dvtppx.html

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      <div class="content-block-title">Is there a high bleeding risk?
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        <li>Frank intracranial bleeding</li>
        <li>Incomplete SCI with perispinal bleeding</li>
        <li>Active major bleeding or very high bleeding risk</li>
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            <div class="item-inner"><div class="item-title">Yes</div></div>
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                <li>Mechanical thromboprophylaxis only.</li>
                <li>If high bleeding risk resolves, add LMWH</li>
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            <div class="item-inner"><div class="item-title">No</div></div>
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              <li>Begin LMWH (40 mg sc daily) +/- mechanical prophylaxis acutely.</li>
              <li>In the inpatient rehabilitation phase, can choose LMWH, warfarin (INR 2-3), or direct oral anticoagulant.</li>
               <li>Continue thromboprophylaxis at least 8 weeks and while admitted to inpatient rehabilitation.</li>
              <li>Chronic SCI patients should receive thromboprophylaxis during time period of increased risk.</li>
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        <p>Do not routinely screen with Doppler ultrasound for clinically inapparent DVT on admission to rehabilitation.</p>
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                <div class="item-title">References</div>
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                 <p>Consortium for spinal cord medicine. Prevention of venous thromboembolism in individuals with spinal cord injury. Clinical practice guidelines, Paralyzed veterans of America 2016(3rd edition).</p>

                 <p>Kirshblum S, Nieves J, Clark D, Gonzalez P, Cuccurullo SJ, Luciano L. Physical Medicine and Rehabilitation Board Review. Cuccurullo SJ LJ, editor. 3 rd ed. New York, NY: Demos Medical; 2015. Chapter 7, Spinal cord injuries. p.551-620.</p>
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