All inpatients having a VTE assessment completed on admission to hospital and at 24 hours or first consultant review.
All patients admitted to CCU having a separate VTE/ bleeding assessment performed with a daily assessment performed thereafter.
All patients admitted to CCU are commenced on LMWH prophylaxis or an alternative if LMWH is contraindicated.
LMWH is prescribed and given within 24 hours of admission unless contraindicated.
LMWH is continued for at least seven days.
Platelet count is monitored regularly for heparin-induced thrombocytopenia if LMWH is prescribed (100%).
If mechanical prophylaxis is deemed to be appropriate, it is started on admission to CCU and continued until normal mobility has been resumed.
Where there has been an exception to standard prophylaxis, it is recorded clearly in the records.
If regional anaesthesia has been administered, LMWH dose is timed to minimise the risk of complications such as epidural haematoma in relation to insertion and removal of catheter (100%).
Patients in the last days of life are not given DVT prophylaxis. Where it is administered, it is reviewed on a daily basis.
On discharge from critical care, the continued requirement for thromboprophylaxis is assessed, with consideration of continuing risk factors.
