Trauma Guideline Manual - SUNY Upstate Medical University

128____________ Trauma Guidelines ManualSUNY Upstate Trauma CenterPRACTICE GUIDELINES: DEEP VENOUS THROMBOSIS PROPHYLAXISOBJECTIVES:1. Define the patient at risk for deep venous thrombosis (DVT) and will benefit from appropriateprophylaxis in the surgical setting2. Define guidelines for DVT prophylaxis that most appropriately reduce the incidence of DVTand pulmonary embolus3. Define diagnostic and treatment protocols for DVT4. Define surveillance protocols to detect occult DVTDEFINITIONS:Deep venous thrombosis (DVT) – spontaneous development of clot in the veins of the leg orpelvisPulmonary embolus – dislodged clot that has formed in the veins of the leg and/or pelvis thathas migrated to the right heart or pulmonary arterial circulationDVT prophylaxis – specific therapy that is used in high-risk patients to prevent the occurrence ofDVTPulmonary embolus prophylaxis – specific treatments to prevent the migration of blood clots intothe pulmonary vasculatureGUIDELINES: PATIENTS > 12 YEARS OF AGE1. Determination of DVT riska. Every patient admitted to the trauma service will undergo a DVT risk assessment byusing the “Risk Factor Assessment Tool” (in table below)b. SCD – Sequential compression device on all patients post-op or at bedrest with nocontraindications( i.e. External fixator, compartment syndrome, etc)c. Heparin prophylaxisi. Heparin 5,000 units SQ q12 hours ONLY for patients with renal failure.2. Moderate Risk – SCD and Lovenox 40mg SQ daily3. High Risk – SCD and Lovenox 30mg SQ BID4. Very High Risk – SCD and Lovenox 30mg SQ BID