Revision Date: January 2013
Scope and Target Population
Adult patients age 18 and over with venous thromboembolism (VTE), excluding those with familial bleeding disorders or pregnancy.
- Improve accurate diagnosis and treatment of venous thromboembolism (VTE).
- Prevent progression or recurrence of thromboembolic disease.
- Safely use anticoagulants to reduce the likelihood of patient harm and complications of anticoagulation therapy.
- Increase the percentage of patients who are evaluated for medication reconciliation upon change in level of care and/or upon discharge.
- A clinical pretest probability assessment should be completed in patients with suspected venous thromboembolism.
- D-dimer can be used as a negative predictor to eliminate need for further testing.
- Confirm diagnosis of lower extremity deep vein thrombosis (DVT) with imaging study, preferably duplex ultrasound.
- In patients with a high clinical pretest probability for pulmonary embolism (PE), begin anticoagulation without delay.
- Achieve rapid, effective anticoagulation.
- In patients with acute VTE, heparin (UFH or LMWH) or fondaparinux should be given for at least five days and until the INR > 2.0 for two consecutive days.
- Arrange for home therapy in appropriate patients.