Venous thromboembolism (VTE) is a major health problem that affects an estimated 900 000 patients in the United States annually and results in an estimated 300 000 deaths.1 The prevalence is predicted to more than double within the next 35 years.2 Critically ill patients who receive VTE prophylaxis have a significantly lower risk of death than do those who do not receive VTE prophylaxis.3,4 In a recent study, the incidence of deep vein thrombosis (DVT) in critically ill patients without prophylaxis was 11%.5
Assess all patients upon admission to the critical care unit for risk factors for VTE and bleeding, and anticipate orders for VTE prophylaxis depending on the risk assessment. [level D]
Patients at risk and regimens for VTE prophylaxis include
For acutely ill medical patients who are at increased risk: low-molecular-weight heparin (LMWH) or low-dose...