Just when you think you have heard all the ways that warfarin can be screwed up ...

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A patient had been discharged from the hospital after stopping warfarin for surgery. The instructions were to start Lovenox and get her INR chacked in 5 days to see if was back up to 2.0, so she could restart her warfarin. Well guess where her INR was!! She was very unhappy to find that she was going to have to continue twice daily injections for at least 5 more days. You might think that she had misunderstood, but she brought in the written instructions and sure enough that was what they said. They were written by the nurse discharging her and were not from the hospital where I work, so I have no idea who originated the idea.

BTW - I heard of a new way to prevent eggplant belly when on Lovenox. Hold an ice cube on the injection site until it stings then wipe with alcohol. The inject the Lovenox without blowing out the bubble and no rubbing. Then hold the ice cube over the site until it stings again. It reportedly prevents bruising.
 

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