Lower Limb Immobilisation Venous Thromboembolism (VTE) Prevention Policy

Introduction

Lower limb immobilisation accounts for 1.5-3% of all VTE events in the UK. Depending on the patient profile and type of immobilisation used, the incidence of VTE’s in patients with immobilisation ranges between 5-39% compared with an incidence of 0.12-0.18% in a normal undifferentiated population.

The NICE Guideline CG92, 2010 : Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital: (http://guidance.nice.org.uk/CG92)

The guideline does not offer any advice on the management of patients requiring lower limb immobilisation managed in the out-patient setting.

The Royal College of Emergency Medicine (RCEM) set up a policy group which published guidelines for the use of thromboprophylaxis in ambulatory trauma patients requiring temporary lower limb immobilisation in 2013 based on best available evidence. (https://www.ncbi.nlm.nih.gov/pubmed/24142947)

Scope

This policy is relevant to all clinical staff involved in the care of adult out-patients who present to the Emergency Department or Fracture Clinic and require lower limb immobilisation.

Patients below 18 years of age should undergo individual risk assessment where deemed necessary by the clinician and a decision regarding VTE prevention made in consultation with the Consultant in charge of the patient.

Policy Details

See also:

• Thromboprophylaxis in Lower Limb Immobilisation Risk Assessment Tool