On Thu, 22 Jul 2004 17:26:37 +0100, Julian Bradley
<[log in to unmask]> wrote:
>If additional information is needed that can only be determined by a
>doctor, and not held on file at the hospital, please clarify what this is.
The BNF implies that knowing whether there is current bleeding or
major risk factors for bleeding is important, which is where a phone
call between a doctor and the patient might be needed. In the near
future our local PCO will be taking over OOH cover, so the question of
whether it is appropriate GP work for that time of night will be their
problem.
In the absence of bleeding the BNF suggests stopping warfarin for INRs
of 6 and above. It also suggests giving vitamin K for INRs of above 8
if there are risk factors. In practice the OOH GP probably won't have
access to vitamin K, so the latter group would be a turf to
Haematology.
David
--
Dr David G Evans
Cardiff
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