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Indications For Hematology Consultation

Indications for Hematology consultation with anticoagulant therapy:

  • Initiation of therapy for patients:

    • Not in critical care unit

    • Age < 30 days

    • Baseline INR ≥ 1.2 prior to initiation of warfarin

    • Impaired renal function

  • Maintenance of anticoagulation therapy with:

    • Delay in reaching therapeutic anticoagulation

    • Progression of thrombus

    • Concern for heparin induced thrombocytopenia (HIT)

    • Hemorrhage and need for antidote

  • Surgery or invasive procedure in patients with:

    • Mechanical/prosthetic mitral valves

    • Atrial fibrillation

    • Recent/recurrent thromboembolism

  • Use of LMWH other than enoxaparin

 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

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