DVT

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Thanks

Typed by the thumbs of
Norman on his BlackBerry 

Norman McSwain, MD
Tulane Univ Surgery
504 988-5111

----- Original Message -----
From: trauma-list-bounces at trauma.org <trauma-list-bounces at trauma.org>
To: Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>
Sent: Sun Mar 15 13:10:13 2009
Subject: RE: DVT

Norm

We used Fragmin, then changed to Enoxaprarin and are changing back to
fragmin - all cost related. We also are run on a state tender per province
in RSA. No clinical difference in equipotent doses.

Tim

Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer University of KwaZulu-Natal Dept Surgery
Deputy Director - IALCH Trauma Service
Durban - South Africa
> 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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