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Venous thromboembolism (處理 :red_flag:覺得他是又不是，覺得不是又是，當診斷出來又太晚，所以預防很重要…
Venous thromboembolism
Risk factors
左到右 高到低(table 6.1)
:warning:Major trauma
:explode:spinal cord injury
:explode:hip,pelvis fracture
:warning:Major sugery
:explode:hip, pelvis sugery
:explode:cancer
:explode:麻醉＞30mins
:warning:Acute medical problems
:explode:right heart failure
:explode:acute stroke
:explode:sepsis
預防(table 6.2)
low dose unfractionated heparin (LDUH)
bleeding risk<1% 不須監測
except hip/knee sugery都可用
Low-molecular-weight heparin (LMWH)
不須監測
抑制Xa
major orthopedia sugery
heparin-induced thrombocytopenia 低(0.2%)
IPC
GCS
診斷
exclude rather than confirm
No good clinical and lab
D-dimer
其他也會上升
NPV 92%
proximal leg vein duplex ultrasound
CTA
Radionuclide lung scan
處理 :red_flag:覺得他是又不是，覺得不是又是，當診斷出來又太晚，所以預防很重要
Heparin
用potamine反轉
LMWH
warfarin
thrombolytic therapy
disperation than anticipation
embolectomy
vena cava interruption