DVT protocols

[lleamon]

DVT risk assessment & protocols: what is your OB unit doing? All admitted C/S pts. fall into the high risk category...Does your unit have any standing orders on TED and/or SCD and at what point are these orders implemented... Pre-op, post-op?...keep in mind unsched. c/s pts. as well, when to implement?

[Elvish, BSN, DNP, RN, NP]

We implement our pretty much asap when they get onto the floor post-recovery, with orders to d/c once pt is ambulatory. Usually our docs will write for one or the other, not both.

Most of our moms move around so well, they really don't need them for any significant length of time at all.

[TRINI_RN]

Our protocol for scheduled c/s is to put the scd's on in Preop. The Docs want the scd's running at least a 1/2 hour before surgery starts. Had a fluffy lady the other day with hx of DVT and PE for indux, she'd taken her last lovenox the night before. Had to ask the MD if he'd like to add SCD's to the admit orders

[lakec4me]

We do a DVT risk assessment on all labor patients. For scheduled c/s we put SCDs on pre-op. For unscheduled, we also put them on pre-op, unless it's a stat, then we put them on as soon as possible.

[nkochrn, RN]

All C/S patients are given SCD's upon admission or as soon as emergency c/s planned, they are left on for 48 hrs or until dismissal. We don't usually do lovenox in our OB's.

[RNBelle]

Wow! Protocols!? We do NOTHING and it aggravates me to no end!!!!!!! No SCDs, no TED hose, NOTHING!!!!

[momsdabom]

Here's a new flash, PCMH a tertiary care facility in Eastern NC, uses SCD on epdural pts in order to stay compliant with these new guidelines. God, I hope that doesn't catch on.

[FemmeRN]

We do SCD's on all c/s patients. Our standard computer order is "SCD's--continue until discharge". So, according to our manager, if the patient is in the bed, the SCD's must be on. However, many of the doctors come around and tell the patients, oh you've been up and moving around, you don't need these anymore. Hopefully we'll all be getting on the same page soon! We also have a few doctors who will order both TED's and SCD's on some patients.

[babyktchr, BSN, RN]

We do what everyone else is doing. I think to accomodate the ambulating patient, TED's could certainly be used, instead of putting those compression things on them again while in bed.

[HappyNurse2005, RN]

we use foot pumps as opposed to the knee high or thigh high scd's on the post c/s patients, starting right after c/s.

for our antepartum pt's on bedrest, they also get foot pumps. some of the fluffier apu pt's on strict bedrest get foot pumps and heparin. the foot pumps are pretty common/universal, though they aren't a standing order. the heparin really varies doctor to doctor

[CoffeeRTC, BSN, RN]

Interesting. Remembering my Csection a few yrs ago..I don't remember any prevention for DVTs except being allowed oob as soon as the epi wore off and the cath was pulled. I was in bed for at least 18 or more hrs after the surgery.