59MDWI44-139 — Anticoagulation Management Protocol

59MDWI44-139 governs the 59th Medical Wing’s anticoagulation management program and therapy at the WHASC Anticoagulation Clinic.

Search 59MDWI44-139

  • Publication number: 59MDWI44-139
  • Title: ANTICOAGULATION MANAGEMENT PROTOCOL
  • Date: 2021-09-02

View 59MDWI44-139 on armypubs.army.mil


It covers referral, warfarin therapy, patient education, class preparation, clinical assessment, dosing, and INR testing intervals. The publication requires compliance with its anticoagulation management standards and defines related staff duties.

Applies to: This instruction applies to all cardiology and pharmacy personnel involved in anticoagulation therapy management.

Topics covered

  • Anticoagulation class preparation
  • Warfarin therapy
  • Patient education
  • Encounter assessment
  • Anticoagulant dosing
  • INR testing intervals
  • Anticoagulation-related complications

Questions and answers

How many new patients can be scheduled for one anticoagulation class?

A maximum of 8 new patients will be scheduled per anticoagulation class. (paragraph 1)

What should new patients bring to anticoagulation class?

Instruct patients to bring all current medications to class. (paragraph 1)

How soon must new patient consults be received?

All new patient consults must be received within 24 hours of the scheduled class date. (paragraph 1)

What is the standard starting dose for warfarin?

The standard starting dose for warfarin is 5 mg. However, starting doses such as 2.5 and 10 mg may be used in select patients. (Attachment 2). (paragraph 4)

When should new patients have an INR obtained after starting warfarin?

For new patients, or patients who had warfarin interruption, an INR should be obtained within 3-5 days after starting warfarin to assess initial response. (paragraph 4)

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