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Thu May 10 05:36:55 BST 2007

Dr. Mattox is 100% correct.  Wouldn't use the trauma patients.  Would march
to pharmacy committee with a neurosurgeon in tow.  Would ask the pharmacy
committee to show you any data in trauma patients (not ortho patients with
an isolated hip replacement or knee replacement).  Without good data you are
putting your patients at risk.  Wouldn't do it.  I have fought this battle
at 2 institutions.    

E

Errington C. Thompson, MD, FACS, FCCM
Trauma/Surgical Critical Care
Mission Hospital
Asheville, NC
Author - A Letter to America
www.whereistheoutrage.net

Everyone deserves to make an informed decision
                                - Errington Thompson, MD

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Wednesday, May 09, 2007 10:01 AM
To: trauma-list at trauma.org
Subject: Re: LMWH usage in Trauma patient

In a message dated 5/9/2007 8:38:07 A.M. Central Daylight Time,  
EGomez2 at um-jmh.org writes:

Our  institution is changing their LMWH from enoxaparin to dalteparin and
we
also have fondaparinux.  Does anyone have any experience with  dalteparin?
What dose are you using: 5000 units QD or 2500 units BID  ?    

Yes, we have had experience with both and have had to have some major  
changes.    I will be happy to talk to anyone OFF  line.    Dalteparin is
NOT 
approved for use in trauma  patients.    I would strongly recommend you use
what has 
been  reported to be evidenced based.    Several hospitals in the Texas  
Medical Center have had concerns with the pharmacy making decisions which
can  
adversely affect DVT prophylaxis.    

k

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LMWH usage in Trauma patient