The timing and duration of anticoagulation therapy in patients with epidural catheters is critical to prevention of epidural hematomas.

Daily epidural catheter assessments are important for identifying potential complications including epidural hematoma, abscess formation, and catheter dislodgement.

This case report presents a scenario where systemic anticoagulation was emergently initiated for ECMO in a patient with an epidural catheter, and due to the nature of the patient’s critical clinical condition, could not be assessed or removed for the duration of the therapy.