DVT

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In a message dated 3/14/2009 22:01:24 Central Standard Time,  
errington at erringtonthompson.com writes:
 
Trauma patient in the ICU on the vent.  The 48-year-old gentleman  who was
involved in a motor vehicle crash.  The patient was found to  have the
following injuries -- 4 rib fractures, pulmonary contusion, T4/T5  chance
fracture without neurologic deficit and a scapular fracture.   The patient is
on prophylactic doses of a low molecular weight  heparin.  An ultrasound
seven days after the injury reveal a  nonocclusive thrombus in the popliteal
vein.   

Treatment?


 
ck: unilateral or bilateral DVT? if unilateral, I'd consider putting a  
venous flow enhancement device on the contralateral leg. any other risk  factors 
for DVT including central lines? also, how much is he needing vent  help? 
(thinking of this in terms of early mobilization).
 
Otherwise, agree with continuing LMWH and monitoring the size of the  clot.




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