{"text":"Itis fhe responsibility of the consultant in charge to decide on the appropyiate VTE proph_y\"la)ds.. Foliow recommendations recorded in \nthe patient specific VTE prophylaxis instruction sheet. Contra-indications or drug ifteractions with any of these agents must be \nobserved \u2014 if in doubt discuss directly with consultant\u2019s team. \nThromboprophylaxis on Admission \nA \nProcedure During admission \ns Hip fracture Standard VTE risk | Enoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \n\u00a2 Lower limb fractures least 4 hours after surgery, whichever is latest \ns Total hip replacement Reduce dose to 20mg if eGFR <30ml\/min or if patient weights <50Kg \ns Other major . \nelective surgery Increased VTE Enoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \nto lower limbs risk | least 4 hours after surgery, whichever is latest \nReduce dose to 20mg if eGFR <30ml\/min \u2018or if patient weights <50Kg \nTotal knee replacement Standard VTE risk | Aspirin drally 150mg daily \nOr \nEnoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \n. least 4 hours after surgery, whichever is latest \nReduce dose to 20mg if eGFR <30ml\/min or if patient weights <50Kg \nIncreased VTE Enoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \nrisk least 4 hours after surgery, whichever is latest . \nReduce dose to 20mg if eGFR <30mi\/min or if patient weights <50Kg \nRivaroxaban (under consultant advice onh}) \nfollowing total hip or total knee replacement \u2014 \nCheck BNF for advice on dose and duration.of treatment. \n. A small:proportion of patients may require thromboprophylaxis with rivaroxaban \nin these cases follow orthopaedic and\/for haematology consuitant recommendations. \nDiscuss arrangements with cfinical pharmacist if patient is to be discharged on \nrivaroxaban. Note that rivaroxaban is licensed for orthopaedics thromboprophylaxis only after elective hip or knee replacement and its \nuse following an initial course of enoxa \narin is off-label, \nOther elective surgery (including Standard VTE risk | No need for pharmacological; thromboprophylaxis \nupper limb, arthroscopy and increased VTE Follow recommendations from orthopaedic and\/or haematology consultant - \nforefoot surgery) risk ' \nElective spinal surgery Thromboprophylaxis assessment done on a case-by-case basis depending on the type of surgery \nand risk factors \u2014 follow recommendations from spinal surgeon \nMultiple Trauma Thromboprophylaxis assessment done on a case-by-case basis depending on the extent of \ninjuries \u2014 follow recommendations from orthopaedic andfor haematology consultant \nSpinal cord injury Thromboprophylaxis assessment done on'a case-by-case basis depending on the type of injury - \nfollow recommendations from the spinal injuries team \nOrthopaedic patients who do not \nrequire surgery \nFollow thrombopraophylaxis guideline in the Therapeutics Handbook \nThromboprophylaxis on Discharge \n_Procedure On discharge \n\u00ab Hip fracture Standard VTE fisk | Continue enoxaparin SC for an overall treatment course of 2 weeks or until \ndischarge (whichever is sooner) . \nIncreased VTE Continue enoxaparin SC for an overall treatment course of 5 weeks* \n. risk : \n\u00a2 Lower limb fractures Standard VTE risk | Aspirin orally 150mg daily for 5 weeks \n\u00ab Total hip replacement - ' \n* Othermajor elective Increased VTE Continue enoxaparin SC for an overall treatment course of 5 weeks? \nsurgery risk \nTo lower [limbs . \n\u00a2 Total knee replacement \nRivaroxaban (under consultant advice only) \nA small proportion of patients may require thromboprophylaxis with rivaroxaban \nfollowing total hip or tota! knee replacement \u2014 in these cases follow orthopaedic and\/or haematolegy consuitant recommendations. \nCheck BNF for advice on dose and duration of treatment. Discuss arrangements with clinical pharmacist if patient is to be discharged on \nuse following an initial course of enoxa \narin is off-label, \n| rivaroxaban. Note that rivaroxaban is licensed for orthopaedics thromboprophylaxis only after elective hip or knee replacement and its \nOther elective surgery (including | Standard VTE risk | No need for pharmacological; thromboprophylaxis . \nupper limb, arthroscopy and Increased VTE Follow recommendations from orthopaedic and\/or haematology consultant \nforefoot surgery) - risk - ! \nElective\u00e9 spinal surgery Thrombaprophylaxis assessment done on a case-by-case basis depending on \nand risk factors \u2014 follow recommendations from spinal surgeon \nthe type of surgery \n\u201cMultiple Trauma \nThromboprophylaxis assessment done on a case-by-case basis depending on the extent of - \ninjuries \u2014 follow recommendations from orthopaedic and\/or haematology consultant \nSpinal cord injury \nThromboprophylaxis assessment done on a case-by-case basis depending on the type of injury \u2014 \nfollow recommendations from the spinal injuries team \nOrthopaedic patients who donot \nrequire surgery \nFollow thromboprophylaxis guideline in the Therapeutics Handbook \n*Arrangements for the supply and administration, of enoxaparin- after discharge are currently under discusslon with Primary Care. Contact clinical \npharmacist for information on local arrangements in your hospital. \nVTE RAT Ortho V.14 10\/03\/14 \nThromboprophylaxis Guidelines for Orthopaedic 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