{"text":"It is the responsibility of the consultant in charge to decide on the appropriate VTE prophylaxis. Follow recomm'pndations recorded in \nthe patient specific VTE prophylaxis instruction sheet. Contra-indications or drug interactions with any of these agents must be \nobserved - \nif in doubt discuss directly with consuitant\u2019s team. \nThromboprophylaxns on Admission \nProcedure During admission ' . : \n\u00bb 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 \no Total hip replacement Reduce dose to 20mg if eGFR <30ml\/min or if patient wetghts <50Kg \n\u00a2 Other major. \nelective surgery Increased VTE Enoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \nto lower limbs \u2018risk least 4 hours after surgery, whichever is latest \nReduce dose to 20mg if eGFR\"<30ml\/min or if patient weights <50Kg - \nTotal knee replacement Standard VTE risk | Aspirin orally 150mg daily \nOr \nEnoxaparin SC 40mg once daily started on the day of surgery at 6pm or at \nleast 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 <30ml\/min or if patient weights <50Kg \n- Rivaroxaban (under consultant advice only) \nfollowing total hip or total knee replacement ~ \nA small proportion of patients may require thromboprophylaxis with rivaroxaban \nin these cases follow orthopaedic and\/or haematology consultant recommendations. \nCheck BNF for advice on dose and duration of treatment. Discuss arrangements with clinical 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 \/ts \nuse following an initial course of enoxa, \narin Is off-fabel. \nOther elective surgery (including | Standard VTE risk | No need for pharmacological; thromboprophylaxis \nupper limb, arthroscapy 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 dependlng on the type of surgery' \n. and 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 and\/or haematelogy 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 do not \nrequire surgery \nFollow thrombaoprophylaxis guideline in the Therapeutics Handbook \nThromboprophylaxis on Discharge \nProcedure On discharge : \n* Hip fracture Standard VTE risk | 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* \nrisk ) \n\u00bb Lower limb fractures Standard \\\/TE risk | Aspirin orally 150mg daily for 5 weeks ) \n\u00bb Total hip replacement . r ) \n\u00a2 g:l::rrvna]or elective Increased VTE Continue enoxaparin SC for an overall treatment course of 5 weeks* . \nrisk - \nTo lower limbs \nTotal knee replacement \nRivaroxaban (under consultant advice only) \nfollowing total hip or total knee replacel \nment - \nA small propoition of patients may require thromboprophylaxis with rivaroxaban \nin these cases follow orthopaedic and\/or haematology consultant recommendations. \nCheck BNF for advice on dose and duration of treatment. Discuss arrangements with clinical pharmacist if patient is to be discharged on \nrivaroxaban. Aote 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 \nupper limb, arthroscopy and \nStandard VTE risk \nIncreased VTE \nNo need for pharmacological; thromboprophylaxis \nFollow recommendations from erthopaedic 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 \nMuitiple Trauma Thromboprophylaxis assessment done on a case-by-case basis depending on the extent of \ninjuries ~ follow recommendations from orthopaedic and\/or haematology consultant \nSpinal cord injury Thromboprophylaxis assessment done on a case-by-case basis depending on the type of injury ~ \nfallow recommendations from the spinal injuries team \nOrthopaedic patients who do not \nrequire surgery \nFollow thromboprophylaxis guideline in the Therapeutics Handbook \n*Arrangements for the supply and administration of enoxaparin after discharge are currently under discussion with Primary Care. Contact clinical \npharmacist for information on local arrangements in your hospital. \nThromboprophylaxis Guidelines for Orthopaedic Patients \nVTE RAT Ortho V.14 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