Heparin Infusion

Summary

1. Insert two cannulas (one for heparin, one for drawing) and send off an aPTT.
2. Use the heparin infusion form. On the back there’s a protocol for ACS (on the left) and one for AF + VTE + Prosthetic Heart Valves (on the right)
3. Cross out the left/right table that you don’t need.
4. Check the patient weight. On the top table (on either left/right side), circle the row of the patient’s weight class.
5. Give the IV bolus dose and chart the infusion rate at the front.
6. Draw up the next aPTT as per the protocol at the bottom table.
7. Look at the bottom table (on either left/right side), and look at the row the patient’s aPTT is.
8. Give the bolus dose (if necessary) and continue the infusion (if indicated).
9. Then repeat aPTT as per the last column.

Example

Heparin protocol for a patient with a STEMI. Patient is 75kg.

1. Turn to the back and cross off the necessary table.

2. Circle the weight of the patient (75kg). This makes the IV bolus dose 4,000 units, and the starting infusion rate is 9mL/hr.

3. In the protocol, it says “First aPTT is 3 hours after commencement”. Draw up an aPTT then.

aPTT returns 35

4. As per the bottom chart, you chart the bolus of 2000 units. Continue the infusion.

5. Draw the next aPTT a 4-6 hours later, as per the form.