Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Bleeding vs. clotting risk - When is heparin bridging appropriate?Hi all, I am just a simple-minded EMT, trying to understand this concept for a family member who recently underwent surgery.The family member has chronic a-fib, which has been well managed with warfarin. He needed a trans-urethral resection of a bladder tumor (TURBT). His cardiologist said he should not be off warfarin for more than 72 hours, and his urology surgeon said to stop the warfarin 48 hours in advance of the surgery (meaning the plan was to resume the warfarin 24 hours after surgery). After the surgery, the surgeon said he was not able to cauterize all of the 'wound' (I am not sure the correct term here), so my family member had a good amount of hematuria, though the surgeon said it was not a life-threatening amount.He was supposed to take aspirin after being discharged, but they ended up admitting him due to a good amount of clotting in the bladder, which required daily irrigation. I am not sure if the nurses ever ended up giving him aspirin or heparin while he was off the warfarin. The surgeon seemed very concerned about the bleeding, and said that my family member could not go back on his blood thinners for another 48 hours after the initially planned resumption (which would result in a total of 5 days off the blood thinners).Now my question is, isn't it easier to fix a bit of bleeding than a blood clot (which could cause CVA, AMI, or PE)? Wouldn't it be better to keep him on blood thinners and handle the bleeding, than to risk a deadly clot?We would ask his surgeon, but it's sort of a foregone conclusion at this point as my family member has already been discharged. So, this is just for my personal education. Thanks for your insight.. ### Response: isn't it easier to fix a bit of bleedingGeneral surgeon here. No, it's not always easier. Sometimes the tissues are just oozy, and you can't just throw a simple suture in or cauterize it and make it stop. Sometimes, the more you cauterize something thats oozy and inflamed, the more it oozes and bleeds on you. Sometimes, you just need to let the body do its thing and form a clot. So either you stop blood thinners for as small a window as possible, and accept the risk of developing a clot elsewhere, or you keep them on blood thinners and just let them ooze and ooze and ooze, potentially requiring blood transfusions, which then opens them up to other risks. Others may have other viewpoints, but this is from a surgical view..