4. Use approved Heparin PowerPlan or in the event of CPOE downtime, use VCMC 345-066 order form. Exclusion Criteria: 1. Do not initiate on patient with epidural catheter. 2. Do not initiate on patient with platelets <50,000 or PTT>79 seconds. 3. Do not initiate on patients with suspected or proven DIC, TTP or HIT. Dosing: 1..