usmletopper2
Forum Senior
Topics: 25
Posts: 114
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how do you manage a if a pt on warfarin needs
1.tooh extraction
2.polypectomy
3.major surgery
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| Vietnamese
Forum Elite
Topics: 12
Posts: 285
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Stop warfarin for days and shift to Heparin and then stop heparin 1 day before procedure.
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| usmletopper2
Forum Senior
Topics: 25
Posts: 114
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no need of chnage i anti coagulants for minor procedures such as cataract surgery,tooth extraction,colonoscopy,small polypectomy where clips are placed immediately
Stop oral anticoagulants at least 5 days preoperatively, and do not perform the procedure until the PT is in the reference range. Substitute intravenous heparin infusion for oral anticoagulant therapy preoperatively to prevent thromboembolic complications in the perioperative period. Stop the intravenous heparin infusion 6-12 hours preoperatively to allow the aPTT to return to normal for adequate intraoperative hemostasis. Restart the intravenous heparin infusion within 6 hours of completion of the surgical procedure to prevent postoperative thromboembolism. Resume oral coumadin therapy as soon as the patient is able to tolerate oral liquids. Do not release the patient until PT is once again therapeutic.
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| mikky
Forum Elite
Topics: 16
Posts: 369
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nice explanation..usmle topper...
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| Vietnamese
Forum Elite
Topics: 12
Posts: 285
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Thanks usmletopper2 for the details. 
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