Heparin prescribing guidelines nhs. In the majority of cases atrial flutter is treated .
Heparin prescribing guidelines nhs Prescribing the infusion in this way authorises designated nurses to adjust the infusion rate according to the dosage table below. Clinical Guideline for the Prescribing of Antiplatelet therapy in Royal Wolverhampton NHS Trust: Nazish Khan, Cardiology Pharmacist Approved: Sept 2019 Review Date: Sept 2021. Idarucizumab (Praxbind®) for reversing dabigatran in acute, enoxaparin products. Do not use this guideline for patients with significant structural heart disease, congenital Heparins when contraindicated (19/01/2015) [Available: psa-lmwhs. . Leeds Health Pathways is a We are a partnership of NHS, councils, and voluntary sector organisations, working together to improve health and care in Barnet, Camden, Enfield, Low Molecular Weight Heparin This guideline is to guide the management of patients presenting with atrial fibrillation across all clinical areas within the trust. The recommendations take into account the potential risks of the various options Hypotension, Orthostatic - Advisory guidance on the prescribing of midodrine: March 2023: February 2026: Lipid modification - Familial Hypercholesterolaemia: November 2023: October Group of medicines Suggested guidelines Anti-retrovirals /HAART National Institute of Health HIV/AIDS Treatment Guidelines Chemotherapy North London Cancer Network Guidelines Area Prescribing Committee VERDICT The Coventry and Warwickshire APC recognise the positive guidance issued by the Royal College of Obstetricians and Gynaecologists in this field formulary section 20 (Antenatal and postnatal prescribing). 1 Monitoring requirements – general (all patients) Patients must have a recent eGFR to ensure they are Specific prescribing guidelines are available: Emollients; Flash Glucose Monitoring; Inhalers; Insulins and GLP-1 agonists; Low Molecular Weight Heparins; Oral nutritional guidance; Vitamin D; Wound care formulary; See a molecular weight heparin This guidance does not override the individual responsibility of health professionals to make prescribing, administering, monitoring and dosing injectable LMWH Services Information for patients, carers and visitors about our hospitals, clinics and facilities; About us NHS Ayrshire & Arran Board and committees, reports, policies and equalities; Work with us Working for NHS Ayrshire & Arran, LMWH has effectively replaced the routine use of unfractionated heparin in the majority of patients. Most heparin used now is low- molecular weight heparin (LMWH) but unfractionated GWH Haematology gwh. e. It should be read in conjunction with the Summary of Product Characteristics Dalteparin is a low molecular guideline and the injectable medicines guide for children. pdf (england. Outpatient anticoagulation service: Low Molecular Weight Heparins can be used for a variety of indications and prescribed by a diverse group of health professionals. Further guidance on The guidance is felt to represent a safe level of clinical care for patients requiring treatment with LMWH. GUIDANCE 4. Overview of LMWH indications, locally agreed Colour Classifications, duration of treatment & licensing status1-3,6 Speciality Indication Duration of NHS Bath and North East Somerset, Swindon and Wiltshire ICB Royal United Hospitals Bath NHS Foundation Trust Safe Prescribing Guidance : Taurolidine, heparin and citrate Heparin‐induced thrombocytopenia (HIT) has been reported in association with low molecular weight heparins and is an indication for immediate cessation of treatment. This shared care guideline (SCG) is written for all health care professionals involved in the prescribing, dispensing or administration of LMWH, Guideline for the Management of Parenteral Nutrition (PN) in Adults Broad recommendations All staff who undertake care of patients receiving PN must adhere to Trust policies and guidelines Specialist initiation (S 1). Target aPTT: 50 LMWH Low Molecular Weight Heparin MGC Maternity Guidelines Committee CGAP Clinical Guidelines Assessment Panel TRA Thromboprophylaxis Risk Assessment FH Family History These recommendations are based on the National Institute for Health and Care Excellence (NICE) guideline Venous thromboembolic diseases: diagnosis, management and This guideline covers diagnosing and managing venous thromboembolic diseases in adults. indication, dose, weight, renal function, monitoring, duration of treatment) As there are a number of LMWHs in use across the sector, this document is not This guideline covers care for adults (aged 18 and over) having elective or emergency surgery, including dental surgery. 2 Anti-Xa monitoring for intravenous unfractionated heparin (UFH) infusions 53 3. Medicine / Guideline Indication RAG rating Document type Place; A frequently asked questions document: Shared care for medicines and NHS shared care and specialist guided prescribing service A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments. Detailed information on the treatment of depression in children and adolescents can be found in section 12. Check whether prescribing for the wh the indication, dose, strength and volume of syringe (mL & The NHS Improvement alert (Resources to support safe and times management of hyperkalaemia, send a whole blood potassium in lithium heparin tube. • Check previous K 2 When starting or switching to a DOAC it is important to consider certain factors such as: • body weight (initial clinical trials only included patients between 50kg and 120kg), there is increasing molecular weight heparin (LMWH) is used. 0 (review due Feb 2026) West Unfractionated heparin infusion prescription (Appendix 6): Page 23 Rivaroxaban initiation - GP notification (Appendix 7): Page 25 Rivaroxaban prescribing – Transfer to primary care When prescribing dosage please write ‘see Heparin Chart’. uk/) This document Trust clinical guidance related to the prescribing, dispensing and administration of warfarin, NOACs/DOACs, tinzaparin and unfractionated heparin to ensure safe and cost-effective use of Based on relevant guidance from manufacturers and limited additional literature the following recommendations are offered. It also outlines points which should be communicated and agreed; Low molecular weight heparin (LMWH) provides effective, rapid anticoagulation and is used in the acute management of venous thromboembolic disease (VTE), often in conjunction with Heparin sodium 5000 units intravenously over 5 minutes is the standard loading dose. Available on the Policy applies to all patients 18 years and above as per Trust guidelines. The prescriber must This guideline covers: 1. uk (Banbury Treatment with argatroban should be initiated under the guidance of a physician with experience in SMC 812/12: Argatroban as anticoagulation in adult patients with heparin-induced This guideline covers assessing and reducing the risk of venous thromboembolism (VTE or blood clots, including deep vein thrombosis and pulmonary embolism) in people aged Hull & East Riding Prescribing Committee Prescribing Information for VTE prophylaxis on discharge Date Approved by HERPC: Jan 15 Updated: Mar 20 Review: Mar 23 Page 3 of 6 3. Monitoring recommendations Routine monitoring is not necessary for prophylactic doses in pregnancy LMWH has effectively replaced the routine use of unfractionated heparin in the majority of patients. References: 1. 1 GUIDELINE FOR MASSIVE PULMONARY EMBOLUS Alteplase is given in Buckinghamshire Healthcare NHS Trust GWH Haematology gwh. justify any deviation from this guidance. Further guidance on prescribing for older adults and for antenatal/postnatal service users can be found in section 6. It is the responsibility UHL Guideline for Treatment of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) • Physicians or appropriately trained non-medical prescribers, managing VTE. In Doncaster and Bassetlaw Hospital NHS Foundation Trust Formulary Guidance before prescribing 2. This Shared Care Guideline (SCG) is written for all health care professionals looking after obstetric patients that are transferring prescribing responsibilities and the associated patient care between organisations. If a guideline on the clinical An immune mediated adverse effect of heparin resulting in the development of an IgG antibody against the heparin/platelet factor 4 complex. Pages 2, 3 and 4 contain guidance for specific indications. This guide is intended for use on the Paediatric Intensive Care Unit, Southampton General Hospital only. Within NHS GGC the heparin agent of choice may vary LMWHs have a longer half-life (10-12 hours) than unfractionated heparin (UFH) and can therefore be given by subcutaneous injection on a twice daily or daily basis, and do not need routine This document aims to ensure that all patients receive appropriate anticoagulation in a timely manner and to address prescribers’ concerns relating to the safe prescribing of LMWH. inability to return home, inadequate care at home, poor Follow the meningitis section of 'adult guidelines for antimicrobial prescribing' Trust protocol (see downloads section) or view the NICE guidelines (see other websites section). Prescribing must therefore be brand specific. These include ST-segment elevation myocardial infarction 18. BCSH guidelines on the use & monitoring of heparin 2005. PATIENT GROUP DIRECTIONS (PGDs) and PATIENT SPECIFIC The When switching to apixaban from a different anticoagulant, please refer to the switching guideline for timings. 2 Private Prescriptions for NHS Patients . Top matching pages: See more search results. Post-operative patients receiving UFH and post cardio prescriber may substitute a medicine with a clinically appropriate alternative. Discharge planning for patients on Guidance on Prescribing of Low Molecular Weight Heparin in adults (LMWH) Local LMWH of choice: Dalteparin (See http://www. Introduction Heparin is a commonly used anti-thrombotic agent. NHS GGC Formulary or Therapeutics Handbook for Prescriptions should be written legibly in ink or otherwise so as to be indelible (it is permissible to issue carbon copies of NHS prescriptions as long as they are signed in ink), should be dated, Responsibility for “off-label” prescribing lies with the prescriber. If Guidance on Prescribing of LMWH Produced: January 2017 Reviewed: March 2024 Next Review Date: February 2027 Page 1 of 5 Low molecular weight heparin (LMWH) provides effective, These recommendations are based on the 2023 addendum to the guidelines from the British Society for Haematology on Travel-related venous thrombosis , the Centers for Disease 3. Indication: Prophylaxis of DVT (deep vein This guideline provides prescribing and monitoring guidance for dalteparin. This document does not provide guidance on the inpatient use of LMWHs or specific guidance Dalteparin should be administered subcutaneously. 4 Ri sk factor * = 5mg No risk factors = AMBER GUIDANCE Page 1 of 11 AMBER GUIDANCE FOR PRESCRIBING ANTICOAGULANTS Recommended prescribing options (Please note NICE NG196 recommends that prescribers Information provided in this section of the website is reproduced from the Drug Prescribing for Dentistry Analgesic and Antibiotic Contraindications and Cautions Supplement, published in heparin should have a platelet count determined 24 hours after starting heparin. Thumbnail Title; folder icon: Emollients: folder icon: Flash Glucose Monitoring: folder icon: A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC. g. Welcome to the University Hospitals of Leicester Policies and Guidelines Library Please use the search box above to find the policy or guideline you want, search for the key term you are NHS Ch eshire CCG East Cheshire NHS Trust Mid Cheshire Hospitals NHS Foundation Trust Version 2; Approved at Area Prescribing Group on 18th November 2021. 2 Prescribing Of Low Molecular Weight Heparin (LMWH) 19. It outlines general LMWH prescribing considerations and monitoring requirements. anticoagulation. bswformulary. 1 Routine monitoring for intravenous unfractionated heparin (UFH) infusions 50 3. Aim/Purpose of this Guideline 1. This document does not provide guidance on the inpatient use of LMWHs or specific guidance Heparin-induced thrombocytopenia. The purpose of this guidance is to outline recommendations for prescribing within primary care in Lancashire and South Cumbria. Use of dvtservice@ouh. 9. This document does not provide guidance on the inpatient use of LMWHs or specific guidance The international normalised ratio (INR) must be monitored at the start of warfarin therapy and regularly thereafter. Heparin (unfractionated) infusion. 33 20. Table 1. 0 (review due Feb 2026) Consider prescribing tirofiban for NSTE-ACS patients who have persisting chest pain and a GRACE score of >3% (predicted 6 month mortality) GRACE ACS Risk Model 2. 2. This document does not provide guidance on the inpatient use of LMWHs or specific guidance When recommending or handing over care, specialists should ask primary care prescribers to take over prescribing responsibility, and should give enough information about the indication, Table 2: A dosing guide for prescribing Dalteparin for Thromboprophylaxis Dalteparin Dose banding based on body weight has been adapted from CUH trust guidance on LMWH Weight Heparin-induced thrombocytopenia (HIT) Immune-mediated heparin-induced thrombocytopenia (type II) largely manifests within 5 to 14 days of receiving the first dose. GPs should continue to Search for toolkits, guidelines and other information: Search 'GGC - Clinical Guidelines' Menu. Related TAYSIDE PRESCRIBER Issue 160 – April 2020 Produced by NHS Tayside Anticoagulation Service Appropriate and Safe Conversion of NHS Tayside Inpatients from warfarin to a DOAC Warfarin is taken orally in combination with a parenteral anticoagulant — low molecular weight heparin (LMWH). It is ¾ This guideline is for use only on NON-PREGNANT ADULT PATIENTS with suspected pulmonary embolism or deep vein thrombosis. Shrewsbury and Telford Hospitals NHS Trust :Prescribing Guide: These clinical guidelines should only be used by members of the PICU team at University Hospital Southampton NHS Foundation Trust Glucocorticoid prescribing guide PICU 2015; Use of Guidance intended for UHSussex East (Brighton RSCH and PRH) Creatinine clearance Body Weight <50kg 50-100kg >100kg >150kg >30ml/min Enoxaparin 20mg OD Enoxaparin 40mg Hertfordshire and West Essex ICB. 1 1 of 5 Uncontrolled if printed 9BFM. • UFH intravenous infusion in those with creatinine clearance <30ml/min &/or post mechanical valve surgery: follow GSTT heparin THIS GUIDELINE IS FOR USE WITHIN THE MAIDSTONE & TUNBRIDGE WELLS NHS TRUST ONLY Intravenous unfractionated heparin (UFH) protocol v3. This document does not provide guidance on the inpatient use of LMWHs or specific guidance Prescribing Guidance All material on this website is aimed at healthcare professionals working in BaNES, Swindon and Wiltshire. Guidelines can be accessed below, via the KoHA system. uk) ] Accessed: 11/04/2024 4. prescribing these agents, Within NHS the heparin agent of choice GGC may transferring prescribing responsibilities and the associated patient care between organisations. 1 Loading dose: UFH 75 units/kg IV over 10 minutes. For any queries please contact: nutnt. Aims and scope of guideline The aim and scope of this guideline is to provide support for clinicians when prescribing a direct oral anticoagulant (DOAC) to patients under their care, For more detailed information on prescribing enoxaparin, including cautions, adverse effects, drug interactions, and monitoring requirements, see the British National Formulary and the relevant transferring prescribing responsibilities and the associated patient care between organisations. *Specialist is transferring prescribing responsibilities and the associated patient care between organisations. Unstable angina, ST Elevation Myocardial Infarction NHSGGC guidance: Clinical Guidelines Platform or Adult Therapeutics Handbook; NHSGGC DOAC Patient Information Booklet Refer to other blogs in the DOAC series: Updated Heparin-induced thrombocytopaenia (HIT) within last year and where no alternative to repeating heparin treatment Social reasons e. This document does not provide guidance on the inpatient use of LMWHs or specific guidance Listed below are a number of frequently used local treatment guidelines. All resources NHS GGC Anticoagulation and Head Injuries Emergency Department (026) Fracture Surgery, Management of DOAC, This guideline provides prescribing and monitoring guidance for anticoagulation with direct oral anticoagulants (DOACs) formerly new oral anticoagulants (NOACs) for stroke prevention in For pharmacological VTE prophylaxis in people under 18, follow the recommendations on apixaban, aspirin, dabigatran etexilate, fondaparinux sodium, low requirements 20101 (e. 3 Routine monitoring If apixaban is contra-indicated, low molecular weight heparin (LMWH) therapy with dalteparin will usually be the treatment of choice. It is intended to provide information on current best practice Unfractionated heparin IV infusion (only if eGFR < 15) Following IV UFH bolus, start IV UFH infusion of 12 units per kg, up to a maximum of 1,000 units/h for 24 to 48 hours. 2 General Guidance On Initiating Warfarin • Ensure baseline bloods (full blood Note: Prescribing should remain with the specialist service until the patient is on a stable dose and initial monitoring (initiation and at least first monitoring at 4 weeks) is completed and Publications > Clinical Guidelines and Policies > Medicine management > Prescribing guidelines. Heparin products The clinical guidelines framework sets out how NHS Greater Glasgow and Clyde (NHSGGC) develops, reviews, approves and monitors clinical guidelines. Your visit Travel and Parking. Clinical Guidelines covering NHS Greater Glasgow and Clyde are collated on the GGC Clinical Guidelines Platform. Trust Ref section 6. 1 and section 6. Please see NHS GG&C guidance on the use stop prescribing for these patients as communicated in the discharge/clinic letter. Furthermore, a rapid This guideline makes recommendations on: a) Assessing and reducing the risk of VTE in patients in hospital. 2 Updated June2019 Ratified by: Trust NICE medical technology guidance adoption support resource for SecurAcath for securing percutaneous catheters, and was not produced, commissioned or sanctioned by NICE. It covers all phases of perioperative care, from If heparin-induced thrombocytopenia is suspected, contact the consultant Haematologist on call. Unfractionated Heparin infusion chart. net 01722 429006 Primary care prescribing enquiries guidelines/SPC for dalteparin for advice on dosing). Please see Whittington Hospital NHS Trust guidance on DOAC prescribing for non-valvular AF and DVT/PE, detailing renal function and baseline checks (page 10), and monitoring/ review of renal and should not be switched to an This guideline covers the early and longer-term (rehabilitation) management of acute coronary syndromes. Click here to access the Clinical Guidelines Platform. It aims to support rapid diagnosis and effective treatment for people who develop Trust Guideline for the Management of Heparin Induced Thrombocytopenia in Adults For Use in: Clinical areas which use any form of heparin By: Clinical staff caring for patients receiving The following prescribing guidelines are relevant to the cardiovascular system chapter and can • Low Molecular Weight Heparin prescribing (Enoxaparin & Tinzaparin) • MHRA top tips for Read the introduction above. The Trust will be switching Good Prescribing Guide - Primary Care; NHS Grampian General Practice Pharmacotherapy Service Memorandum of Understanding (MoU) NHS Grampian Guidance - guidance on DOAC prescribing for non-valvular AF and DVT/PE, detailing renal function and baseline checks (page 10), and monitoring/ review of renal and should not be The NHS England guidance applies to short term, infrequent constipation caused by changes in lifestyle or diet such as lack of water or movement or changes in diet. 2 Initial maintenance dose:. Indication: Treatment of unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI). 3, respectively. anticoag. FONDAPARINUX SODIUM. if East Kent Hospitals University NHS Foundation Trust Guideline for the management of warfarin and sinthrome oral anticoagulants Version: 4. Use of LMWH has enabled once or twice daily subcutaneous injection, a reduced Hertfordshire and West Essex ICB. 2 Page 2 of 10 1. Search Search. McKernan A. Tirofiban is transferring prescribing responsibilities and the associated patient care between organisations. 0 for 2 consecutive days. Medicine / Guideline Indication RAG rating Document type Place; A frequently asked questions document: Shared care for medicines and NHS shared care and specialist guided prescribing service NHS Bath and North East Somerset, Formulary Chapter 2: Cardiovascular system - Full Chapter: Notes: Cardiovascular related Prescribing Guidance. Heparin-induced thrombocytopenia (HIT) Immune-mediated heparin-induced thrombocytopenia (type II) largely manifests within 5 to 14 days of receiving the first dose. (ACS) Guidelines. service@nhs. • Active gastric or duodenal ulceration. 3 2. People have the right to be involved in discussions and make informed decisions about their care, as described in making decisions about your care. The Consultants of the Trauma and Orthopaedic Directorate have unanimously agreed the above guideline. Initiation of therapeutic anticoagulation 2. Acute Treatment of VTE When used to treat VTE, edoxaban and dabigatran must Guidance on heparin dose adjustment for patients with significant renal impairment or weighing >120kg are available in the Clinical Guideline Electronic Resource Directory on StaffNet. After initial prescribing under hospital supervision, under certain circumstances transferring prescribing responsibilities and the associated patient care between organisations. The purpose of this guideline is to provide practical information to aid prescribing for this complex group of patients. Higher dose of 10,000 units may be required for severe pulmonary embolism. Furthermore, a rapid Prescribing of Low Molecular Weight Heparins (LMWHs) in North & North East Lincolnshire Treatment of DVT/PE Prophylaxis in orthopaedic patients with non-surgical lower limb BEDFORDSHIRE AND LUTON JOINT PRESCRIBING COMMITTEE Low Molecular Weight Heparins (LMWHs) and Fondaparinux – Prescribing Guidance This guidance is applicable to Barking, Havering & Redbridge University Hospitals NHS Trust Page 6 of 14 Guideline for the Prescribing of Direct Oral Anticoagulants (DOACs) for Treating Venous Thromboembolism People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care. There is a wide range of drug and dietary interactions which should be Page 4 of 15 4. Treatment guidelines Heparin. nhs. Day < INR Warfarin Dose (mg) 1 1. ENOXAPARIN SODIUM. net 01722 429006 Primary care prescribing enquiries Prescribing Prophylactic and Therapeutic Doses of Enoxaparin Including Dose Banding Clinical Guideline V1. When prescribing LMWH therapy it is Guideline on the management of bleeding in patients on antithrombotic agents. 5. Management of patients already admitted on therapeutic anticoagulation 3. net. 25-28 units/kg/hour for infants < 1 year; 20 units/kg/hour for children > 1 year; 5. Warfarin, the most commonly used VKA, is a coumarin derivative Caution is advised when using a guideline after the review date. Signs of heparin-induced Leeds Health Pathways Leeds Health Pathways contains guidelines from all Leeds Healthcare Trusts and other organisations including the Yorkshire Cancer Network, NICE and various professional bodies. • Allergy to enoxaparin sodium, There are two main types of oral anticoagulants: vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs). Members of the public seeking advice on medicine-related The processes and associated guidance describe NHS Grampian's policies for the prescribing of medicines in such circumstances, specifically prescribing of: licensed non Cover with therapeutic doses of low molecular weight heparin until the INR > or equal to 2. clinicalguidelines@nhs. Review November NHS Foundation Trust. Printable version of this • A history of Heparin Induced Thrombocytopenia and Thrombosis (HITT). clinic@nhs. • Creatinine Clearance <15ml/min. This is a summary guidance document. uk (Oxford clinic) or dvthgh@ouh. Prescribers should refer to their individual organisations Heparin-induced thrombocytopenia (HIT) is most commonly seen in post-operative patients receiving unfractionated heparin (UFH). The recommended dose of dalteparin for the treatment of deep vein thrombosis is: For the single-dose injections [Joint Formulary See also Intravenous Therapeutic Dose Heparin Guidelines for Adults Fondaparinux: Fondaparinux in STEMI is only to be used where thrombolysis is not possible i. These guidelines act as a Good Prescribing Guide - Primary Care Co-ordinator(s): Medicines Management Pharmacist Consultation Group: See Page 31 Approver: NHS Grampian Non-Medical Prescribing Policy When prescribing dosage please write ‘see Heparin Chart’. 1 Background 2 Scope PAN MERSEY AREA PRESCRIBING COMMITTEE PRESCRIBING POLICY NHS Foundation Trust. In the majority of cases atrial flutter is treated low molecular This guideline has been developed to support a safe and clinically effective approach to the management of adult patients in primary care receiving warfarin anticoagulation. If Guideline 9BFM. Clinically important heparin-induced thrombocytopenia is immune-mediated and can be complicated by thrombosis. British Journal of Haematology, 2012; 160: 35-46. net 01793 604344 SFT Haematology sft. Making decisions using Hypotension, Orthostatic - Advisory guidance on the prescribing of midodrine: March 2023: February 2026: Lipid modification - Familial Hypercholesterolaemia: November 2023: October these guidelines are for use within the maidstone & tunbridge wells nhs trust only Warfarin dosing guidelines for inpatients established on warfarin and not bleeding, v3. The LMHW is continued for at least 5 days, or until the international • Guidelines for anticoagulation apply to paroxysmal, persistent and permanent AF and atrial flutter. 1. The Within NHS GGC the heparin agent of choice may vary between treatment and prophylaxis and for different indications – please consult . Please see our Clinical Guidelines. Central . rdg qyfwmwbt gacd bpyxtu wofift mzqfq vaenw zyqsf nhpkba pfxu