Here’s
something out of the ordinary….. coag results seem to be to pot.
Specimen Results Entry
29/01/2015 18:00 DASTARDLY, DICK 06/01/1935 Male 000000 Emergency Care Centre 1 The Street Folkestone Dr SOB, large pleural effusion, metabolic acidosis.On U HAWK Specimen No : AK681632H Selected Auth Level : S --------------------T-------------------T-------------------T------------------- PT 31.3 F000 | | | APTT 47.5 F000 | | | | | | | | | --------------------T-------------------T-------------------T------------------- LTG comments : CS,CX,CXR,DIC,EXT,IA,INT,ITS,LUPUS,PTT,RM,TS,TSW,VWF 1 Auth'd 2 Unauth'd 3 Nomin'd 4 Change 5 Reject 6 Options 7 eXit> U |
Specimen Results Entry
29/01/2015 18:00 DASTARDLY, DICK 06/01/1935 Male 000000 Emergency Care Centre 1 The Street Folkestone Dr Specimen No : AK681632H Selected Auth Level : S Specimen No : AK681632H Selected Auth Level : S --------------------T-------------------T-------------------T------------------- PT 31.3 F000 | | | PT50 17.0 F008 | | | APTT 47.5 F000 | | | APTT50 34.3 F008 | | | APTTR ^1.6 F008 | | | INR 2.2 F000 | | | FIB 2.91 F008 | | | TT 20.7 F008 | | | | | | | | | --------------------T-------------------T-------------------T------------------- LTG comments : CS,CX,CXR,DIC,EXT,IA,INT,ITS,LUPUS,PTT,RM,TS,TSW,VWF 1 Auth'd 2 Unauth'd 3 Nomin'd 4 Change 5 Reject 6 Options 7 eXit> U |
Further
testing doesn’t really throw us any bones at first sight… is the patient on
anticoagulants?
Specimen Results Entry
29/01/2015 18:00 DASTARDLY, DICK 06/01/1935 Male 000000 Emergency Care Centre 1 The Street Folkestone Dr SOB, large pleural effusion, metabolic acidosis.On U HAWK Specimen No : AK681632H Selected Auth Level : S ------T-----------------------------------------------------------------------] Date|29/01/2015 20/09/2014 19/09/2014 20/11/2012 14/11/2012 13/11/2012 | Time|18:00 u/k u/k u/k 09:30 09:45 | Spec|AK681632H AW195849Z AW195351J AW222189T AW206838M AW201661M | |BIO BIO BIO BIO BIO BIO | Test--+-----------------------------------------------------------------------{ PT |31.3 18.0 17.3 | PT50 |17.0 | APTT |47.5 39.9 37.4 | APTT50|34.3 | APTTR |^1.6 ^1.3 ^1.2 | INR |2.2 1.2 1.2 7.2 2.4 2.1 | FIB |2.91 4.91 | TT |20.7 16.3 | | | ------T-----------------------------------------------------------------------] 1 View 2 Graph 3 eXit X More >> |
But
look at the history… those INRs. Warfarin?
The
patient was actually taking apixaban – a factor Xa inhibitor prescribed for
treatment and secondary prophylaxis of DVT and PE.
A new one on me...
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