Doubt in CCS PLZ help. - tanya_step2ck

[ArchivalUser]

Hey,
when I am doing ccs, the case is ending very early than expected. the 5 minute screen is popping up though the patient is still in ICU and still needs some ICU attention for example- the patient just underwent some surgery, for example a case of PE on heparin and warfarin in the ward still his INR is sub therapeutic..... in that case do i need to discontinue npo/ heparin in the 5 minute screen though he needs heparin for 3 more days till his INR become 2/3.???

[ArchivalUser]

'need to discontinue npo/ heparin in the 5 minute screen though he needs heparin for 3 more days till his INR become 2/3.???'
--- No
continue the med you need to give pt

[ArchivalUser]

No you must not discontinue the medication on 5 minute screen if you have not seen an inr > 2.0 result before reaching the 5 min screen. The point of when to d/c heparin depends on whether INR is greater than 2 or not. So, if 5 min screen came up before you saw that inr result, continue heparin.
On 5 minute screen, schedule pt/inr daily using the later option. This is very very imp. To discontinue meds on 5 min screen depends on simulated time and whether we met targets for the case when we reach 5 min screen. For eg: if a pneumonia case was admitted and if he is afebrile after starting iv antibitiocs and case ended and 5 min screen comes, we have to see simulated time. If simulated time is less than 24 hours, continue iv antibiotics. If simulated time > 1 day, patient is eating and afebrile for 24 hours as per previous updates, d/c iv antibiotics on 5 min screen and switch to PO ( from dr.red ccs cases)

[ArchivalUser]

gd