Blood Clots, Deep Vein Thrombosis and Pulmonary Embolism

Prophylaxis for DVT (chemical/mechanical prophylaxis):
– Chemical methods will include anticoagulants such as aspirin, Lovenox, Coumadin, Heparin and others.
– Each of these has their advantages and disadvantages.
– Lovenox decreases the incidence of DVT, but does not decrease the rate of death from PE.
– None of the anticoagulation agents including Lovenox provide absolute protection against DVT or PE.
– Both the chest and orthopaedic surgeons’ organizational guidelines are related to total joint arthroplasty and hip fractures.
– Currently there are no guidelines for prophylaxis in trauma patients.
– When giving prophylaxis, you must weigh the risk of complication (bleeding) versus the benefit of preventing DVT.
– Mechanical prophylaxis should be used in the majority of patients or in all patients who need prophylaxis.
– Mechanical compression is recommended by the American Academy of Orthopaedic Surgeons (AAOS) in low or high risk groups, especially if the patient is having a joint replacement.
– Mechanical compression increases the venous return and endothelial-derived fibrinolysis.