FIELD REFERENCE
Full criteria & treatment guidance
Indications
- Continuation of the sending clinician’s prescribed heparin infusion during authorized IFT under PR-220; not field initiation.
Contraindications & local exclusions
- Cited injection label: prior HIT/HITT, heparin/pork hypersensitivity, inability to perform appropriate coagulation testing during full-dose therapy, or uncontrolled active bleeding (except bleeding due to DIC).
Precautions
- PR-220 requires stopping for bleeding/hemorrhage, SBP below 90, or a fall greater than 20 mmHg from baseline, with transport to an appropriate ERC. Verify prescribed rate, pump, records and patient status.
- These are selected safety checks, not a complete prescribing monograph. Product labeling and OCEMS authorization answer different questions; confirm the actual product, patient population and applicable order.
Scope & authority
- This is continuation/monitoring authority during an authorized IFT, not routine 9-1-1 heparin administration.
- Bleeding and falling BP require action under the procedure.
Adult / adolescent
- PR-220 addresses a pre-existing heparin infusion. Obtain the prescribed rate, bleeding history, and relevant transfer records from the sending RN/physician.
- Use a working infusion pump at the sending facility’s prescribed rate. The procedure does not provide an independent field loading dose or titration schedule.
Pediatric
- OCEMS does not list a separate pediatric dosing regimen. A pediatric transfer needs the sending team’s explicit order and appropriate transport authorization; do not weight-scale an adult heparin infusion from this page.
Pediatric dosing availability
- Use the sending team’s patient-specific transport order and authorized scope. OCEMS does not provide an independent pediatric initiation regimen for transport medications.
| Weight | OCEMS pediatric dose |
|---|---|
| Any weight | No general OCEMS pediatric dose is listed; follow the applicable order or medical direction. |
Use, monitoring & documentation
- Secure the vascular access and verify the pump. Continuously observe vital signs, rhythm, and bleeding.
- Stop the infusion and transport to the nearest appropriate ERC for bleeding, systolic BP below 90, or a systolic decrease greater than 20 mmHg from the initial measurement, as directed by PR-220.
- Document the ordered rate, monitoring, any stop time/reason, and the patient’s condition at transfer of care.
VISUAL FIELD REFERENCE
IFT heparin: maintain, monitor, stop when indicated
Adult & pediatric scope · IFT-ALS
Pre-existing infusion during authorized interfacility transport.
Maintain the sending facility’s rate
Use a working infusion pump at the sending facility’s prescribed rate. The procedure does not provide an independent field loading dose or titration schedule.
Observe vital signs, rhythm, and bleeding
Secure the vascular access and verify the pump. Continuously observe vital signs, rhythm, and bleeding.
Stop and route to an appropriate ERC
Stop the infusion and transport to the nearest appropriate ERC for bleeding, systolic BP below 90, or a systolic decrease greater than 20 mmHg from the initial measurement, as directed by PR-220.
- This is continuation/monitoring authority during an authorized IFT, not routine 9-1-1 heparin administration.
Selected checkpoints; read the complete guide for criteria, exclusions, doses, and ongoing care. PR-220
UNDERSTAND THE CARE
Why a transport infusion is a reconciliation task
The transport team is continuing a prescribed therapy under a specific authorization. Reconcile the written order with the bag or syringe label, pump settings and connected line before departure. A generic drug-reference dose cannot replace the sending team’s patient-specific infusion instructions.
Applying the guidance
Keep the stop criteria available throughout transport and document baseline findings, the prescribed rate and any change or concern. Communicate bleeding, line or pump problems and the action taken under the procedure. Pediatric treatment is not created by scaling an adult infusion example; it remains governed by the treating team and authorized transport scope.
Diagram text & teaching checkpoints
- Order
- Patient-specific prescribed continuation.
- Reconciliation
- Label, concentration, pump and line agree.
- Monitoring
- Bleeding and the procedure’s stop criteria.
- Handoff
- Rate, amount, events and actions taken.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.
Resolve the infusion discrepancy before departure
Use the sending clinician’s order, the labeled solution and the pump display together. If the prescribed rate and the pump disagree, the receiving transport team should clarify the discrepancy with the sending RN or physician before treating either value as the intended order. A prior transport with a familiar concentration is not sufficient evidence for this patient.
PR-220 specifically calls for asking about the prescribed infusion rate and known bleeding, obtaining pertinent records, and ensuring secure access and a working pump. Include the baseline blood pressure in that reconciliation because the procedure uses change from baseline as well as an absolute pressure threshold.
For example, a patient’s pressure may still be above the absolute stop threshold while its fall from the initial measurement meets the separate change criterion. Assess both conditions and use the procedure’s action. At handoff, communicate the prescribed rate, whether the infusion remains running, any interruption time and reason, and the patient’s bleeding and perfusion findings.
Source: Monitoring Heparin Infusion during Interfacility Transports.