Evidence-based guidelines recommend that
heparin-induced
thrombocytopenia (HIT) should be suspected whenever a patient develops
thrombosis or
thrombocytopenia 5 to 14 days after
heparin initiation. The authors determined how frequently emergency department (ED) physicians document HIT risk assessment in patients presenting with
thrombosis. Relevant data were extracted from the ED charts of 134 patients with venous or arterial
thrombosis. Documentation (ie, notation of positive or negative findings) existed for recent
heparin exposure in 7 (5.2%) of 134 charts, recent hospitalization in 33 (24.6%), history of
thrombocytopenia in 0 (0%), and history of
thrombosis in 62 (45.5%). Of 35 patients administered
heparin in the ED, the preheparin platelet count was available for 19 (54.3%) and old records for 5 (14.3%). Thus, HIT risk assessment frequently remains undocumented for ED patients with
thrombosis, including those administered
heparin. Approaches to increase HIT awareness and facilitate HIT risk assessment and documentation in the ED may be needed.