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DVT Prophylaxis with heparin in head injury

Ian Seppelt SeppelI at wahs.nsw.gov.au
Sat Sep 4 06:33:29 BST 2004


There is good evidence that DVT prophylaxis with heparin is safe 48 after any acute haemorrhage has stopped. If you can get sequential calf compressors they are equally effective in general ICU patients as sc heparin [see for example the Project Impact database (Rocha A.T et al, Venous thromboembolism prophylaxis with sequential compression devices in medical ICU patients: analysis of the project impact database, Crit Care Med, 2003, 31(12) A14) with nearly 16,000 medical ICU patients with a DVT incidence of 1.0 - 1.3% (p = NS)]. If multiple limb injuries or pelvic trauma then low molecular weight heparin should be used, again after 48 hours from the acute injury.

Cheers, Ian


Ian Seppelt FANZCA FJFICM
Staff Specialist in Anaesthesia and Intensive Care Medicine
The Nepean Hospital, 
PO Box 63, Penrith NSW 2751
Clinical Lecturer, University of Sydney


>>> jacobjns at yahoo.com 09/04/04 11:21am >>>
Dear Sir,
 
Best birthday wishes.
 
Iam Dr.Jacob John working as a neurosurgeon in a
community hospital in Kollam,Kerala,India ,area of
interest being Trauma Care.
 
Iam in your mailing list and very much benefitted and
enlightened by the discussions .
 
I had sent a query earlier but didnot appear in the
mailing list;Idon't know why.
 
1.We had 5 cases of head injury (3 on ventilator) who
had a sudden death :the sequence of events being
sudden desaturation and cardiac arrest.Autopsy has
proved pulmonary thromboembolism as the culprit.
 
I would like to get the opinion regarding DVT
prophylaxis with heparin in head injury-Any protocol.

I doubt the efficacy of non pharmacological treatment
of DVT in polytrauma.What do others feel.

Graded compression stockings -it is difficult to get
in this part.

Many polytrauma patients have associated lower limb
fractures which add to this problem.
 
Hope this will appear in the mailing list.
 
Dr.Jacob John MBBS,MS(Surgery),M.Ch(Neurosurgery)
Neurosurgeon,
Bishop Benziger Hospital,Kollam,Kerala,India.
jacobjohns at sancharnet.in 
jacobjns at yahoo.com 
 

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