Haematology consult guide

Haematology consult guide

Mar 4, 2018 0
onthephones

Editor: Shafqat Inam

Contributors: Stephanie Anderson, Ahmed Alcheikh, Edward Abadir

Reviewed:  Caroline Dix, James Edwards

  • Full blood count (recent, preferably that day).
  • Vital signs and temperature.
  • History of bleeding or bruising.
  • History of deep venous thrombosis or pulmonary embolism – provoked or unprovoked? Superficial or deep? How long ago was the VTE?
  • What anticoagulant the patient is on, indication and the time of last dose.
  • Contraindications to anticoagulation?
  • Any new drugs which have been started?
  • History of haematological malignancy and treatment.
  • Regarding derangements in full blood count: new or chronic, trend of any abnormalities, correlation with previous results outside of hospital is also valuable.
  • What haematologist (if any) the patient is known to/has seen in the past.
  • Vitals, especially temperature.
  • Weight.
  • Haematological examination if relevant (lymphadenopathy, splenomegaly, hepatomegaly).
  • Full blood count and differentials including the neutrophil count.
  • Creatinine clearance (based on weight) – required for most anticoagulants.
  • Details of recent chemotherapy treatment, including timing.
  • Previous blood counts and/or scan results.
  • Use your online local resources for reversal of anti-coagulation that are available on your hospital intranet.
  • Haematology can assist you in how to reverse coagulation but typically cardiology should be consulted regarding risks/ benefits of reversal in patients in atrial fibrillation and/or mechanical valves.

Helpful resources

An update of consensus guidelines for warfarin reversal

  • Huyen A Tran, Sanjeev D Chunilal, Paul L Harper, Huy Tran, Erica M Wood and Alex S Gallus, on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust 2013; 198 (4): 198-199. DOI: 10.5694/mja12.10614.  Abstract available from https://www.ncbi.nlm.nih.gov/pubmed/23451962

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Tags: #blood count,#blood culture,#blood disease,#consult guide,#haematology,#junior doctors

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