Lovenox and the removal of adductor canal catheters

[turnupthevapor]

I think it is a waste to disrupt the lovenox schedule for the removal of a adductor canal catheter....Do all my fellow warriors agree?

It's only DVT dosing anyway and for goodness sake we give lovenox before some of our gastric bypass surgeries and THAN DO SURGERY! agreed?

I am sure it may sense to time it to 12 hours since the last dose but that is very very difficult to coordinate!

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[seinfeld]

I think it is a waste to disrupt the lovenox schedule for the removal of a adductor canal catheter....Do all my fellow warriors agree?

It's only DVT dosing anyway and for goodness sake we give lovenox before some of our gastric bypass surgeries and THAN DO SURGERY! agreed?

I am sure it may sense to time it to 12 hours since the last dose but that is very very difficult to coordinate!

2 things

1. Change the hospital dosing schedule to 9 and 2100, with prophylactic dosing always occurring once daily at 2100. Nothing happens after 9pm electively and by the am whatever risk people think exists is mitigated (this was actually pretty easy to do as everyone from surgery to IR liked it not being an issue to think about)

2. Doesn't matter IMHO for the once daily prophylaxis (30-40mg) lovenox dose.

 

[deleted162650]

I wouldn't think twice about pulling it even on therapeutic dosing. The better answer though is to stop doin AC catheters.

 

[psychbender]

In residency, our Acute Pain Service was able to get everyone to do just what Seinfeld suggested, and it worked great for all involved.

Also, for the once daily prophylaxis dosing, I wouldn't think twice about it. In residency, we did ballsy things like pulling or placing fem/sci/brachial plexus catheters 10 hours after the last 1mg/kg dose of lovenox, and having the nurses give the next dose two hours later. It was a calculated risk for our unique patient population that paid off hundreds of times, and to the best of my knowledge, there still had yet to be an issue with bleeding related to that practice there. Now, if confronted with that issue today at my current hospital, I'd likely adhere to the ASRA guidelines, as no one would back me up if there was an issue.

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