guidance

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When is pharmacological VTE preventionimpractical or contraindicated?Do not offer pharmacological VTE prophylaxis if patient has anyrisk factor for bleeding and risk of bleeding outweighs risk of VTEWho is at risk of bleeding?All patients who have any of the following:Concurrent use ofanticoagulants knownto increase the riskof bleeding (such aswarfarin with INR > 2)Thrombocytopenia(platelets < 75 x 109/l)Active bleedingAcute strokeAcquired bleedingdisorders (such asacute liver failure)Uncontrolledsystolic hypertension(≥ 230/120 mmHg)Lumbar puncture /epidural / spinalanaesthesia withinthe previous 4 hoursor expected withinthe next 12 hoursUntreated inheritedbleeding disorders (suchas haemophilia or vonWillebrand’s disease)
When is current mechanicalcompression contraindicated? 4 ,5• Suspected or proven peripheral arterial disease 4,5• Peripheral arterial bypass grafting 4• Peripheral neuropathy or other causes ofsensory impairment 4• Local conditions in which stockings may cause damage,such as fragile ‘tissue paper’ skin, dermatitis, gangreneor recent skin graft 4• Known allergy to material of manufacture 4• Cardiac failure 4,5• Severe leg oedema or pulmonary oedema fromcongestive heart failure 4,5• Unusual leg size or shape 4• Major limb deformity preventing correct fit 4Use caution and clinical judgement when applying anti-embolism stockingsover venous ulcers or wounds.
Page 1 and 2: NICE guidanceNICE guidance (MTG19)
Page 3: The geko device is cost saving 1,3
Page 7 and 8: Potential clinical areas to be expl

guidance

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