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Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage

Marrinan, E; Chen, L; Werring, D; Turner, D; (2020) Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage. British Journal of Hospital Medicine , 81 (2) pp. 1-6. 10.12968/hmed.2020.0007. Green open access

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Abstract

BACKGROUND/AIMS Four-factor prothrombin complex concentrate is the first-line treatment in vitamin K antagonist-related intracerebral haemorrhage. Early administration is associated with improved patient outcomes. A quality improvement project investigated delays in prothrombin complex concentrate administration in vitamin K antagonist-related intracerebral haemorrhage in order to reduce the time from computed tomography scan confirming intracerebral haemorrhage to prothrombin complex concentrate administration (scan-to-needle time). METHOD Twenty patients were identified by retrospective audit over a 3-year period. The median scan-to-needle time for prothrombin complex concentrate was 156 minutes. Several points of delay were identified, including contacting both haematology and transfusion departments for prothrombin complex concentrate dosing and dispensing. Following this audit, interventions were brought in which included the introduction of a protocol with a prothrombin complex concentrate dosing algorithm, negating the need to contact haematology before administration. A dedicated supply of prothrombin complex concentrate was given to the stroke unit avoiding the need to contact the transfusion service. RESULTS A re-audit showed a 68% reduction in median scan-to-needle time from 156 minutes to 49 minutes. Prospective data collection is ongoing.

Type: Article
Title: Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.12968/hmed.2020.0007
Publisher version: https://doi.org/10.12968/hmed.2020.0007
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Intracerebral haemorrhage, Prothrombin complex concentrate, Stroke, Vitamin K antagonist, Warfarin
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10093440
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