Platelet count on a hip

[ssmallz]

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What is the lowest platelet count that is acceptable for a hemiarthroplasty? Does it change if the pt is on plavix or not?

After discussion with the surgeron, I canceled a hemiarthroplasty today b/c the pt took her plavix 4 days ago and the platelets were 81. H/H was already 9/29, our blood bank is pretty terrible, and she's gonna bleed like stink. With that in mind, knowing that you anticipate significant bleeding and your blood bank won't be able to keep up with more than 4 units of cells w/other products taking up to 2 hours to get, whats the lowest platelet level you'd feel comfortable with? Would you insist on 7 days since plavix or does the risk of her sitting around for 3 days outweigh this in your mind?

 

[imfrankie]

What is the lowest platelet count that is acceptable for a hemiarthroplasty? Does it change if the pt is on plavix or not?

After discussion with the surgeron, I canceled a hemiarthroplasty today b/c the pt took her plavix 4 days ago and the platelets were 81. H/H was already 9/29, our blood bank is pretty terrible, and she's gonna bleed like stink. With that in mind, knowing that you anticipate significant bleeding and your blood bank won't be able to keep up with more than 4 units of cells w/other products taking up to 2 hours to get, whats the lowest platelet level you'd feel comfortable with? Would you insist on 7 days since plavix or does the risk of her sitting around for 3 days outweigh this in your mind?

I personally let surgeons cancel cases. Lay the case out for them and they can make the call if it's an emergency.

 

[ssmallz]

I personally let surgeons cancel cases. Lay the case out for them and they can make the call if it's an emergency.

That's what I did, once he realized the platelet issue + plavix + bleeding he decided to postpone for 48hrs for tune up