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HEPARIN-INDUCED THROMBOCYTOPENIA

Heparin-Induced Thrombocytopenia

WHAT YOU NEED TO KNOW:

What is heparin-induced thrombocytopenia? Heparin-induced thrombocytopenia (HIT) is a condition that causes a decrease of platelets in the blood. Platelets help the blood clot. HIT usually occurs after you are treated with heparin.

What increases my risk for HIT?

  • Recent surgery, especially heart or bone surgery

  • An IV or central line that is flushed with heparin or coated with heparin

  • A type of heparin used from cows or pigs

  • Taking heparin for more than 4 days

  • Female gender

What are the signs and symptoms of HIT?

  • Pain, redness, and swelling of an arm or leg

  • Bruise-like discoloration of your skin

  • A rash or sore where a heparin shot was given

  • Weakness, numbness, or problems moving your arms or legs

How is HIT diagnosed? Tell your healthcare provider if you have been treated with heparin. He will ask when you were treated with it and for how long. You may need any of the following tests:

  • Blood tests will show how many platelets are in your blood. You may need blood tests every 2 to 3 days.

  • An immunoassay test will show if you have HIT.

How is HIT treated? All heparin treatments will stop, including heparin flushes and catheters coated with heparin. You may need any of the following:

  • Blood thinners

    help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:

    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.

    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.

    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.

    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.

      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.

  • Antiplatelets, such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.

When should I contact my healthcare provider?

  • You have a fever.

  • You have numbness in your arms or legs.

  • You have severe pain in your arms or legs that does not go away.

  • You have trouble standing and walking.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

    • Discomfort or pain in your back, neck, jaw, stomach, or arm

    • Trouble breathing

    • Nausea or vomiting

    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.