DVT Prophylaxis

Last updated 26.09.12

 

Index

 

Rationale

-  Prevention of DVT & therefore PE

 

Features

-  Combination of mobility, anticoagulation & compression stockings

-  Should be considered for all in-pts

 

Anticoagulation

-  Duration

-  Until fully mobile

-  Surgical ptsPre-Op

-  Needs to be ceased 6hrs prior to Sx

-   12hrs if for epidural/spinal

-  If unsure of time of Sx or likely delayed consider to start on Enoxaparin

-  If pt on Warfarin on admission & for Sx --> W/H & either

-   Start Enoxaparin until INR is <1.5 OR

-   Reverse Warfarin w Vitamin K

-  If on Clopidogrel/Aspirin start on Enoxaparin as pt most likely will be delayed 3-4/7 prior to major Sx

-  Surgical ptsPost-Op

-  Commence Enoxaparin 6hrs post-op if nil bleed/high risk & obs stable

-   12hrs if epidural/spinal

-  Medical pts

-  For pts w prolonged admissions

-  Immobile patients

 

Stockings

-  TEDS (Thrombo-Embolus Deterant Stockings) or Graded Compression Stockings (GCS)

-  Decreases venous pooling in lower limb

-  Most compression at ankle then tapers

-  Various lengths: from ankle to knee, thigh or hip