Blood Management - Thrombosis Anticoagulation Program

Chronic anticoagulation therapy is being used with increasing frequency. Some individuals receiving anticoagulation therapy will require surgical or invasive procedures. Because of a high risk of bleeding, oral anticoagulant therapy must be discontinued prior to the procedure/surgery and then re-instituted following. The interruption of oral anticoagulation increases the risk of thromboembolism during these periods.

Coordination of perioperative anticoagulant management is complex, time consuming and involves multiple disciplines (surgery, anesthesia, nursing and pharmacy). The participation of the patients themselves is imperative as well. The purpose of the formation of a team to manage the perioperative anticoagulation is to develop a comprehensive and systematic approach for patients requiring surgery or invasive procedures. The procedures outlined below will help to ensure this information is communicated to the appropriate stakeholders for the safe and efficient care of QEII patients.

Referral Process

Patients to be assessed in Perioperative Anticoagulation Program must be referred to the Hematology Clinic. Anticoagulation Program Perioperative Referral Form must be faxed to (902) 473-6260, attention to Irene Yorke or Lisa Gray . A minimum of 14 days notice is required to schedule patients to facilitate teaching. The referral should indicate whether the patient will be admitted to hospital postoperatively or not, what type of anesthesia to be used (general/regional) and the indication for the use of anticoagulants.

Urgent referrals (i.e. less than seven days prior to surgery) must be discussed with Dr. David Anderson. Referrals will be triaged by the case management coordinator depending on the date of the procedure. Clinic appointments will not be made without a procedure date.