what should be target INR in pre op?
Less than 1.5
Sir if it’s 2 or 2.5, and we want to do a emergency procedure say for appendix or sbo, then what to do? Pt is a c/o A.fib on warfarin… There are no signs of bleeding, normal ecg currently.
unless the INR reduces to less than 1.5, we cannot go for emergency surgery.
If INR is raised, we can give prothrombin factor concentrates or fresh frozen plasma, but the former is better, in order to achieve desired INR
emergency is emergency… no waiting or wasting…
If surgeon says … emergency… we have to take it… bleeding can be controlled by surgeon. By cautery/ tourniquet / clamp etc…
In mean while… I will supplement with iv fluids…and get ffp etc monitor patient…
Follow transfusion protocol…
Okay sir. Thank you.