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DVT PROPHYLAXIS Dr. E M. Regis Jr. Dept. Of Orthopaedics 10/08/15

dvt prophylaxis

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  1. 1. DVT PROPHYLAXIS Dr. E M. Regis Jr. Dept. Of Orthopaedics 10/08/15
  2. 2. Overview Definition Incidence Aeitology/ Risk Factors Pathophysiology Signs/ Symptoms Diagnosis Complications Prophylaxis Conclusion
  3. 3. Definition thrombus (clot) formation predominately in the deep veins of the legs. eg. femoral vein, popliteal vein
  4. 4. Incidence 1-2 per 1000 annually in the United States 60,000-100,000 die of DVT {10-30% within 1st month of diagnosis}
  5. 5. Aeitology/ Risk Factors Virchows Triad a) stasis b) hypercoagulability c) vessel wall damage (intima)
  6. 6. INJURY TO VEIN; fractures severe muscle injury major surgery (abdominal, pelvis, hip or legs) SLOW BLOOD FLOW; confinement to bed limited movement sitting for prolong periods with crossed legs paralysis
  7. 7. INCREASED ESTROGEN; birth control pills HRT sometimes used after menopause Pregnancy, up to 6 weeks postpartum OTHER FACTORS; previous DVT or PE family history of DVT or PE age (risk increase as age increases) obesity catheter located in a central vein inherited clotting disorders (protein c deficiency, antithrombin deficiency)
  8. 8. Signs & Symptoms pain or tenderness warmth swelling redness or discoloration distention of surface veins difficulty breathing (S.O.B) tachycardia or irregular heart beat chest pain or discomfort anxiety haemoptysis hypotension/ lightheadedness
  9. 9. Diagnosis HISTORY & PHYSICAL EXAMINATION CHEST X-RAY ECG Labs including D-dimers DUPLEX ULTRASOUND VENOGRAPHY spiral CT chest V:Q scan (ventilation/perfusion) pulmonary angiogram
  10. 10. Complications Pulmonary Embolism Death Post-thrombotic Syndrome
  11. 11. Prophylaxis Mechanical compression stockings intermittent pneumatic compression devices ivc filters
  12. 12. Pharmacological 1. Platelet Active Drugs {aspirin 50-100mg/d} 2. Courmarins {Warfarin} 3. Heparins (UFH) 4. Low Molecular Weight Heparins (LMWH) {Enoxaparin} 5. Factor Xa Inhibitors {Rivaroxaban}