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Your patient weighs 96 lb. The doctor orders Heparin for the patient, a bolus of 60 units/kg to be pushed over 5 minutes and an infusion to run 14 units/kg/hr. You have Heparin Sodium with a concentration of 800 units/mL available for the bolus. For the infusion you have bags with 25,000 units of Heparin in 1000 mL D5W.

In addition, every six hours the patient’s blood will be tested for clotting time, and the aPTT result will be determined. Here is the heparin protocol to be used.

aPTT Result

Bolus Dose

Hold time (min) for Infusion

Change to Infusion Rate


Less than 55

15 units/kg

No hold

Increase 4 units/kg/hr



10 units/kg

No hold

Increase 2 units/kg/hr



5 units/kg

No hold

Increase 1 unit/kg/hr



No bolus given

No hold

No Change



No bolus given

No hold

Decrease 1 unit/kg/hr



No bolus given


Decrease 2 unit/kg/hr



No bolus given


Decrease 3 units/kg/hr


More than 140

No bolus given


Decrease 5 units/g/hr



Question: At what rate to set the initial IV infusion.


available: 25,000 units in 1000 mL D5W

units per mL = 25000 units/1000 mL = 25 units/mL

14 units/kg/hr: for 43.6 kg = 610 units/hr.

610 units/hr(25 units/mL/) = 24.4 mL/hr.

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