Treatment of DVT's

Originally posted by askater11

Has anyone else seen patients with I.V. access being tx. with lovenox SQ only?

There's nothing wrong with treating a DVT strictly with Lovenox. I've treated people off on on this way for well over a year. It just depends on the Dr. If you treat with heparin then you have to switch over to Warfarin, then your adjusting it to fit the INR...With Lovenox you can send them home with SQ's after a day or two. It's adjusted by poundage then your pretty much done. No need for the frequent blood draws.

The last poster is correct. There is no delicate balance of lab values to worry about with Lovenox. Many DVT's are now being treated on an outpatient basis. This is probably due to 2 factors: The insurance companies don't want to pay for a lengthy (our average was 5 -7 days) stay; and the recommended tx is rest, anticoags, and depending on the doc, warm moist compresses. These can be done in the comfort of the patients home with or without home care assist. As an ER nurse, I don't automatically insert an IV into a suspected DVT, although I usually do and just draw blood from the site.

I think this kind of somewhat comlicated outpatient treatment is on the horizon for many many illnesses. Look for them soon in a home near you...lol

This is really interesting.

Learned something new again today!

We routinely use Lovenox at the hospital where I work. Mostly on total joint replacements, and some M.I. patients. It cuts down hospitalization time, and is , what our docs consider, to be safer than heparin and warfarin.:) :)

I've been getting those shots in my belly for over two years now. Every time I'm hospitalized, which is quite often. And the best part is, they don't even hurt.

Fran:)

If it is so easily handled with levanox, how come I get so many patients on heparin drips still? I work occasionally in tele and unit, and it seems like they run sales on heparin drips.Must be where the emboli can launch from...any opinion, please share. These patients seem like they could be out patients.

I recently was diagnosed with a DVT (April 2003) and was placed on Lovenox SQ q12 hours for 7 days along with PO Coumadin. I was on Coumadin for 6 months and had to go in frequently at first for INR checks and then when my INR was where they wanted it, I went in once a month. They adjusted my Coumadin dosing according to the INR results. The DVT was resolved as of July but I remained on the Coumadin for the entire 6 months.

I've seen Lovenox exclusively used for DVT as well.

Here in the UK for a few years we have been using s/c heparin (cannot remember the name) initially it was given twice daily and then another s/c heparin was licenced and that was once daily, certainly made our lives a lot easier and I felt safer for the patient as the bleeding risk factor was reduced.

Anna

Originally posted by BarbPick

If it is so easily handled with levanox, how come I get so many patients on heparin drips still? I work occasionally in tele and unit, and it seems like they run sales on heparin drips.Must be where the emboli can launch from...any opinion, please share. These patients seem like they could be out patients.

Because it's hard to teach old dogs new tricks, and $$$ more for heparin protocols. They don't use it for the same reason it's been difficult for some to use the new ACLS cardiac drugs that have been out for the last four years.