Venous thromboembolism

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Types

Clinical Spectrum of Venous thromboembolism

Only 40% of ambulatory ED patients with PE have concomitant DVT[1][2]

Prevention

Chemical Prophylaxis of VTE

  • Lovenox 30mg SubQ q12 hrs (if Cr Clearance > 30)
    • Check Anti-Xa level every week EXACTLY 4 hours after 3rd dose of lovenox
      • prophylactic goal: 0.2-0.6
      • therapeutic goal: 0.6-1.2
  • Recheck AntiXa level after each 3rd dose if dose is changed until you are at goal
  • Recheck level every week (usually qMonday) for all patients
  • If renal dysfunction order heparin 5000 Units SubQ q8 hrs (search “SURG DVT/VTE prophylaxis” order set)

See Also

External Links

References

  1. Righini M, Le GG, Aujesky D, et al. Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial. Lancet. 2008; 371(9621):1343-1352.
  2. Daniel KR, Jackson RE, Kline JA. Utility of the lower extremity venous ultrasound in the diagnosis and exclusion of pulmonary embolism in outpatients. Ann Emerg Med. 2000; 35(6):547-554.