Assessment of VTE and bleeding risk
Assess risk of VTE at admission
Increased risk of VTE
Assess risk of bleeding
See bleeding risk indicators (Table 2 in main guideline)
Bleeding risk indicators
present
Consider whether risk of
VTE outweighs the risk of
bleeding.
If it does prescribe:
Enoxaparin 40 mg daily by
SC injection
(20 mg if eGFR
2
< 30 ml/minute/1.73m or
patient weighs < 50 kg)
Otherwise mechanical
thromboprophylaxis
(see guidance below)
See indicators of high risk
(Table 1 in main guideline)
No increased risk of VTE
No mechanical or pharmacological
thromboprophylaxis required
Review VTE risk and bleeding risk
assessments in 24 hours
Bleeding risk indicators
absent
Further information on
assessment:
Do not offer pharmacological
Enoxaparin 40 mg daily prophylaxis to patients with risk
by SC injection factors for bleeding shown in Table 2
(20 mg if eGFR (main guideline) unless the risk of
< 30 ml/minute/1.73m2 or VTE outweighs the risk of bleeding.
patient weighs < 50 kg)
Patients already receiving
and in addition for surgical therapeutic anticoagulation do not
patients, anti-embolism need additional thromboprophylaxis.
stockings
Re-assess risk of VTE and of bleeding every 48 - 72 hours, or
earlier if patient condition changes