Case managing heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia (HIT) and its two subtypes, early onset (Type I) and delayed onset (Type II), are becoming an increasing concern in acute care. Also called "white clot syndrome," this condition can lead to thrombosis and loss of limb. Alternatives to heparin therapy, such as low molecular weight heparin, are discussed as ways to decrease HIT. An algorithm has been developed to guide identification and monitoring of patients at risk for HIT. The article presents the expanded role of the clinical nurse specialist as case manager in clinically managing patients with actual or potential HIT. The case manager's role for patients receiving heparin lies in increasing the awareness of this condition among all clinicians and serving as a resource for current information regarding its prevention, diagnosis, and treatment.