VTE Flashcards
(30 cards)
Define hospital acquired VTE
VTE within 90 days of hospital admission
Symptoms of DVT
Unilateral leg swelling/pain
Skin hot to touch
Vein distension
Skin changes
Symptoms of PE
Haemoptysis
SOB
Chest pain
RF for VTE
IBD
Surgery
Trauma
Hormonal contraception or HRT
Postpartum or pregnancy period
Significant immobility
Obesity
Malignancy
Inherited hypercoagulable states
Bleeding risk factors
Thrombocytopenia (Platelets <75)
Liver failure/disease
Inherited bleeding disorders
Active bleeding
Surgery with a high bleeding risk
Anticoagulants concurrent use
Acute stroke
Clotting risk factors
Age >60
Active cancer
Dehydration
Immobility
Use of HRT/ contraception
Undergoing hip/knee surgery
Which patients should anti-embolism stockings be avoided in?
Peripheral oedema
Peripheral arterial disease
Peripheral neuropathy
Acute stroke
Local conditions e.g., gangrene
When is it advised Pharmacological prophylaxis should be started within for an inpatient?
Within 14 hours
When should VTE prophylaxis be offered to a patient already on anticoagulation?
If there is an interruption to their therapy e.g., peri-operative
When should mechanical prophylaxis be offered to a patient?
When there is both a bleed and a clot risk
For surgical patients
How long should mechanical prophylaxis be continued for if indicated for a patient?
Until mobile, or discharged, or if elective spinal or cranial surgery, or spinal injury then 30 days
Minimum days recommended for pharmacological prophylaxis if indicated?
7 days
How long should pharmacological prophylaxis be extended to for major cancer surgeries?
28 days
How long should pharmacological prophylaxis be extended to for spinal surgeries?
30 days
What pharmacological prophylaxis is indicated in acute stroke?
IPCs to be started within 3 days of stroke and continued for for up to 30 days/ until mobile
Pharmacological prophylaxis options post elective hip replacement surgery?
10 days of LMWH, followed by 28 days of low-dose Aspirin OR
28 days LMWH w/ mechanical prophylaxis OR
Rivaroxaban
Pharmacological prophylaxis options post elective knee replacement surgery?
14 days of low-dose Aspirin w/ mechanical prophylaxis OR
14 days of LMWH OR
Rivaroxaban
Which DOACs should be taken with food to aid absorption?
Rivaroxaban 15mg and 20mg
Apixaban DVT/PE dosing
10mg BD for 7 days, followed by 5mg BD maintenance
Rivaroxaban DVT/PE dosing
15mg BD for 21 days, followed by 20mg OD maintenance
Dabigatran PE/DVT dosing
LMWH for 5/7, followed by 110-150mg OD Dabigatran dependent upon weight
Edoxaban PE/DVT dosing
LMWH for 5/7, followed by 30-60mg of Edoxaban dependent upon weight
Warfarin PE/DVT dosing
LMWH + Vitamin K antagonist for 5 days or until INR 2 with two consecutive readings, followed by vitamin K antagonist on its own
Duration of anticoagulation in patients with an unprovoked VTE?
Consider reviewing at 6 months
