- Guidance - VTE
Link:www.nice.org.uk/guidance/cg92/resources/guidance-venous-thromboembolism-reducing-the-risk-pdf
- Patients at risk
- Medical
- Mobility reduced for >/= 3/7
- Ongoing reduced mobility plus any risk for VTE
- Surgical
- Anaesthetic + Surgical time >90 mins
- Pelvic/Lower limb surgery and combined time >60 mins
- Acute surgical admission with inflammatory/intra-abdominal condition
- Significant reduction in mobility
- Any VTE risk factor present
- Advice
- Patient having elective surgery
- Stop COCP/HRT 4/52 prior to surgery
- Assess risk/benefit of stopping antiplatelet medication
- Plan anaesthesia
- All patients
- Admission
- Assess risks and benefits
- During ward based care
- Before discharge
- Patients discharged with VTE prophylaxis
- Risks for bleeding
- Active bleeding
- Acquired bleeding disorder (eg liver failure)
- LP/Epidural/Spinal in previous 4 hrs
- Acute stroke
- Thrombocytopenia
- Uncontrolled hypertension (>230/120)
- Inherited bleeding disorders
- Risk factors for VTE
- Cancer/Cancer treatment
- Age >60
- Critical care admission
- Dehydration
- Thrombophilias
- BMI >30
- Significant medical co-morbidity
- HRT
- Hx of TED or 1st degree relative with VTE
- VVs with phlebitis
- COCP