Blood Anticoagulant Ratios

Mrs JL is a 78 year old who is being discharged from your ward after being admitted following a severe bout of gastroenteritis. She has made a full recovery and is about to be discharged. You took a medication history from her when she was admitted and recorded that she was taking aspirin 100mg daily and clopidogrel 75mg daily after having had a drug eluting stent inserted 6 months previously. Her other admission medications include metformin 1g daily, perindopril 5mg daily. Mrs JL’s discharge script includes all the medications on admission except the clopidogrel. Is it Ok to cease the clopidogrel in this patient?

Intravenous (IV) fluids were bolusing; however, when blood pressure was only obtainable manually and revealed that her blood pressure was 74/34, the decision was made to send the patient to the intensive care unit (ICU). There, coagulation studies revealed an elevated PT, PTT, D-dimer, and a decreased fibrinogen count. She received a peripherally inserted central catheter (PICC), a transfusion of two units of packed red blood cells (PRBCs), as well as cryoprecipitate therapy during her treatment in the ICU.

7. HEMATOCRIT VELUE FOR MALE WITH APLASTIC ANEMIA. % WBC FOR MALE WITH APLASTIC ANEMIA. WHERE THE VALUES WITHIN THE NORMAL RANGE? WHY OR WHY NOT?

During the blood test, for example, the presence of clots in the blood sample can artificially increase the drug concentration on the report since blood is a heterogeneous mixture, which often forms clots. The possibility of blood clotting cannot be ignored because it occurs very frequently for many reasons, such as certain

Low levels of hematocrit can mean blood loss, which is the case for this patient. Along with testing the patient’s stool and completing a computerized tomography scan, KH also tested positive for occult blood in the stool, using a simple smear test called a guaiac. The guaiac test will indicate blood in the stool that is not visible to the naked eye. Patients who have a slightly low hematocrit and hemoglobin may be asymptomatic or have mild symptoms. Symptoms of anemia present in this patient are fatigue, dyspnea and shortness of breath (Honan, 2013).

The collection and preparation of the unit was investigated, but no possible errors were discovered. An AABB Transfusion article (see attached article) explaining a similar issue was discovered. In the article, the blood center received multiple returns from a Hospital due to clots after thawing. After investigation, the blood center discovered

(Karmiova, 2001) and is predictive of subsequent multiple organ failure, infection and than eventually death in these patients. These conditions have many features common with sepsis. Blood concentrations of various cytokines, soluble receptors and endotoxins increase within as early as 3 hours after cardiac arrest, the magnitude of these changes is associated with the outcome. Activation of blood coagulation without adequate activation of endogenous fibrinolysis is an important pathophysiological mechanism that may contribute to microcirculatory reperfusion disorders (Böttiger, 1995). For patients that undergo CPR and achieve ROSC, their coagulation/anticoagulation and fibrinolysis/antifibrinolsis systems are activated. Anticoagulant factors such as antithrombin, protein S and protein C are decreased and this decrease is associated with transient increases in endogenous activated protein C after resuscitation (Adrie,2005). The stress of total-body oxygen debt also affects adrenal production and function. Although patients have increased plasma cortisol levels they have a relative adrenal insufficiency defined as failure to respond to corticotrophin. This failure to respond causes the adrenal cortex to not be stimulated to secrete the hormones necessary to respond to stress.

The third test that can be affected is the direct antibody test. This is typically seen when non-EDTA (Ethylenediaminetetraacetic acid) tubes are used. This is due to these tubes not containing a chelating agent with rids the patients serum

A hematocrit and hemoglobin value can provide with an indirect measurement for levels of RBC’s in the blood and how much hemoglobin there is in the blood. My patients Hct was 29.3L on 10/25 which is higher than a few days prior which was 24.5L but lower than admit day 10/17 32.3L. A low level of RBC’s can indicate anemia or hemorrhage but not immediately after, not until the blood volume is replaced with fluids (Pagana et. al. 2014). However, in her case low levels of H&H are also a consequence of hemodialysis. The patients Hgb was 9.1L on 10/25 but 10.5L on admit 10/17 her lowest being 10/21 at 7.9L. This value can also indicate anemia due to decrease of RBC’s which is also an indicator of the rapid blood loss through hemodialysis or through

Thromboelastography also known as TEG is a serum laboratory test that determines coagulation of blood. Blood clotting is called hemostasis and is an active, extremely complex process, involving many interacting factors including clotting, fibrinolytic proteins, activators, inhibitors and cellular elements (Eitel, 2012). It can help in determining if a patient may have a clotting factor or anemia by looking at clot strength and fibrinolysis. The test is usually utilized for surgery and anesthesia and does not replace other serum coagulation tests such as prothrombin time (PT,INR) or partial thromboplastin time (aPTT). TEG is able to assess platelet function, clot strength, and fibrinolysis where these other tests cannot.

According to the article “Anticoagulants: A Review of the Pharmacology, Dosing, and Complications” by Mohammed Alquwaizani, Leo Buckley, Christopher Adams, John Fanikos, anticoagulants persist as the primary strategy for preventing and treating thrombosis. Hemorrhage is a principal adverse event while using anticoagulant drugs.

Introduction: Atrial fibrillation (AF) produces a five-fold increase in the risk of stroke, and the exclusion of the left atrial appendage (LAA), the main source of thrombi, is an interesting therapeutic option in patients with contraindications for oral anticoagulation.

Modern technology has led to extreme advances in all aspects of medicine and the research that goes into making new discoveries. It has especially been useful in developing greater steps for prevention of further injury ranging from simple prophylactic treatments to major invasive surgery. Specifically, anticoagulants have made great strides in their development over the past decade, and have played huge roles in increasing the survival rate of patients and people in and out of the operating room. The longstanding problem however with anticoagulants has been that many have lacked a truly specific reversal agent for their blood clotting actions, which has led to complications in patient’s health and well-being over time. For some time now researchers

Hello Flo, I agree on the great information you provide on warfarin. Accordingly, working on a surgical unit, we deal with patient on coumadin on the daily basis. Education are provided to these patient before and after surgery. Consequently, there are patients that arrive for surgery with elevated INR, which the physician will treat or cancel the surgery. Physician normally have patient to discontinue coumadin three to five days prior to surgery, to prevent excessive bleeding. " The management of anticoagulation in patients undergoing surgical procedures is challenging because interrupting anticoagulation for a procedure transiently increases the risk of thromboembolism. At the same time, surgery and invasive procedures have associated bleeding

A haematology laboratory focuses on the study of morphology and physiology of the blood; they aim to monitor diseases of the blood and blood-forming organs. Haematological tests are carried out on blood samples to speedily diagnose diseases such as leukaemia, anaemia and problems within blood. The design of a haematology lab should be close by the Specimen Control department; they will need modular G-wall lab benches which are flexible for this lab type. Support panels can also be used to increase privacy and discipline within this environment, the technical machinery within this laboratory should consist of microscopes and various centrifuges. The instruments used within this laboratory type could include, analyzers enable