Hospital Medicine   

Is there any evidence supporting the use of heparin boluses?

Considering the short half-life, at what point would it be deemed too late to administer any reversal agent, and to consider withholding it?

In light of ANNEXA-I RCT results: Connolly et al., PMID 38749032.

Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

Solid tumor patients, other hematologic malignancies, patients with autoimmune diseases on immunosuppressive therapy? Do you consider workup if they a...

High-risk PEs are typically treated with loading doses of anticoagulants or bridging with LMWH. Do you omit the bridging/loading period and go straigh...

When would you consider using anticoagulation and for how long?

If they have been on IV heparin for 3 days, for example, would you subtract those days from the recommended loading dose time?

Is parasitemia >10% and severe hemolysis with Hb less than 7 enough to initiate this?

Assume thrombolytics are not indicated. Do you favor early DOAC transition after 24-48 hours of heparin gtt or do you favor LMWH for 10-14 days follow...

Are there specific mass features that would influence your treatment decision?

Is it different than early mobility that we always encourage?

Practice is variable in the community, with some hematologists frequently prescribing ESAs for severe anemia that is mostly inflammatory. Do the risks...

If hydroxyurea modifies the course of sickle cell disease by increasing fetal hemoglobin, is there any benefit to using it in patients with fetal hemo...

E.g. in a patient with tenuous cardiac function, would starting treatment several weeks earlier potentially improve outcomes?

Please comment on temperature recommendations and role of exchange transfusion. 

What is your preferred agent (DOAC, warfarin, enoxaparin), and is periprocedural bridging necessary?

Please specify your approach in elective and emergency surgical situations

If not, what instructions do you give to patients regarding checking temperature at home/return precautions?

e.g. DITP from eptifibatide after a cardiac intervention

How does cirrhosis and/or underlying thrombophilia affect your decision?

Does manipulation of blood products (leukoreduction, irradiated) affect your approach? There is growing evidence that routine premedication (at least ...

What are your target goals during transfusion, either prophylactically or during acute complication? Does your management change between vaginal deliv...

The use of anti-fibrinolytics is typically contraindicated in DIC, but does it have benefit in DIC states characterized by hyperfibrinolysis?

Does having a concurrent consumptive process e.g. DIC change your management? 

Do you always treat with the full 21-day treatment course, or can defibrotide be stopped if certain criteria are met sooner?

Especially in a triple-positive patient with an acute ischemic stroke who may have urgency for anticoagulation with high bleeding risk and severe thro...

How do you manage an uncomplicated DHTFR versus a hyperhemolysis?

Should we use a different dose in critically ill patients in the ICU? When should we consider intermediate-dose anticoagulation?

Would you offer this routinely or only if specific complications arise, such as distal emboli?

CT scans show omental and pelvic disease.

I.e., Can day 2 Rituximab (RCHOP) or day 6 Rituximab (DA-EPOCH, Hyper CVAD) be given? Or should only Day 1 Rituximab be used with chemoimmunotherapy i...