Outpatient VTE prophylaxis

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Guys and Gals,

I am just trying to get a sense of the practice out there in terms of
outpatient DVT/PE prophylaxis after d/c from the trauma service. Let's
take some examples

1. Patient with multiple long bone/pelvic fractures who will be
non-weight-bearing for 6 weeks

2. Patient with long bone/pelvic fracture who will be NWB on one leg

3. Patient with long bone/pelvic fracture +/- other trauma (liver,
spleen, ptx, etc.) who will be limping but ambulatory

4. Patient with paraplegia/quadriplegia



Questions: 
a. Do you anticoagulate as an outpatient? 
b. With what? 
c. How long?

Our practice sadly varies but our basic answesr would be:

1. a.Yes. 
b. With LMWH if insured/can afford or coumadin (INR 2-2.5 if not). 
c.6 weeks

2. No — but I worry a lot.

3. No

4. a.Yes. 
b. LMWH. 
c. I don't know they all go to rehab. 


Thanks in advance!

Bill Bromberg

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