VTE Lecture Flashcards
Do DVTs/SVTs form in upper or lower extremitites?
DVT/SVTs in upper extremities often form from complications from…
PICC or PORT lines
for VTE, rates among highest risk populations can be as high as __% among those not receiving thromboprophylaxis
80%
Critical ill
Cancer
Stroke
Pregnancy
MI
Age >75
Previous VTE
Prolonged immobility
Renal failure
Inherited hypercoaguable states
high risk populations for VTE
No pharmacotherapy
Early and often ambulation
Mechanicals SCDs
..used for what population of ppl for VTE prevention
Non-high risk
- *pharmacotherapy tx!!** (LMWH or UFH)
- SQ Lovenox 40 mg daily
- SQ Heparin 5000 units q12
VTE prevention for what population of ppl?
High risk
(no need to continue pharmacotherapy beyond acute stay unless going to rehab)
What must you watch for if a person is on Heparin?
Heparin Induced Thrombocytopenia (HIT)
*can be immediate or delayed when on Heparin
50% decrease in platelets should be a RED FLAG!!!
Heparin Induced Thrombocytopenia (HIT)
Tx= Stop all Heparin like products
Arixtra=the go to in this situation
Heparin Induced thrombocytopenia (HIT)
Dx:
Lower extremity swelling, pain, discoloration
Palpable cord, + Homan’s sign, edema, discoloration
DVT
Forcibly and abruptyl dorsiflex the pt’s ankle
Pain in calf and popliteal region= positive sign
Homan’s sign (for DVT)
a low probability Well’s Score has a __% negative predicted value
a low probability Well’s score + a negative d-dimer has a __% negative predicted value
low Well’s score= 96%
low Well’s score + negative D-dimer= 99%
3+ Wells Score= ?
1-2 Wells Score= ?
0 or less Wells Score= ?
3+= high probability
1-2= moderate
0 or below= low
Admit to hospital
Ultrasound to confirm dx
Anticoagulation: IV Heparin or SQ Lovenox for a minimum of 5 days!!!
DVT tx
For a DVT, must be on Heparin for at least how many days
5 days