Download VTE Template

VTE Guidance Template
[Specialist Society]
The consensus views of the [Specialist Society]
GENERAL RECOMMENDATIONS
1. Avoid drugs which interact with pharmacological prophylaxis when used
(aspirin, NSAIDs, clopidogrol).
2. Avoid mechanical methods for patients with poor or insensate skin.
Level of VTE Risk
Very Low
Low
Moderate
High – but outweighed by risk of bleeding
High
Extreme
Recommended Prophylaxis
None
None/mechanical
Mechanical
Mechanical and then add
Pharmacological Prophylaxis (PP)
when bleeding risk diminishes
PP
PP
GENERAL LIKLIHOOD OF RISK [FOR SPECIALTY SURGERY]
General Risk Factors
Total anaesthetic and surgical time
greater than 90 minutes
Bed rest greater than 3 days or
significant reduction in mobility
Acute trauma
Age greater than 60 years
Active malignancy including
chemotherapy and radiotherapy
Personal history of VTE
Inherited thrombophilia
Family history of VTE (first degree
relative)
Obesity BMI >30
Pre-existing major illness (cardiac
respiratory metabolic inflammation acute
infection)
Drug use associated with risk of VTE
(oestrogen containing contraceptive pill,
hormone replacement therapy tamoxifen)
Likelihood for
open and major
[Specialty]
surgery
Likelihood for
arthroscopic and
mini-open
[Specialty]
surgery
Immobility
Pregnancy
or less than 6 weeks post-partum
Dehydration
Critical care patient
DURATION OF RISK
Procedure
Day case and arthroscopic surgery
Mini-open day case and overnight stay
surgery
Open internal fixation for fracture in
under 60 year olds with surgery lasting
less than 90 minutes
Open internal fixation for fracture in over
60 year olds with surgery lasting more
than 60 minutes
Open internal fixation for fracture with
surgery lasting more than 90 minutes
[Specialty] joint replacement
Revision [Specialty] joint replacement
Tumour surgery
Duration of Risk
RISK FOR PROCEDURES AND GROUPS OF PROCEDURES FOR [SPECIALTY
SURGERY]
Procedure
Arthroscopy and day case procedures
Arthroscopy and mini-open overnight stay
procedures
Internal fixation of fractures
Joint replacement and revision joint
replacement
Tumour surgery and anthrodesis
LITERATURE
Most Significant Reviews:
References:
Expert Opinion and Surveys:
Risk Level