DVT / VTE Prophylaxis
Low Risk: 
 - Ambulatory
 ...
236
Description

DVT / VTE Prophylaxis

Low Risk: 

 - Ambulatory

 - Estimated LOS <48 hr

 - Not meeting moderateor high-risk criteria

Moderate Risk: 

 - Major surgery (>45 min, not craniotomy, ortho, spine, or for cancer)

 - Acute illness; immobility w/ est LOS >48h

 - H/o VTE, thrombophilia (incl. hormone tx)

 - Active malignancy

High Risk:

 - Major surgery (craniotomy, ortho, spine, or for cancer)

 - Critical illness in ICU

 - 2+ moderate risk factors

30 / 30 / 30 Rule:

 • Pharmacologic prophylaxis: can be administered if platelets >30K

 • Mechanical prophylaxis: SCD boots should not be off the pt for >30% of the day

 • Ambulation: pts should ambulate 30 min/shift (60 min/day)

Pharmacologic prophylaxis options:

 • Enoxaparin (lovenox): 40 mg SC daily, default in patients with CrCl >30 and BMI <40

 • Heparin (UFH): 5,000 units SC Q8H-Q12H, preferred in patients with CrCl <30 or BMI >40

     - Q8H dosing preferred in hospitalized cancer patients, as Q12H dosing is less effective

 • Fondaparinux: 2.5 mg SC daily (can be used if concern for HIT)



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MGH White Book Manual
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Account created for the MGH Internal Medicine Housestaff Manual "White Book" - https://stk10.github.io/MGH-Docs/WhiteBook-2019-2020.pdf
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