Cardinal Health

Preventing Venous Thromboembolism: A Healthcare Professional Guide to Intervention 10 Who is at Risk? Risk Identification &Management. Risk factors are accumulative, the more risk factors in place, the greater the risk of VTE. To effectively provide prophylaxis to surgical and medical patients, it is essential to look beyond the presenting diagnosis. Every patient must be risk assessed according to their individual level of VTE risk to ascertain the most appropriate measure to prevent VTE in the individual patient. Today’s hospital population may be at higher risk for VTE due to the following factors: advanced age, increased number of co-morbidities; longer stays in critical care units, increased incidence of cancer with more intensive cancer therapy and extensive surgical procedures. There are numerous local and international VTE Guidelines published to assist with the identification and treatment of patients at risk of VTE. Unfortunately despite the extensive evidence available these are often poorly adhered to. The final decision to provide thromboprophylaxis is a clinical decision based on the number and type of risk factors balanced against risk of bleeding and any contradictions to mechanical or chemical prophylaxis The illustration below highlights some of the risk factors for VTE as well as some of the possible complications. Death Possible Complications Risk Factors Risk Factors • Stroke • Increased Blood Thickness • Obesity • Aged Over 40 • Malignancy • Surgical Procedure • History of DVT or PE • Being confined to bed for more than 72 hours • Heart Conditions • Pregnancy • Oral Contraceptive • Immobility Possible Complications • Persistent Swelling • Bacterial Infection • Increased Pigmentation • Pruritus (Itchiness) • Pain • Eczematoid Dermatitis • Ulceration *GREATER THAN 4 HOURS The Risk of VTE is up to 50 Times Greater for a surgical patient when compared to being on a long plane flight. 16