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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.

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