date:_______ Time:________RN Acknowledged: _________________________________________________________
Provider Initial:______________
PATIENT INFORMATION
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Suspected Heparin Induced
Thrombocytopenia (HIT) [30400758]
PHYSICIAN ORDERS
Provider Initial:______________
PATIENT INFORMATION
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Suspected Heparin Induced
Thrombocytopenia (HIT) [30400758]
PHYSICIAN ORDERS