The physician orders the patient to be started on Heparin infusion for DVT using the Heparin Protocol below. The patient weighs 176 lbs. Weight Based Heparin Protocol: Give the patient a bolus of heparin 80 units/kg (Use Stock: Heparin sodium 10,000 Units/mL for IV use). Start Heparin infusion to run at 18 units/kg/hr (Use standard concentration: 25,000 units heparin in 250 mL D5W). Check aPTT in 6 hours after infusion started. Adjust heparin therapy based on the table below. Heparin Protocol aPTT results Bolus or Hold Change Infusion Rate Order aPTT lab again PTT < 35 Bolus 80 units/kg Increase by 4 units/kg/hr 6 hours after bolus PTT 36-45 Bolus 40 units/kg Increase by 3 units/kg/hr 6 hours after bolus PTT 46-56 None Increase by 2 units/kg/hr 6 hours after an increase PTT 57-75 None No change In the morning and daily PTT 76-90 None Decrease by 2 units/kg/hr 6 hours after a decrease PTT 90-120 Hold infusion 1 hr Decrease by 3 units/kg/hr 6 hours after a decrease PTT > 120 Hold infusion 2 hr Decrease by 4 units/kg/hr 6 hours after a decrease How many units is the initial heparin infusion dosage (Use 2 above)? Record your answer as a whole number. __________ units/hr
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