I'm very confused with some managements of UW CCS. Why a FOBT is ordered prior heparin/Levonox if the case does not have any anticoagulation contraindication (cns bleeding, melena, hematoma, recurrent PE while on warfarin with full therapeutic INR)? The test will delay the order of heparin which is important in a patient with PE or unstable angina/NSTEMI to decrease mortality.
Other concern is that if a patient is diagnosed with anemia (Hgb 9, Hct 27) due a malignancy and needs surgery, why a PRBC transfusion is not ordered prior surgery while the other preoperatory labs are running? At least I order the transfusion but it is not mentioned in the explanation....oral iron was given instead. In "the real world" this patient will not underwent surgery with Hgb 9. At the real test, a PRBC transfusion is ordered prior surgery if the patient has anemia?????
I'm freaking out right know and my test is next week. I graduate 12 years ago, have been working for 10 years, between ER and private practice, and had never seen something like this before.
UW team, please if you can clarify this concerns I will appreciate it!