Flashcards in 3 Anticoagulation - Consultant Deck (23):
Symoptoms of DVT
if patient has eGFR
High risk surgeries include
Orthopadedic, hip and knee replacement, gynacological
After surgery continue thromboprophylaxis until
mobile or discharge
commonest way to diagnose a DVT?
colour duplex scan
how to diagnose PE?
Perfusion scan (cannot see on xray)
Wells score tells us (DVT)
Which patients to scan and not
Likelyhood that pt is having a DVT
>2 is high
Wells score catagories (DVT):
Paralysis/ recent plaster
Tenderness along deep veins system
Entire leg swollen
D dimer levels indicate
....clotting is occurring
D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis
What does the D-dimer test tell us?
Negative - rules out DVT
High - further testing required
Which first: D-dimer or wells score?
When to use D-dimer test?
When the risk is low to EXCLUDE DVT
Well's score (PE) catagories:
Symptoms of PE
Alternative diagnosis less likely
Heart rate >100
Immobilisation in past 4 weeks
High >6 **** Moderate 2-6 **** Low
Learn coagulation cascade slide
two types of heparin
Route of admin of
UFH - IV/SC
LMWH - SC only
Which heparins require monitoring
UFH - yes - vital
LMWH - no usually
Cost of heparins
UFH - low
LMWH - high
Which heparin has greater
LMWH - antiXa
UFH - antithrombin
What do you monitor in UFH?
-Heprain (antifactorXa) assay is used in specialsed cercumstances (preg,paeds,renal fail)
How often to meaure APTT
every 4h to start then every 6.
Why do we try to avoid UFH?
monitoring is intensive