Mikael Häggström: Started

2019-12-20T07:50:34Z

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==={{#if:{{{header|}}}|{{{header}}}|Coagulation: Low risk of bleeding}}===
This procedure counts as conferring a relatively low risk of clinically significant bleeding{{#if:{{{when|}}}| {{{when}}}, and the following bleeding precautions refer to such cases|}}.<ref>The coagulation section follows local practice at: {{NU Hospital Group}}</ref>

====Required lab test====
{{#ifeq: {{{PT}}} |no|None necessary.|Prothrombin time (PT or INR):
*Inpatients: within 24 hours
*Outpatients with a healthy liver: Within 2 weeks
*Outpatients with liver disease and no additional acute disease since then: Within 1 week}}

====Lab interpretation====
*{{#ifeq: {{{PT}}} |no|If ''prothrombin time'' has been tested, ||}}INR should be corrected if over 2.0
*If ''partial thromboplastin time'' (aPTT or APTT) has been tested, it should be corrected if over 1.5 times its normal upper limit.
*If ''platelet count'' has been performed, transfusion is indicated if it is below 50 x 10<sup>9</sup>/L (equals 50,000/µL).

====Anticoagulant medication====
*Coumarin (warfarin): Normally stop 3-5 days before, in order to reach INR ≤ 2.0
*Low-molecular-weight heparin (LMWH): Stop 1 preceding dose
*Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa, Lixiana):
:*Glomerular filtration rate over 30 ml/min: Stop 24 hours before
:*Glomerular filtration rate less than 30 ml/min: Stop 48 hours before
*Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
*Dipyridamole (Persantine): Stop 48 hours before
*NSAIDs (including aspirin): No need to stop
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==Tailoring==
Prothrombin time (PT or INR) can be put as not necessary by including the template as:<br><code><nowiki>{{Low risk of bleeding|PT=no}}</nowiki></code>

==Example procedures==
*Nephrostomy tube change
*Catheter insertion into plaura or peritoneum
*Superficial biopsies and drainage (neck, extremities and walls of thorax and abdomen
*Suprapubic catheter insertion

==See also==
*[[Template:Moderate risk of bleeding]]

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Template:Low risk of bleeding - Revision history

Mikael Häggström: Started