{"text":"NHS GG&C Rlsk Assessment for Venous Thromboembollsm (VTE) \nTrauma and Orthopaedic surgery \n\u2018Risk Assessment should be completed for all \npatients on admission to hospital \nPatients should be reassessed every 48 - 72 \nhours or sooner if condition changes i \nAssessment should be documented in Kardex . \nProvide patient information on VTE prevention \nLB \nCLELLAND \nAgnes \n39 Rennie Roag \nKilsyth \nGlasgow, Lanarkshire \nF \n08\/09\/1955 \nG659pQ \nNon-oger\u00e9tive patients start here \nOperative patients start here \n\" -Yes \nv \n\u2018Is the patient bed-bound or expected to have reduced \nmobility relative to normal state for2 2 days? \n. Indicators of patients at sta ndarc_l and ncreased nsk of VTE (tick all that apply) \niy \nmore than 2 days \n{1 Hip or knee replacement surgery or\u2019 \nother major orthopaedtc elective surgery \n_ STANDARD RISK INCREASED RISK \n[ Acute trauma\/surgical admission [ gritical care admission [T varicose veins with phlebitis \n[} pehydration 0besnty (BMI>30Kg\/m?) ] current significant medical - \nAge >60 years ] Active cancer or cancer treatment condition e.g. \n] surgical procedure with total ] Thrombophilia o Serious Infection \nanaesthetic\/surgical time >90 mmutes, or | [J-Personal history or first degree relatlve . \u00a2 Heart Failure \n>60 minutes if surgery of lower limb with a history of VTE * e Respiratory Failure \n[] Expected significant reduction in [1 Pregnancy-or <6 weeks post partum \u00ab Inflammatory Disease \nmobility relative to their normal state for seek specialist advice) : \nHormone replacement therapy, \ntamoxifen \n[ Oestrogen contamlng contraceptlve pil \n\u00a5 \n- Yes __- Standard\/Increased \n.i Risks \nNO__.\u2014D \nDoes the patient have any bleeding risk fadors?{\ufb01d: all that apply) \n{JSurgery expected within the next 12 hours : \n[Cdsurgery expected within the next 48 hours and\/or risk of chnlmlly |mportant bleedmg : \n[CJActive bleeding or risk of bleeding Includmg \ne New-onset stroke \ne Platelet count <75 x 10\u00b0\/L \n\u00bb Acute liver failure \n\u2018s Active-duodenal ulcer or gastric ulcer \n[IConcurrent use-of therapeutic anticoagulant \n[JAcute bacterial endocarditis \n[TJany spinal intervention (praphylactic enoxaparin is contramdl cated far 12 hours before \nspinal and epidural anaesthetics and lumbar puncture. Enoxaparin contraindicated for 4 \nhours after spinal and epidural anaesthetics and removal of epidural catheter.) \n[persistent uncontrolled hypertension (BP > 230\/120 mmHg) - \nCJuntreated-inherited bleeding disorder (e.g. haemophilia or Von Willebrands) \n[Ispinal surgery (seek specialist advice) \n[proliferative diabetic retinapathy \n7 \u2018 : \nBleeding \nv Risks \nYgs No. \nv \n\u00ab Discuss with senior dlinical staff before prescribing pharmacolegical prophylaxis \n\u00ab Consider mechanical prophylaxis e.g. AES. unless contra-indicated \n\u00bb Reassess patient every 48 hours ar sooner if condition.changes \no Complete risk assessment result box at foot of page. \ne Risk assessment now complete \n.o No thromboprophylaxis required \no Complete Risk Assessnent \nResult box at foot of page \no Continue to review every 48 =72 '} \nhours or sooner if condition \nchanges. \n\u00ab Document all assessments on \nkardex \n\u00ab Tick to confirm [] \nNO BLEEDING RISKS \n\" o Prescribe thromboprophylaxis for \n\u2018standard\/increased risk as \ndenoted overleaf , \n\u00bb Complete Risk Assessment \nResuit box at foot of page \ns Continue to review every 48 - 72 \n~ hours or sooner if condition \nchanges \n\u00ab Document all assessments \non kardex \ne Tick to confirm O \nRisk Assessment Result (tick all that apply)\u2019 \nVTE Risk factors assessed [ IYes []No Bleeding Risk factors assessed \nPrescribed: DThromboprophyIaxus in accordance with Table overleaf DAES [ INONE \nAssessors Name: Assessors signature: \n(PRINT NAME) \u2018 \nOves[CNo Patient Informed \n\"Oves (I No \nInformatuon leaflet supplned Clyes ENo \nDate: \nVTE RAT Ortho V.14 10\/03\/14\u2019 \nQ)MMM@O( a_l' Pft\u2019 \u2019O\/O aSSZSSVW+ Clnmc \n1(g(is 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