Should IPC be a first line “appropriate” choice for patients at moderate risk of VTE?
At UCSD, we originally wanted to keep IPC as an option for patients at moderate risk for VTE (in spite of a lack of solid evidence in the literature for medical patients). Our audits revealed about 55% compliance with IPC, however, and we then adapted the approach of the ACCP Consensus conference, which relegates IPC to patients with contraindications for pharmacologic prophylaxis but also as a secondary method to enhance the effectiveness of pharmacologic prophylaxis. Which patients need IPC in addition to pharmacologic prophylaxis? At UCSD, we decided the very high risk MUST have it, while other patients COULD have it. Which patients should have Heparin 5000 units q 12 hours as an option vs Heparin 5000 units q 8 hours? We initially had 4 levels of VTE risk. We allowed Heparin 5000 units q 12 h as a choice for patients at moderate VTE risk (which described many of our medical ward patients), but advocated the higher frequency 5000 units q 8 h for high risk patients (which typified ou
Related Questions
- Epidural anesthesia is commonly and appropriately used in patients at varying levels of VTE risk. What interventions and recommendations exist to minimize the risk of bleeding in these patients?
- Should intermittent pneumatic compression (IPC) be a first-line, appropriate choice for patients at moderate risk of VTE?
- How effective are IPC devices in reducing DVT in patients at moderate risk of DVT?
