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    Clinical Diagnosis of

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    Nor Shuhada Haron
    The document discusses various methods for preventing venous thromboembolism (VTE) in hospitalized patients, including mechanical methods like anti-embolism stockings and intermittent pneumatic compression devices as well as pharmacological options like unfractionated heparin, low molecular weight heparins, and oral anticoagulants. It provides guidance on properly fitting and using anti-embolism stockings, administering different pharmacological prophylaxis drugs, and continuing prophylaxis treatment for an appropriate duration based on a patient's risk level and recovery from illness or surgery.

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    Clinical Diagnosis of

    Uploaded by

    Nor Shuhada Haron
    19 views14 pages
    The document discusses various methods for preventing venous thromboembolism (VTE) in hospitalized patients, including mechanical methods like anti-embolism stockings and intermittent pneumatic compression devices as well as pharmacological options like unfractionated heparin, low molecular weight heparins, and oral anticoagulants. It provides guidance on properly fitting and using anti-embolism stockings, administering different pharmacological prophylaxis drugs, and continuing prophylaxis treatment for an appropriate duration based on a patient's risk level and recovery from illness or surgery.

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    The document discusses various methods for preventing venous thromboembolism (VTE) in hospitalized patients, including mechanical methods like anti-embolism stockings and intermittent pneumatic compression devices as well as pharmacological options like unfractionated heparin, low molecular weight heparins, and oral anticoagulants. It provides guidance on properly fitting and using anti-embolism stockings, administering different pharmacological prophylaxis drugs, and continuing prophylaxis treatment for an appropriate duration based on a patient's risk level and recovery from illness or surgery.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    19 views14 pages

    Clinical Diagnosis of

    Uploaded by

    Nor Shuhada Haron
    The document discusses various methods for preventing venous thromboembolism (VTE) in hospitalized patients, including mechanical methods like anti-embolism stockings and intermittent pneumatic compression devices as well as pharmacological options like unfractionated heparin, low molecular weight heparins, and oral anticoagulants. It provides guidance on properly fitting and using anti-embolism stockings, administering different pharmacological prophylaxis drugs, and continuing prophylaxis treatment for an appropriate duration based on a patient's risk level and recovery from illness or surgery.

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    Clinical diagnosis of

    VTE Prophylaxis
    • Mehanical
    • Pharmacological
    Mechanical prophylaxis
    • Mechanical methods may also be combined with
    pharmacological prophylaxis to increase efficacy in
    high-risk patients.
    • Do not increase the risk of bleeding, mechanical
    methods may be preferred in patients at increased risk
    of bleeding from pharmacological prophylaxis.
    • Eg
    Anti-embolism stockings (thigh or knee length)
    Intermittent pneumatic compression devices (thigh or
    knee length).
    Anti embolism stocking
    • Anti-embolism
    compression stockings
    are commonly referred
    to as TED hose
    • They are used to
    support the venous
    and lymphatic drainage
    of the leg.
    Pre-caution
    • Ensure that patients who need anti-embolism stockings have their legs
    measured and that the correct size of stocking is provided. Anti-embolism
    stockings should be fitted and patients shown how to use them by staff
    trained in their use.
    • Use anti-embolism stockings that provide graduated compression and
    produce a calf pressure of 14–15 mmHg
    • Encourage patients to wear their anti-embolism stockings day and night
    until they no longer have significantly reduced mobility.
    • Remove anti-embolism stockings daily for hygiene purposes and to inspect
    skin condition. Inspect the skin two or three times per day.
    • Discontinue the use of anti-embolism stockings if there is marking,
    blistering or discolouration of the skin, pain or discomfort.
    Intermitten pneumatic device
    • Technique to prevent
    thrombosis in bedridden
    patients. It uses an inflatable
    device that squeezes the calf
    when it inflates, preventing
    pools of blood forming
    behind the valves in the
    veins, thus mimicking the
    effects of walking.
    Pharmacological
    • These include:
    Standard unfractionated heparin (usually in
    low dosage)
    Low molecular weight heparins or heparinoids
    Oral anticoagulants
    Dextran 70
    Unfractionate heparin LMW heparin/heparinoid Oral anticoagulant

    •SC in a dose of 5000U •SC for prophylaxis of VTE. •The recommended


    every 12 hours after the therapeutic range is 2.0 to
    surgery. •They are effective as 2.5
    once-daily injections
    • Meta-analyses have •Used when heparin is
    revealed that low dose •LMWH is less likely to contraindicated
    heparin reduces the produce heparin-induced
    incidence of all DVT and thrombocytopaenia and •require daily monitoring
    PE. osteoporosis than (INR) or the prothrombin
    unfractionated heparin time.
    Surgical patient
    • Advise patients to consider stopping oestrogen-containing
    oral contraceptives or hormone replacement therapy 4 weeks
    before elective surgery. If stopped, provide advice on
    alternative contraceptive methods.
    • Consider regional anaesthesia for individual patients, in
    addition to other methods of VTE prophylaxis, as it carries a
    lower risk of VTE than general anaesthesia.
    • Extend pharmacological VTE prophylaxis to 28 days
    postoperatively for patients who have had major cancer
    surgery in the abdomen or pelvi
    DURATION OF PROPHYLAXIS

    1. Specific antithrombotic prophylaxis should be continued for


    at least 5 days or until hospital discharge if this is earlier than
    5 days.
    2. In high-risk patients, prophylaxis should be continued until
    illness and immobility have resolved, or until hospital
    discharge if this is earlier.
    3. After hospital discharge, increased risk of VTE may continue
    for several weeks in patients with continuing risk factors .In
    such patient, consideration should be given by the doctor to
    continue prophylaxis after discharge.
    4. If the hospital team recommends prophylaxis after discharge,
    they should communicate with the patient prior to discharge.

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