Anticoagulant treatment during travel

doi:10.1136/bmj.330.7486.292

BMJ 2005;330:292 (5 February), doi:10.1136/bmj.330.7486.292

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Anticoagulant treatment during travel

The first 150 words of the full text of this article appear below.

How do you manage a patient who has been taking warfarin lifelong and wants to go on a three month, round the world, cruise?Her international normalised ratio is reasonably stable, butshe normally has to be retested every five to six weeks.

Richard J Young, general practitioner

Paston Surgery, Norfolk

I am by no means an expert in haematology or travel medicine,but I suspect your patient is not the first to try and leavethese civilised shores while taking an anticoagulant, so theremust be a solution. The ship's doctor can presumably take blood,and, though possibly not having a haematology laboratory onboard, may be able to get the bloods tested when the ship docks.Alternatively, you could give your patient a suitcase full oftreatment dose tinzaparin or enoxaparin.

John F Bolton, urology specialist registrar

Calderdale Royal Hospital, Halifax

There are several self managed anticoagulation systems availablein Britain. The one I'm familiar with is by Roche. The testingis similar to that . . . [Full text of this article]

Andrew Duncan Muir, cardiac surgery specialist registrar

Royal Victoria Hospital, Belfast

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