ICSI has made a significant format enhancement in our scientific documents. All scientific documents (excluding Order Sets) now have “interactive” capability that allows a user to click on various links in the document and easily navigate from one area to another. For example, you can click on an algorithm box (those denoted with an “A” and those that refer to other algorithm boxes) and link directly to supporting annotation.

A tip for quickly going back and forth within the document:
Go to View, Toolbars, More Tools, Page Navigation, Previous View.
This should give you a back arrow tool that will allow you to go back and forth between views easily.

Note: The interactive links within ICSI PDF guidelines may not work on some mobile devices. However, the GoodReader App (and possibly some other "reader" applications) will allow anyone to open ICSI interactive PDF Guidelines on their mobile device and utilize most of the interactive capabilities.

Scope and Target Population:
Adult patients age 18 and over with venous thromboembolism (VTE), excluding those with familial bleeding disorders or pregnancy.

Aims:

1. Improve accurate diagnosis and treatment of venous thromboembolism (VTE).
   
2. Prevent progression or recurrence of thromboembolic disease.
   
3. Safely use anticoagulants to reduce the likelihood of patient harm and complications of anticoagulation therapy.
   
4. Increase the percentage of patients who are evaluated for medication reconciliation upon change in level of care and/or upon discharge.
   

Clinicians Highlights:

• 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 (with compression).
  
• 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.