Table 10. Protocol for managing anticoagulation during procedures/surgeries (5 plans)

PLAN	PROTOCOL		DAYS OF INADEQUATE ANTICOAGULATION *
1	Continue warfarin		0
2	Hold warfarin	With Pre and Post procedure heparin	1
3	Hold warfarin	With Post procedure heparin	3-4
4	Hold warfarin	With Pre procedure heparin	4-6
5	Hold warfarin only		6-8

* = Minimal days

• #2-#4 = Bridging therapy = use heparin while holding warfarin,The availability of the low molecular weight heparin (LMWH) makes it convenient to use full dose heparin as an outpatient. Remember that the LMWH has a longer half-life than the unfractionated heparin (UFH).
• For more urgent surgery, please review Section "Managing High INR or Bleeding." "8. Patient who requires more rapid or urgent INR reversal before procedure/surgery".