Category Archives: Anticoagulation

Case 23 – summary

This was a case involving a common medical problem – the DVT.  There were a number of important points 1) Idiopathic DVT (i.e. those not provoked by a risk factor such as surgery, plaster casts, pregnancy and medications) require careful thought … Continue reading

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Case 23 – update 4

Our young patient with newly diagnosed DVT has cervical cancer and needs total abdominal hysterectomy semi-urgently.  As the DVT is recent and as the surgery has a high risk of blood loss it is felt that inserting an IVC filter … Continue reading

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Case 23 – update 3

Unfortunately following gynaecological review our patient is found to have cervical cancer.  She needs hysterectomy within the next week.  Following #teamhaem suggetstions she is given intravenous iron in an attempt to optomise her haemoglobin pre surgery and avoid the use of blood … Continue reading

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Case 23 – update 2

Thanks for all of your comments so far.  We have decided that she has a high Well’s score and therefore does not need a d-dimer in diagnostic work up.  However having a baseline d-dimer may be useful in later stages … Continue reading

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Case 23 – update 1

The patient attends EAU and more history is gained by the medical SHO. She is a 31 year old female who has felt her right calf has been more swollen for the last three days.  She has not had any … Continue reading

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Case 23 – the beginning

Welcome to #teamhaem! For those of you who are new – welcome! The case will evolve over the next week or so, depending on the information you want and suggest.  Just follow us and the hashtag #teamhaem on twitter – … Continue reading

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Case 6 – summary

Beriplex use for warfarin reversal Using the BCSH guidelines, we can identify that this patient requires reversal of warfarin immediately, given the history of a possible fall (head injury) and the history of amnesia. Major bleeding is defined as limb … Continue reading

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Case 6 – update 2

So …. CT confirms a subdural bleed and the patient has recieved beriplex at a dose of 30 units/kg and vitamin K 2mg IV.  Initial INR was 2.6 and repeat INR 30mins following beriplex was 1.2.    Discussion with neurosurgeons … Continue reading

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Case 6 – update 1

20 minutes after his son reports that he appears more confused.  On review you note a slight facial droop, his speech is a little slurred, and he is definitely more confused.  His daughter has brought in a list of medications … Continue reading

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Case 6 – the beginning

You are working a night shift in A&E.  A 82 year old gentleman attends with his son.  The son reports that his father had a fall earlier that day.  The son was in the house, but did not witness the fall.  … Continue reading

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Case 1 – summary

Thank you for your comments about anticoagulation management in HIT. Argatroban and danaparoid would be appropriate anticoagulants to use in this setting. Lepirudin is no longer available, having been recently withdrawn from Europe. Fondaparinux would not be suitable at this … Continue reading

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Case 1 – update 2

Hello all. Thank you for your comments on investigations for HIT. As mentioned by a number of contributers there are a number of tests available when investigating a patient for possible HIT. These are summarised in a comment from a … Continue reading

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Case 1 – update 1

Welcome back team. Thanks for your comments so far. On reviewing the case notes you find out the following: Mr X has had simple valve replacement but developed acute kidney injury and has been on CVVH for six days now … Continue reading

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Case 1 – the beginning

Welcome to TeamHaem’s first case discussion. Please read the following case outline and respond to the initial question posed via Twitter. Keep an eye on the twitter feed as more information will be released as the discussion develops. A 65 … Continue reading

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