{"id":3706,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/anticoagulanttherapybridging\/"},"modified":"2023-07-31T11:17:49","modified_gmt":"2023-07-31T10:17:49","slug":"anticoagulanttherapybridging","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/anticoagulation\/anticoagulanttherapybridging\/","title":{"rendered":"Bridging of Anticoagulant Therapy"},"content":{"rendered":"\n<title>Anticoagulant therapy bridging<\/title>\n\n\n\n<p>Please state the nature of the procedure, for which bridging therapy is required, the name of the responsible clinician and at which hospital location the procedure will be performed.<\/p>\n\n\n\n<p>Note that referrals will almost always be from the specialist setting undertaking the procedure, but please see \u2018Who not to refer\u2019 for advice about minor procedures, too.<\/p>\n\n\n\n<p><strong>C.M &amp; L.W 31-07-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">\u200bWho to refer:<\/h4>\n\n\n\n<p>Patients requiring surgery on long-term warfarin for:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>prosthetic heart valves;<\/li>\n\n\n\n<li>venous thromboembolism who require major elective surgery<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p>Do not refer patients undergoing minor procdures for which anticoagulation does not require to be interrupted eg.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>endoscopy without biopsy or minimal\/small biopsies (refer to British Society of Gastroenterology Guidelines)<\/li>\n\n\n\n<li>patients requiring routine dental extraction or minor dermatological procedures eg small skin biopsies, removal of minor skin lesions. <\/li>\n<\/ul>\n\n\n\n<p><strong><em>In such cases warfarin may be continued but the INR should be checked within 24 hours of the procedure.<\/em><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Department of Haematology, RIE or SJH (SCI Gateway if from a GP).<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">\u200bPrimary care investigations<\/h4>\n\n\n\n<p>Initial investigations \u2013 normally done by the specialist arranging the procedure:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC<\/li>\n\n\n\n<li>INR<\/li>\n\n\n\n<li>U&amp;Es<\/li>\n\n\n\n<li>Weight (Kg)<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Anticoagulant therapy bridging Please state the nature of the procedure, for which bridging therapy is required, the name of the responsible clinician and at which hospital location the procedure will be performed. Note that referrals will almost always be from the specialist setting undertaking the procedure, but please see &lsquo;Who not to refer&rsquo; for advice<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":15981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[253],"class_list":["post-3706","page","type-page","status-publish","hentry","category-anticoagulanttherapybridging"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/coagulopathy\/anticoagulanttherapybridging\/\" rel=\"tag\">Anticoagulant Therapy Bridging<\/a>","rttpg_excerpt":"Anticoagulant therapy bridging Please state the nature of the procedure, for which bridging therapy is required, the name of the responsible clinician and at which hospital location the procedure will be performed. Note that referrals will almost always be from the specialist setting undertaking the procedure, but please see &lsquo;Who not to refer&rsquo; for advice","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3706","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3706"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3706\/revisions"}],"predecessor-version":[{"id":16149,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3706\/revisions\/16149"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/15981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3706"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3706"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}