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Screening for HIT

• Due to the significant morbidity and mortality associated with the fully developed disorder, it is essential that the diagnosis be considered in all patients receiving all forms of heparin, at any dosage and by any route.



• Routine monitoring of the platelet count is the cornerstone of surveillance. All patients should have a count recorded before the initiation of heparin therapy to serve as a baseline value.



• However, as the frequency of the disorder varies greatly depending on patient, product and dosage variables, it is not cost effective to initiate continuous and frequent platelet monitoring in all patients.



• The American College of Chest Physicians has recently issued carefully considered guidelines based on a wide body of published experience in the field¹⁸ (Table 1 below is adapted from their recommendations).



• In the UK the BSH published their guidelines in January 2006.

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