Corona Virus (Covid-19) Blood Clots and other helpful information.
THE NEW ANTICOAGULATION UK PODCAST SERIES
In the first in our podcast series 'Beyond the Blood Clot' we discuss issues surrounding anticoagulation and the Coronavirus. Hosted by Eve Knight, the CEO and Co-founder of the charity Anticoagulation UK, Eve is joined by Helen Williams, National specialty advisor for cardiovascular disease for NHS England.
Anticoagulation and the Coronavirus: Your questions answered
During this uncertain time, Anticoagulation UK will be providing and sharing information and resources.
Please, stay at home to stop coronavirus spreading. If you need medical help for any reason, do not go to places like a GP surgery, pharmacy or hospital. If you have symptoms of coronavirus (a high temperature or a new continuous cough), use the 111 on-line coronavirus service. If your condition worsens and you have difficulty breathing use the 111 telephone service or dial 999.
Clinical guide for the management of anticoagulant services during the coronavirus pandemic
As healthcare professionals we all have general responsibilities in relation to coronavirus and for these we should seek and act on national and local guidelines. We also have a specific responsibility to ensure that anticoagulant care continues with the minimum burden on the NHS. We must engage with management and clinical teams planning the local response in our hospitals and across primary care.
New guidance has been issued for safe switching of patients on warfarin to direct oral anticoagulants (DOACS) for patients with non-valvular AF and venous thromboembolism (DVT/PE) during the coronavirus pandemic.
- Suggested process for safe switching from warfarin to a DOAC (Undertake steps remotely where possible)
- Pragmatic Approach to Stopping Warfarin and Starting DOAC in relation to the INR
- DOAC counselling checklist
Corona Virus and Self-testing for Warfarin Patients
Due to the COVID 19 situation, hundreds of warfarin patients are getting in touch with ACUK and posting on our Health Unlocked social platform asking if they can self-test and how they can get a monitor.
ACUK does not have any supplies of the hand held monitors and these devices are currently not available on the NHS Tariff and have to be purchased directly from the manufacturer, Roche Diagnostics telephone number 0808 1007666. We strongly suggest you do not purchase from any third party advertising on the internet as its likely the price will be inflated greatly.
Guidance for GPs - Anticoagulation during Covid-19 outbreak
The British Society of Haematology, Heamostasis and Thrombosis Task Force released a statement on 26th March 2020 with key points:
- INR is an essential component of safe anticoagulation that cannot be omitted due to social distancing
- Assess whether a DOAC can be used instead of warfarin. Exclusions are
- Mechanical heart valves
- Antiphospholipid syndrome
- Renal failure with creatinine clearance below 15mls/min
- Patient requiring high range INR
- Concomitant use of medication that interacts with DOAC
- If a DOAC is an option consider switching in line with patient's informed consent
- If people have a high TTR then the interval between testing could be extended to 8-10 weeks
- If people have to self-isolate then the INR can be deferred until after self isolation