• An individual risk assessment for DVT prophylaxis should be carried out for all patients on admission and documented in the clinical case notes. Currently surgical patients at St John’s Hospital site are assessed using the Caprini score.
  • Decisions regarding anticoagulant thromboprophylaxis in acutely-ill hospitalised patients should be made after consideration of risk factors for both VTE and bleeding (Tables A and B, pages 7 and 8, and Tables F, G and H on pages 11-12).
  • Acutely-ill hospitalised medical patients at low risk of VTE, and those who are bleeding or at high risk of bleeding, should not receive anticoagulant thromboprophylaxis. Instead, properly measured and fitted graduated elastic compression stockings (GECS) or intermittent pneumatic compression (IPC) devices should be used. When the bleeding risk subsides, consideration can be given to starting pharmacological thromboprophylaxis.
  • Prescribe all prophylaxis including GECS on the patient Prescription and Administration Record.
  • Hydrate and mobilise all patients as early as possible.
  • Document the reasons in the case notes if thromboprophylaxis is withheld or if there is any deviation from the guideline.