{"text":"NHS GG&C Risk Assessment for Venous Thromboembolism (VTE) \n- Traum\u00e94 and Orthopaedic surgery . \no Risk Assessment should be completed for all \npatients on admission to hospital o L@M@M\ufb02m\ufb02\ufb02\u201d\u2019m\u2019\ufb02w , \no Patients should be reassessed every 48 = 72 CLELLAND \u2018 \nhours or sooner if condition changes ' Qg\u2019,;e;m. 08\/09\/19:5 \n+ Assessment should be documented in Kardex Kilsyth \u00a2 Road | \ne Provide patient information on VTE prevention Glasgow, Lanarkshire \n. Gs59pq .- \n~ = \nNon-operative patients start here \n3 \nl_\u2014\u2018 Org_ _ei'ative patients start here \nYes Is the patlent bed-bound or expected to have reduced \n\u00a9: ' mobility relative to normal state for2 2 days? \nIndicators of patients at standard and increased risk of VIE tick all that apply) _ 7 : \nSTANDARD RISK - INCREASED RISK \u2018 E\u2018Z\u2019 \n[T Acute trauma\/surgical admission. [] gritical care admission_ - 1 Varicose veins with phiebitis \nBpehydration - Obesity (BMI>30Kg\/m?) O Current significant medical - \n{1 Age >60 years [ Active.cancer or cancer treatment - condition e:g. \nSurgical procedure with total : [ Thrombophilia ' \u00bb Serious Infection \n_..3esthetic\/surgical time >90 minutes, or [ Personal history or first degree r\u00e9lative e Heart Failure \n>60 minutes if surgery of lower limb with a history of VTE & Respiratory Failure: \n[] Expected significant reduction\u2019in =~ - \"] Pregnancy or <6 weeks post partum \" e Inflammatory Disease \nmobility relative to their normal state for | (seek specialist advice) * ' \nmore than 2 days , {7 Hormone replacement therapy, \n[] Hip or knee replacement surgery or | tamoxifen \" \n1-other major orthopaedic elective surgery ] Oestrogen containing contraceptive pill \n. : \u2018 - . . . y \nYes \u2014 - Standard, \/Increased No \u2014\u2014\u2014\u2014\u2014\u2014\u00bb | \u00ab Risk assessment now complete \nRisks - \u20181 \u00bb No thrombpprophylaxis required \nDoes the patient have any bleeding risk factors? (tick all that apply) \u00bb Complete Risk Assessment \n- Result box at foot of page \n[CISurgery expected within the next 12 hours \n[(Isurgery exp\u00e9cted within the next 48 hours and\/or risk of clinically important bleeding \n[TJActive bleeding or risk of bleeding including \n\u00bb Continue to review every 48 -72 \" * \nhours:or sooner if condition \no New-onsetstroke - . _ changes. . \ne Platelet count <75 x 10%L o Document all assessnients on \ne Acute liver failure - . _ kardex \ne Active duodenal uicer or gastric ulcer J \nIMJConcurrent use-of therapeutic anticoagulant e Tick to confirm 01 \nK IJ]Acute bacterial endocarditis : \u2014 - \n* | L-]Any spinal intervention: (prophylactic enoxaparin is coritraindicated for 12 hours before \u2018 \nspinal and epidural anaesthetics and lumbar puncture. Enoxaparin contraindicated for 4 : NO BLEEDING RISHS BLEEDI\\NG RISKS ) \nhours after spinal and epidural anaesthetics and removal of epidural catheter.) \n[CPersistent uncontrolled hypertension (BP > 230\/120 mmHg) \nCOuntreated-inherited bleeding disorder-(e.g. haemophilia or Von Willebrands) \n{{ISpinal surgery (seek specialist advice) \u2018 \nClproliferative diabetic retinopathy \ne Prescribe thromboprophylaxis for \nstandard\/increased risk as \ndenoted overleaf \n\u00ab Complete Risk Assessment \nResult box at foot of page \no Continue Yo review every 48 - 72 \nYes___\u00b0 Bleeding No \ne _\u2014 . \u2014+\u00bb hours or'sooner if condition \n. R'sks ) changes \u00b0 \n\u00ab Discuss with senior clinical staff before prescribing pharmacological prophylaxis . \u00bb Document all assessments \no Consider mechanical prophylaxis e.g. AES unless contra-indicated on kardex \n. Reassess patient-every 48 hours or sooner if condition changes\u2019 - \" \u2019 \n\u00ab Complete risk assessment result box at foot of page : \u00bb Tick to confirm [ \nRisk'Assessment: Result (tick all that apply) o \u2019 \nVTE Risk factors assessed [1\u00a5es (INo Bleeding Risk factors assessed [\u00a5esCINo Patient Informed ClYes [ Ne \nPrescribed: [JThromboprophylaxis in accordance with Table overleaf [ JAES [JNONE Information leafiet supplied [lves Cno \nAssessors Name: - . Assessors signature: : Date: C \n\u2018| (PRINT NAME) L . L \n. VTERATonhoV.1410103(14- R ' \" ' : - - . \nQDMI\u2019WM CQO( 0L+ F\/\u2018f \"Q_\/D aSS@SSW+ d IFVl l~C \/7(8\/(\/5( \/\\\/P \n\u2019 ' : 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