PLACE LABEL HERE

KCENTRA

(4 Factor-Prothrombin Complex Concentrate, 4F-PCC)

for LIFE-THREATENING BLEED

PROTOCOL

The following orders will be implemented per physician order of this protocol.

Orders with a “q” are indicator choices and are NOT implemented unless checked

1. DC this protocol if patient has heparin-induced thrombocytopenia (HIT) or KNOWN DIAGNOSIS of diss eminated intravascular coagulation (DIC). Kcentra contains trace amounts of Heparin.

2. Refer to Anticoagulant & Antiplatelet Reversal/Rescue Guidelines 500-56, Attachment C for additional information and recommendations.

3. Patient’s actual weight = _____________ kg

4. Nurse to call pharmacy to notify them that the Kcentra (PCC) order is being sent to pharmacy.

5. q Coumadin (warfarin) Reversal Protocol :

DC Coumadin (warfarin)

INR STAT (unless current INR result is < 2 hrs old) and 30 min after Kcentra dose is complete

Vitamin K 10 mg in 50 ml NS, infuse IV over 20 minutes x 1 dose STAT

Kcentra (PCC) IVPB x 1 dose to be infused at a rate of 8 ml/min (480 ml/hr)

Dose is based on INR as follows:

q INR = 2 to < 4 Dose: 25 units/kg = _______ units (max dose is 2,500 units)

q INR = 4-6 Dose: 35 units/kg = _______ units (max dose is 3,500 units)

q INR > 6 Dose: 50 units/kg = _______ units (max dose is 5,000 units)

6. q Eliquis (apixaban), Xarelto (rivaroxaban), Arixtra (fondaparinux) Reversal Protocol

DC Eliquis, Xarelto and Arixtra

Kcentra (PCC) 50 units/kg = _____units (max 5,000 units) infused at 8 ml/min (48 0 ml/hr)

7. q Tra u ma Protocol (after conventional therapies have proven to be ineffective)

Kcentra (PCC) 2 0 units/kg = _____units (max 5,000 units) infused over 10 minutes

Nursing Instructions Regarding Kcentra infusion:

· Administer through a separate infusion line.

· Do not allow blood to enter the syringe, possibility of fibrin clot formation.

· Flush with NS before and after administration.

______________ ___________________ _________________________________ __________

Date Time Physician Signature PID Number

Copy to pharmacy

*1-35127* FORM 1-35127 REV. 08/2014 Page 1 of 1