DVT prophylaxis

Mechanical:

• Intermittent pneumatic compression or SCD

• Graduated elastic anti-embolism stockings.

Chemical:

• Medical Conditions:

  • Heparin, 5,000 units sc q12 hr

  • Enoxaparin (Lovenox), 40 mg sc daily;

    • if CrCl <30 mL/min, 30 mg sc daily

  • Dalteparin (Fragmin), 2,500 units sc daily

  • Nadroparin, 2,850 unit sc daily

• General Surgery in moderate-risk patient:

  • Heparin, 5,000 units sc q12 hr

  • Enoxaparin, 20 mg sc 1 - 2 hrs before surgery and daily after surgery

  • Dalteparin, 2,500 units sc 1 - 2 hrs before surgery and daily after surgery

  • Nadroparin, 2,850 units sc 2 - 4 hrs before surgery and daily after surgery

  • Tinzaparin (Innohep), 3.500 units sc before surgery and daily after surgery

• General Surgery in high-risk patient:

  • Heparin, 5,000 unit sc q8hr or q12hr

  • Enoxaparin (Lovenox), 40 mg sc q1 - 2 hrs before surgery and daily after surgery, or 30 mg sc q12hr starting 8 - 12 hrs after surgery

  • Dalteparin, 5,000 units sc q8 - 12hr before surgery and daily after surgery.

• Orthopedic surgery:

  • Heparin is not recommended

  • Enoxaparin, 30 mg sc q12hr starting 12 - 24 hrs after surgery or 40 mg sc daily starting 10 - 12 hrs postsurgery

  • Dalteparin, 5,000 units sc q8 - 12 hrs before surgery, then daily starting 12 - 24 hrs after surgery or 2,500 units sc q6 - 8 hrs after surgery, then 5,000 units sq daily

• Major trauma:

  • Heparin, 5,000 units sc q8hr

  • Enoxaparin, 30 mg sc q12hr (for acute spinal cord injury)

  • Enoxaparin, 30 mg sc q12hr starting 12 - 36 hrs after surgery if the patient is hemodynamically stable.