List Archives

Sun Mar 15 15:54:54 GMT 2009

What has been the group experience with Deltiparin (Fragmin) as the prophylaxis.  As of April 1 our pharmacy will no longer supply enoxaparin (Lovenox). This is directive from the state level not local. All of our public hospitals are run be the state of Louisiana not the city or parish (county) 

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

From: trauma-list-bounces at trauma.org on behalf of moore677 at aol.com
Sent: Sun 3/15/2009 9:25 AM
To: trauma-list at trauma.org
Subject: Re: DVT

No evidence to support IVCF if you can safely anticoagulate the patient and they haven't already failed therapeutic anticoagulation.? If clot is above knee popliteal, should fully anticoagulate.? If below knee, would monitor with serial duplexes, although this is not widely agreed upon.

According to the 2008 ACCP guidelines, fully anticoagulate incidental proximal DVT (above knee).

Dell....................

Forrest "Dell" Moore, MD, FACS
Trauma Critical Care Surgery
Co-director Trauma & Surgical ICU
St. Joseph's Hospital and Medical Center
eICU Intensivist/Critical Care Medicine
Banner Healthcare System
Phoenix, AZ
Cell 480 284 1703

-----Original Message-----
From: nappio at aol.com
To: Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>
Sent: Sun, 15 Mar 2009 5:46 am
Subject: Re: DVT

Place a removable greenfield and anticoagulate. Can help prevent propagation of
the clot and reduce his post phlebitic syndrome(anectdotal).  Has he been tested
for deficiencies like anti thrombin 3, factor5 leiden, S/C proteins, etc?
------Original Message------
From: Errington Thompson
Sender: trauma-list-bounces at trauma.org
To: 'Trauma & Critical Care mailing list'
ReplyTo: Trauma & Critical Care mailing list
Sent: Mar 14, 2009 23:01
Subject: DVT

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?

Errington C. Thompson, MD, FACS, FCCM
Trauma/Critical Care
Talk Show Host - WPEK 880 AM
www.whereistheoutrage.net

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