Purpose: To identify a possible cause for resistance to heparin therapy.				Citations with documentation. 04.01.03	Medal Project 2002. See disclaimer.
data	enter
Are you evaluating a patient who appears to be resistant to heparin therapy? (Y or N)		:-):-):-)
Are the dose and route of administration adequate? (Y or N)		:-):-):-)				0
Does the patient have a history of heparin-induced thrombocytopenia? (Y or N)		:-):-):-)
Does the patient have a new onset of thrombocytopenia? (Y or N)		:-):-):-)
Is the patient receiving intravenous nitroglycerin? (Y or N)		:-):-):-)				0
Is the patient receiving a medication that interferes with heparin activity? (Y or N)		:-):-):-)				0
Does the patient have severe acidosis? (Y or N)		:-):-):-)				0
enter an "x" in the appropriate column for each blood level (give only 1 answer per row)
	not tested	decreased	normal	increased
serum antithrombin III levels					Yes	0
	not tested	decreased	normal	increased
serum low-density lipoproteins (LDL)					Yes	0
	not tested	decreased	normal	increased
serum lysozyme (muramidase)					Yes	0
	not tested	decreased	normal	increased
serum platelet factor 4					Yes	0
	not tested	decreased	normal	increased
serum beta-thromboglobulin					Yes	0
	not tested	decreased	normal	increased
serum heparin cofactor II levels					Yes	0
calculate	result
data complete?	Yes
evaluation appropriate?	Yes	:-):-):-)
number of possible causes identified	0
number of potential causes not evaluated	1
Should heparin-induced thrombocytopenia be considered?	not now
Workup:
:-):-):-)
:-):-):-)
• Do tests not already performed.