FOI 2048 VTE Orthopaedics

1) Do you have a specific trust guideline for venous thrombo-embolism (VTE) prophylaxis in patients undergoing trauma & orthopaedic surgery?  Yes

2) If yes to (1), please provide full details of your trust VTE prophylaxis guidelines for patients undergoing all forms of trauma & orthopaedic surgery 

Please see below Trust VTE prophylaxis guidelines for patients undergoing all forms of trauma and orthopaedic surgery:

Orthopaedic Guidelines for Thromboprophylaxis
Hip and Knee Replacements: Routine prophylaxis
In patients Dalteparin 5000 units sc od, commencing at 06:00 on the first postoperative day and continuing until discharge.
Increase dose to 5000 units sc bd if >130kg
Reduce dose to 2500 units sc of if <50kg
On discharge Aspirin dispersible 75mg po od for 28 days.

Hip and Knee Replacements: High risk Patients
These patients are to be identified by the operating surgeon and documented as being for the high risk protocol in the surgeons post-op instructions on the operation note.
In patients Dalteparin 5000 units sc od, commencing at 06:00 on the first postoperative day and continuing until discharge.
Increase dose to 5000 units sc bd if >130kg
Reduce dose to 2500 units sc od if <50kg
On discharge THR rivaroxaban 10mg po od for 28 days
TKR rivaroxaban 10mg po od for 14 days

Fractured Neck of Femur
In patients Dalteparin 5000 units sc od.
Reduce dose to 2500 units sc od if <50kg.
Increase dose to 5000 units sc bd if >130kg.
On discharge Dalteparin continued for a total of 28 days postoperative on discharge. This may not be required if the patient has received 28 days of dalteparin while an inpatient.

3) If no to (1), please provide reasons why not (if known).  N/A

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