Stay Current:
Pediatric Surgery—there's an app for that!
Find a customizable feed of newly released articles from the leading pediatric surgery journals right at your fingertips. Explore the articles our editors and your colleagues are talking about. Discover podcasts with expert discussions on hot topics in the field. Search our vast multimedia library to find articles, reviews, lectures, technique videos, infographics, guidelines, and podcasts. CME credit is available for select content. Presented by Cincinnati Children's Hospital and Children's Mercy Hospital, in partnership with Journal of Pediatric Surgery.
Available on the AppStore Get it on Google PlayWelcome!
Back to Guidelines
DVT Prophylaxis for Trauma Patients
DEFINITIONS
-Altered mobility: A permanent or temporary state in which the child has a limitation in independent, purposeful
physical movement of the body or of one or more extremities.
-Deep Vein Thrombosis (DVT): A blood clot (thrombus) that was initially formed in a deep (non-peripheral) vein.
-Graduated Compression Stocking (GCS): Elastic stockings, either knee- or thigh-high, also known as TED
hose.
-Risk category: Refer to VTE Risk Factors algorithm
-Low risk: No VTE risk factors
-Moderate risk: Multiple risk factors for VTE in the absence of altered mobility or has altered mobility with
one or fewer additional risk factors.
-High risk: Altered mobility plus two or more additional risk factors
-Sequential Compression Device (SCD): A device designed to intermittently squeeze blood from underlying
deep veins in the leg upon compression of an inflatable sleeve, and to allow the blood to flow again when it
decompresses.
-Venous Thromboembolism (VTE): A blood clot (thrombus) in a vein or one that has broken free and is carried
in the bloodstream (embolus).
GUIDELINE
-It is recommended that patients age 10 – 17 years be assessed for VTE risk factors, and based on that
assessment, assigned to a risk category (low, moderate, high).
-At the time of inpatient admission; and
-Reassessed at 48 – 72 hours of hospitalization.
-This should be documented in the patient’s medical record.
-It is recommended that VTE prophylaxis be administered based on risk category as soon as feasible, but within
24 hours of assessment, unless there are contraindications (See algorithm).
-If planning to initiate pharmacologic prophylaxis it is recommended:
-In surgical patients to seek surgical input regarding bleeding risk prior to initiation
-See BESt #049 for management of LMWH prophylaxis
-Obtain Hematology consultation when considering alternative pharmacologic agents.
-Refer to BESt 181 algorithm below for Risk Category Assessment and Prophylaxis for VTE.