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VTE PPX in High Risk Trauma Patients: 2018 Pediatric Surgery Practice Gap #7
Timestops (4)
00:00:15
Introduction to practice gap #7
Introduction to practice gap #7: VTE prophylaxis in high risk trauma patients.
00:00:23
Recommendation for low bleeding risk patients
Recommendation for low bleeding risk patients: SCDs and LMWH.
00:00:34
Recommendation for high bleeding risk patients
Recommendation for high bleeding risk patients: SCDs until ambulatory, then screening ultrasound.
00:00:48
Clarification: High bleeding risk = no LMWH initially.
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Topic Overview
Review of 2018 APSA practice guidelines for VTE prophylaxis in high-risk pediatric trauma patients. Low bleeding risk patients receive SCDs plus LMWH; high bleeding risk patients receive SCDs only until ambulatory, with screening ultrasound on ICU day 7.
Key Takeaways
- Low bleeding risk trauma patients: use SCDs plus low molecular weight heparin for VTE prophylaxis
- High bleeding risk trauma patients: use SCDs only, defer anticoagulation until ambulatory
- Screen high bleeding risk patients with ultrasound on ICU day 7 to detect subclinical VTE
- Risk-stratify pediatric trauma patients before initiating pharmacologic VTE prophylaxis
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Transcript
Join us as we continue our review of the top 10 practice gaps of 2018, first presented at last year's update course by Apps's Practice Development Committee. Number seven. Alex. So number seven is Venus Thromboembolism prophylaxis in high risk trauma patients. So they found that for low bleeding risk patients, it's okay to just do uh, SCDs and low molecular weight heparin. And for high bleeding risk patients, uh, they recommend SCDs and they're until they're ambulatory, and then a screening ultrasound on ICU day seven. So basically, if they're high risk for bleeding, you're leaving out the the low molecular weight heparin. Correct. Okay. Great.
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