First, it is important to note that the recalled heparin is only in the higher dose concentrations. Importantly, other heparin is available from other manufacturers, though it might be less abundant. So I called our pharmacists, and they were nice enough to send on these steps we're implementing:
"Because of this recall we anticipate at least several weeks of short supply as other manufacturers work to get more product to the market. This will impact Evanston Northwestern Healthcare in the following ways:Glad to see my atrial fibrillation ablation procedures can continue...
- Patients on a heparin nomogram with boluses: If a bolus dose of heparin is needed based on the aPTT result, the nurse must contact pharmacy to dispense the bolus. Pharmacy will be drawing up patient specific bolus doses to conserve available stock. Vials of heparin have been removed from general nursing unit Pyxis machines.
- Use of standard heparin for VTE prophylaxis. This strength will be in particularly short supply. Pharmacists will be working with physicians to try to convert as many patients as possible to other prophylaxis measures, e.g., Lovenox (enoxaparin). In addition, the pharmacy will be dispensing the standard heparin prophylaxis doses from the central pharmacy as syringes after our vial stock runs out.
- Several treatment areas that require heparin urgently will continue to have stock in Pyxis or floorstock as usual, however please be aware that it may look different than you may be used to. As always, please be sure to read medication labels carefully. The pharmacy department will be communicating with these areas as we become aware of any changes to products stocked."