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Susan Odiwo January 11, 2011

Prothrombin Time Blood Test-PT

This test is done to evaluate the blood for its ability to clot. It is often done before surgery
to evaluate how likely the patient is to have a bleeding or clotting problem during or after
surgery.

Common causes of a prolonged PT include vitamin K deficiency, hormones drugs


including hormone replacements and oral contraceptives, disseminated intravascular
coagulation (a serious clotting problem that requires immediate intervention), liver
disease, and the use of the anti-coagulant drug warfarin. Additionally, the PT result can
be altered by a diet high in vitamin K, liver, green tea, dark green vegetables and
soybeans.

Normal PT Values: 10-12 seconds (this can vary slightly from lab to lab)

Partial Thromboplastin Time Blood Test-PTT

This test is performed primarily to determine if heparin (blood thinning) therapy is


effective. It can also be used to detect the presence of a clotting disorder. It does not show
the effects of drugs called “low molecular weight heparin” or most commonly by the
brand name Lovenox.

Extended PTT times can be a result of anticoagulation therapy, liver problems, lupus and
other diseases that result in poor clotting.

Normal PTT Values: 30 to 45 seconds (this can value slightly from lab to lab)

International Normalized Ratio Blood Test-INR

The INR is used to make sure the results from a PT test is the same at one lab as it is at
another lab. In the 1980’s the World Health Organization determined that patients may be
at risk because the results of a PT test would vary from one lab to another, based upon the
way the test was done. The “normal” range for one lab would be different than a
“normal” value from another lab, creating problems for patients who were being treated
in several locations. In order to standardize the results between labs, the INR was created.
The INR result should be the same, regardless of the location where the tests are
performed.

Normal INR Values: 1 to 2


Values for ABG’s

Arterial blood gas analysis is an essential part of diagnosing and managing a patient’s

oxygenation status and acid-base balance.

Arterial Blood Gases


Arterial blood gas analysis provides information on the following:
1] Oxygenation of blood through gas exchange in the lungs. 2] Carbon dioxide (CO2)
elimination through respiration. 3] Acid-base balance or imbalance in extra-cellular
fluid (ECF).

Normal Blood Gases


Arterial Venous
pH 7.35 - 7.45 7.32 - 7.42
Not a gas, but a measurement of acidity or alkalinity,
based on the hydrogen (H+) ions present. The pH of a
solution is equal to the negative log of the hydrogen ion
concentration in that solution: pH = - log [H+].
PaO2 80 to 100 mm Hg. 28 - 48 mm Hg
The partial pressure of oxygen that is dissolved in
arterial blood.
New Born – Acceptable range 40-70 mm Hg. Elderly:
Subtract 1 mm Hg from the minimal 80 mm Hg level for
every year over 60 years of age: 80 - (age- 60) (Note:
up to age 90)
22 to 26 mEq/liter 19 to 25
HCO3
(21–28 mEq/L) mEq/liter
The calculated value of the amount of bicarbonate in the
bloodstream. Not a blood gas but the anion of carbonic
acid.
PaCO2 35-45 mm Hg 38-52 mm Hg
The amount of carbon dioxide dissolved in arterial
blood. Measured. Partial pressure of arterial CO2.
(Note: Large A= alveolor CO2). CO2 is called a “volatile
acid” because it can combine reversibly with H2O to
yield a strongly acidic H+ ion and a weak basic
bicarbonate ion (HCO3 -) according to the following
equation: CO2 + H2O <--- --> H+ + HCO3
–2 to +2 mEq/liter

B.E. Other sources: normal


reference range is
between −5 to +3.
The base excess indicates the amount of excess or
insufficient level of bicarbonate in the system. (A
negative base excess indicates a base deficit in the
blood.) A negative base excess is equivalent to an acid
excess. A value outside of the normal range (-2 to +2
mEq) suggests a metabolic cause for the abnormality.
Calculated value. The base excess is defined as the
amount of H+ ions that would be required to return the
pH of the blood to 7.35 if the pCO2 were adjusted to
normal.

It can be estimated by the equation:


Base excess = 0.93 (HCO3 − 24.4 + 14.8(pH − 7.4))
Alternatively: Base excess = 0.93×HCO3 + 13.77×pH −
124.58

A base excess > +3 = metabolic alkalosis a base exc


SaO2ss < -3
= metabolic 95% to 100% 50 - 70%
acidosis

The arterial oxygen saturation.

HEPARIN

Heparin Sodium Injection, USP is a sterile solution of heparin sodium derived from
porcine intestinal mucosa, standardized for anticoagulant activity, in water for injection.
It is to be administered by intravenous or deep subcutaneous routes.
Heparin sodium is not effective by oral administration and should be given by
intermittent intravenous injection, intravenous infusion, or deep subcutaneous (intrafat,
i.e., above the iliac crest or abdominal fat layer) injection. The intramuscular route of
administration should be avoided because of the frequent occurrence of hematoma at the
injection site.

Heparin can cause you to have bleeding episodes while you are using it and for several
weeks after you stop
Coumadin

Coumadin (warfarin) is an anticoagulant (blood thinner). Coumadin reduces the


formation of blood clots by blocking the formation of certain clotting factors.

Coumadin may cause you to bleed more easily, especially if you have: a history of
bleeding problems, high blood pressure or severe heart disease, kidney disease, cancer,
surgery or a medical emergency, a disease affecting the blood vessels in your brain, a
history of stomach or intestinal bleeding, if you are 65 or older, or if you are severely ill
or debilitated.

Coumadin is used to prevent heart attacks, strokes, and blood clots in veins and arteries.

Many drugs (including some over-the-counter medicines and herbal products) can cause
serious medical problems or death if you take them with Coumadin.

Many drugs (including some over-the-counter medicines and herbal products) can cause
serious medical problems or death if you take them with Coumadin.

Coumadin may cause you to bleed more easily, especially if you have:

• a history of bleeding problems;


• high blood pressure or severe heart disease;
• kidney disease;
• cancer;
• surgery or a medical emergency;
• a disease affecting the blood vessels in your brain;
• a history of stomach or intestinal bleeding;
• if you are 65 or older; or
• if you are severely ill or debilitated