End of Chapter Scenario
Chapter 9 – Medications That Affect Coagulation
Scenario 1
You are scrubbed for a repair of an abdominal aortic aneurysm. The preference card indicates that Dr. Fromm wants 5000 units of heparin in 500 mL of saline for topical irrigation. The circulator can find only capsules containing 10,000 units/mL of heparin.
1.
What is one solution to this problem?
One solution would be to mix 0.5mL of heparin with a 500mL bag of saline.
2.
What is another solution to this problem?
Another solution would be to mix 1mL of heparin with a 1000mL bag of saline.
Scenario 2
Mr. Davis is a 67-year-old man admitted to surgery for an immediate laparoscopic cholecystectomy for acute cholecystitis. Review of his medical chart reveals that he is on Coumadin (warfarin).
1.
What complications do you expect to see during this procedure?
A complication I could expect to see would be excessive bleeding.
2.
What additional supplies should you bring into the room in preparation for these complications?
In preparation for these complications, I need to have hemostatic agents available.
3.
What actions may be taken during surgery to treat these complications?
During these complications, heparin would be injected.
