Unfractionated heparin reversal

Background
  • Managed according to clinical severity of bleeding, NOT PTT value
    • Heparin-associated bleeding is not always reflected by a supratherapeutic PTT

Indications
  • Significant bleeding while on [[heparin] drip

Management
  • Stop transfusion
  • Observation alone may be appropriate in less severe cases
  • Protamine
    • Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis)
    • Give 1mg IV for every 100 units of UFH infused in the prior 3hr
    • Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
    • Because half-life is short (7 min) may require second treatment
  • Massive bleed

Disposition

See Also

References
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