Home / About Clots / Managing Anticoagulants Before, During, and After Medical Procedures
Millions of people depend on anticoagulants – also known as “blood thinners” – to prevent life-threatening blood clots. While these medications do not actually “thin” the blood,they do slow the body’s ability to form dangerous blood clots, such as blood clots in the arms or legs (deep vein thrombosis or DVT) and blood clots in the lungs (pulmonary embolism or PE). Blood thinners, however, do not completely stop the body’s ability to clot, because blood clots are a beneficial part of healing from an injury. For example, if you cut your finger with a kitchen knife, your body naturally works to stop you from bleeding too much.
As with any medication you take, there are potential risks when taking blood thinners. These risks include unwanted or even dangerous bleeding. Bleeding risks can be particularly overwhelming to think about, especially if you are preparing for a surgical, dental, or other medical procedure.
Despite the effectiveness of blood thinners, preventable bleeding and clotting events still happen, especially before, during, and after surgery or other medical procedures. Surgery and invasive medical procedures can increase the risk of serious bleeding. Stopping blood thinners can increase your risk for blood clots, due to the underlying risk factor(s) for which your blood thinner was originally prescribed. Many times, these bleeding and clotting risks can be complicated for you to understand, and difficult for your healthcare providers to manage.
It is just as important for you to understand your bleeding and clotting risks as it is for the doctors who are caring for you to manage these risks. The National Blood Clot Alliance, in partnership with IPRO, has developed several downloadable materialsto help you understand your risks, and manage your blood thinners, before, during, and after surgical, dental, or other medical procedures.
Materials to Help You Manage Anticoagulants Before, During and After Surgery or Other Medical Procedures
Anticoagulation Management: What to Expect Before, During, and After Surgery or Other Medical Procedures
This detailed fact sheetprovides a complete description of the different blood thinners that are available, and explains how they can be used to help prevent blood clots, and unwanted bleeding, before, during, and after surgical, medical, or dental procedures.
Every person is different, and every situation needs to be managed carefully. Use this fact sheet before any invasive medical or dental procedure to help you understand your bleeding and clotting risks, and how to best manage your blood thinner.
Click here for more information: What to Expect Before, During, and After Surgery or Other Medical Procedures
Quick Reference: What to Expect Before, During, and After Surgery or Other Medical Procedures
This is a one-page summary of the detailed fact sheet above. It describes each of the available blood thinners, and explains how they can be used to help prevent blood clots, and unwanted bleeding, before, during, and after surgical, medical, or dental procedures.
Use this summary as a quick reference guide before any invasive medical or dental procedure to help you understand your bleeding and clotting risks, and how to best manage your blood thinner.
Click here for more information: Quick Reference:What to Expect Before, During, and After Surgery or Other Medical Procedures
Understanding Anticoagulant Risk Prevention When Surgery or Other Procedures are Planned
This simple plan will help you understand how your medication schedule may changeto help prevent blood clots and unwanted bleeding before, during, and after your surgery, or other dental or medical procedure.
Use this sheet to have a conversation with your doctor, or healthcare provider, and record specific instructions for staring and stopping your blood thinner, if necessary.
Click here for more information: Risk Prevention When Surgery or Other Procedures are Planned
Test Your Knowledge
After reading the materials above, test your knowledge with this quiz.
Share and discuss the results with your doctor, or other healthcare provider, to make sure you understand how to best manage your blood thinner before, during, and after surgical, dental, or other medical procedures.
Click here to take the quiz: Test Your Knowledge
To learn more about blood clot treatment, visit here.
To learn more about hospitalization, surgery and blood clots, visit here.
IPRO is a national organization providing a full spectrum of healthcare assessment and improvement services that foster more efficient use of resources and enhance healthcare quality to achieve better patient outcomes. To learn more about IPRO, visit here.
FAQs
How long before surgery should you stop taking anticoagulants? ›
High bleed risk – For high bleeding risk surgery, omit the DOAC two days before and resume two days (approximately 48 hours) after the procedure, provided hemostasis is secure.
How do you prevent blood clots before surgery? ›- Anticoagulants administered at least 1 hour before the procedure and continued post-operatively. ...
- Compression stockings worn intra- and post-operatively. ...
- Mechanical compression device.
Anticoagulants will increase the risk of bleeding with any surgical procedure. The need for anticoagulation should be balanced against the risk of bleeding for any invasive procedure.
What are patient safety concerns when anticoagulants are administered during surgery? ›In performing noncardiac surgery on patients on anticoagulation, the major concern is when it is safe to perform surgery without increasing the risk of hemorrhage or increasing the risk of thromboembolism (eg, venous, arterial) after discontinuing treatment.
How long does it take for a blood clot to go away with blood thinners? ›Symptoms typically improve within a few days of starting the anticoagulant. Most patients with DVT or PE recover completely within several weeks to months without significant complications or long-term adverse effects.
How long should eliquis be held before surgery? ›ELIQUIS should be discontinued at least 48 hours prior to elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically significant bleeding.
What makes you high risk for blood clots after surgery? ›The main reason you're at an increased risk of developing DVT after surgery is because of your inactivity during and after the surgery. Muscle movement is needed to continuously pump blood to your heart. This inactivity causes blood to collect in the lower part of your body, generally the leg and hip regions.
What surgery causes the most blood clots? ›While a clot can form after any type of procedure, you're more likely to get one if you've had major surgery, particularly on your abdomen, pelvis, hips, or legs. Some specific operations that come with a high risk for DVT and PE are: Knee or hip replacement. Peripheral and coronary artery bypass.
Who is at high risk for blood clots after surgery? ›Deep vein thrombosis can develop after any major surgery. People who have surgery on the legs and hip are especially at risk. A pulmonary embolism is a blood clot that breaks free and travels through the veins. If it reaches the lungs, it can block the flow of blood to the lungs and heart.
What are the three contraindications to the use of anticoagulants? ›Contraindications to anticoagulation used to define the contraindication group were: haemorrhagic stroke, major bleeding (gastrointestinal, intracranial, intraocular, retroperitoneal), bleeding disorders (haemophilia, other haemorrhagic disorders, thrombocytopenia), peptic ulcer, oesophageal varices, aneurysm, or ...
What blood thinners should be stopped before surgery? ›
Typically Coumadin must be discontinued for 5 days prior to surgery. Heparin and LOVENOX must be discontinued 24 hours prior to surgery. However, do not discontinue these medications before consulting your primary care provider or the pharmacists in the Warfarin clinic.
What should patients on anticoagulants avoid? ›Anticoagulants and Herbal Supplements or Vitamins
Herbs and vitamins can interact with anticoagulant medication. Remember, consistent use of a multivitamin with low doses of vitamin K. Avoid vitamins that contain high doses of vitamin K and E. Fish oil may increase the INR level.
Once target anticoagulation is achieved, anticoagulation labs are monitored once daily. Patients on anticoagulant therapy must be educated about their increased risk for bleeding, monitoring for bleeding, managing bleeding if it occurs, and drug-specific information.
What special precautions should be taken with patients who are on anticoagulants? ›This medicine may increase your chance of bleeding. Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Avoid picking your nose. If you need to blow your nose, blow it gently.
What should you assess before giving anticoagulants? ›Prior to initiating anticoagulants in clients – assess baseline clotting factors, INR, or for signs and symptoms of bleeding prior to administration.
When do you stop oral anticoagulants before surgery? ›Discontinue at least 48 hours before elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically significant bleeding. Discontinue 2–3 days prior and bridge with unfrac-tionated heparin if the risk of thrombo-embolism is high.
How long should Xarelto be stopped before surgery? ›Stop XARELTO® at least 24 hours before the procedure. In deciding whether a procedure should be delayed until 24 hours after the last dose of XARELTO®, the increased risk of bleeding should be weighed against the urgency of intervention.
What is the risk of stopping eliquis for surgery? ›Surgery and invasive medical procedures can increase the risk of serious bleeding. Stopping blood thinners can increase your risk for blood clots, due to the underlying risk factor(s) for which your blood thinner was originally prescribed.
Can you have surgery if you are on blood thinners? ›For many minor procedures, including dental procedures, the bleeding risk from continuing blood thinners is fairly small. For some other procedures, the risk of bleeding may be higher when blood thinners are continued. Examples are certain hip and colon procedures.