SAMPLE HEPARIN DRIP CALCULATIONS - DVT PE

SAMPLE HEPARIN DRIP CALCULATIONS Instructions: Review the attached Adult Heparin Drip Protocol that has been developed and published, following Evidenced Based Practice Guideline from the American College of Chest Physicians. Review the various indications for Heparin use in a patient. Then, utilizing the patient information provided below, follow the Heparin Protocol to figure your rates and regulations. Case Study: Your patient is a business man who does a great deal of traveling by air for his job (bi-costal and international flights). He has admitted to your hospital with significant unilateral swelling of his left lower leg and popliteal area and is slightly tachypnic, short of breath, and restless. After a venous ultrasound of the lower extremity, a DVT has been confirmed. He is pending a CT of the chest to R/O pulmonary embolism. The MD has ordered a heparin infusion IV to be started at 18 units/kg/hour , following a loading dose of 80units/kg IVP . His weight is 75 kg. The heparin infusion concentration is 25,000units in 500 ml of D5W bag. Physician orders and Heparin infusion protocol is also provided. Determine the heparin rate of infusion (ml/hr) for this patient. A. Look at the protocol for his condition and weight and verify if the above MD order is aligned with standard procedure. B. Given his current weight, how many units will you be giving by bolus? _______________ C. You have Heparin vials available that have a concentration of 5000units/ml. How many mls will you plan to administer? __________________ D. The drip is to infuse at 18units/kg/hour. How many units per hour is that? __________________ E. Given the concentration in the Heparin bag, how many mls/hr will you program the pump to infuse the appropriate units/hr? _____________________ Part 2: After six hours on the infusion, the nurse obtains a PTT blood level. The PTT is 70sec. This patient has no other potential bleeding precautions, thus is considered a standard bleeding risk patient. With this in mind, and using the heparin protocol, determine whether or not the patient’s heparin infusion rate must be changed and calculate the new rate of infusion if necessary. A. Does the patient’s heparin infusion rate change? Yes or No B. If yes, will you re-bolus? If so, with how much? ______________________ C. Calculate the new heparin infusion rate: _________________ml/hr