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Revision as of 18:26, 24 February 2014 by Vidit Bhargava (talk | contribs)
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Suspected DVT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pretest probability
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
High/Moderate
 
 
 
 
 
Low
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Start anticoagulation unless contraindicated, while awaiting results
 
 
 
 
 
Wait to start anticoagulation, if results will be available within 24 hours
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DVT confirmed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Anticoagulants contraindicated
 
 
 
 
 
Anticoagulants not contraindicated
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treat with inferior vena cava (IVC) filter
 
 
 
 
 
 
 
 
 
Stable DVT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acute DVT
 
 
 
 
 
Initiate treatment with warfarin 10 mg, first 2 days or other VKA's
Adjust dose based on INR
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Home conditions stable?
Good living conditions
Strong support from friends/family
Access to hospital, in case clinical condition deteriorates
Hemodynamic status stable?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treat at home
 
 
 
 
 
Hospitalize and treat
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Choose one of the following parenteral anticoagulants:
LMWH > Fondaparinaux > IV UFH > SC UFH
LMWH:
Enoxaparin 1 mg/kg every 12 hours
Tinzaparin 175 IU/kg four times a day
Dalteparin 100 IU/kg every 12 hours
Fondaparinaux: 7.5 mg once daily
IV UFH: Recommended doses
Bolus 80 U/kg followed by 18 U/kg/hour or
Bolus 5000 U followed by 1000 U/hour
SC UFH: 333 U/kg

Initate VKA, continue parenteral therapy till INR > 2.0 over 24 hours


Total duration of therapy:
First time DVT: Treat for 3 months
Recurrent DVT: Treat for 6 months
Recurrent DVT with high/moderate risk of bleeding: Treat for 3 months