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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2002 December;21(4):330-2

language: English

Venous thromboembolism. Prophylaxis on a Saturday morning in a district hospital

Fassiadis N., Stavrianakis C., Moghraby O. S., Gandhi P., Smedley F. H.

Depart­ment of Gen­er­al Sur­gery, Brom­ley Hos­pi­tal, Brom­ley, UK


Back­ground. Imple­men­ta­tion of guide­lines to pre­vent ­venous throm­boem­bo­lism (VTE) is essen­tial to help guide jun­ior med­i­cal staff but adher­ence to such pro­to­cols is insuf­fi­cient. This study aims to audit the use of VTE pro­phy­lax­is (Tin­zap­ar­in 3500 units and/or throm­boem­bol­ic deter­rent stock­ings (TED) in gen­er­al sur­gi­cal inpa­tients in a dis­trict hos­pi­tal on a ran­dom day at the begin­ning (Group A) and at the end of the jun­ior house ­officer’s 6 monthly term (Group B).
Meth­ods. ­Patients were ana­lyzed with­in the sub­groups elec­tive and emer­gen­cy admis­sions and ­assessed regard­ing the appro­pri­ate pre­scrip­tion of tin­zap­ar­in and TED-stock­ings. The pres­ence of a sig­nif­i­cant time lag ­between ­patients arriv­ing on the ward and VTE-pro­phy­lax­is being pre­scribed was doc­u­ment­ed.
­Results. Tin­zap­ar­in was appro­pri­ate­ly pre­scribed or not pre­scribed if con­tra­in­di­cat­ed in 86% of elec­tive admis­sions in Group A (ver­sus 91% in Group B) and in 58% of emer­gen­cy admis­sions in Group A (ver­sus 85% in Group B). The sub­cu­ta­ne­ous injec­tion of tin­zap­ar­in was com­menced on the day of admis­sion in 67% in Group A and in 75% of ­patients in Group B.
Con­clu­sion. ­Despite the insti­tu­tion of local guide­lines adher­ence to such rec­om­men­da­tions ­appears to be sub-opti­mal even at the end of the jun­ior house ­officer’s 6 monthly term when one would ­expect a high­er vig­i­lance.

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