TY - JOUR
T1 - Emergency Department Awareness of Heparin-Induced Thrombocytopenia
T2 - How Frequently is Risk Assessment Documented in Patients With Thrombosis?
AU - Levine, Robert L.
AU - Funk, Robert
AU - Hergenroeder, Georgene W.
AU - Hursting, Marcie J.
PY - 2010/9/17
Y1 - 2010/9/17
N2 - Evidence-based guidelines recommend that heparin-induced thrombocytopenia (HIT) should be suspected whenever a patient develops thrombosis or thrombocytopenia 5 to 14 days after heparin initiation. The authors determined how frequently emergency department (ED) physicians document HIT risk assessment in patients presenting with thrombosis. Relevant data were extracted from the ED charts of 134 patients with venous or arterial thrombosis. Documentation (ie, notation of positive or negative findings) existed for recent heparin exposure in 7 (5.2%) of 134 charts, recent hospitalization in 33 (24.6%), history of thrombocytopenia in 0 (0%), and history of thrombosis in 62 (45.5%). Of 35 patients administered heparin in the ED, the preheparin platelet count was available for 19 (54.3%) and old records for 5 (14.3%). Thus, HIT risk assessment frequently remains undocumented for ED patients with thrombosis, including those administered heparin. Approaches to increase HIT awareness and facilitate HIT risk assessment and documentation in the ED may be needed.
AB - Evidence-based guidelines recommend that heparin-induced thrombocytopenia (HIT) should be suspected whenever a patient develops thrombosis or thrombocytopenia 5 to 14 days after heparin initiation. The authors determined how frequently emergency department (ED) physicians document HIT risk assessment in patients presenting with thrombosis. Relevant data were extracted from the ED charts of 134 patients with venous or arterial thrombosis. Documentation (ie, notation of positive or negative findings) existed for recent heparin exposure in 7 (5.2%) of 134 charts, recent hospitalization in 33 (24.6%), history of thrombocytopenia in 0 (0%), and history of thrombosis in 62 (45.5%). Of 35 patients administered heparin in the ED, the preheparin platelet count was available for 19 (54.3%) and old records for 5 (14.3%). Thus, HIT risk assessment frequently remains undocumented for ED patients with thrombosis, including those administered heparin. Approaches to increase HIT awareness and facilitate HIT risk assessment and documentation in the ED may be needed.
KW - emergency department
KW - heparin
KW - heparin-induced thrombocytopenia
KW - risk assessment
KW - thrombocytopenia
KW - thrombosis
UR - http://www.scopus.com/inward/record.url?scp=77956505975&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956505975&partnerID=8YFLogxK
U2 - 10.1177/1062860610366033
DO - 10.1177/1062860610366033
M3 - Article
C2 - 20522721
AN - SCOPUS:77956505975
VL - 25
SP - 365
EP - 369
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
SN - 1062-8606
IS - 5
ER -