dr.billah

1. Contraindicationsto VTE prophylaxisfor medical or surgical hospital inpatientsat high risk for VTE.
Absolute contraindications
 Acute hemorrhage from wounds or drains or lesions
 Intracranial hemorrhage within prior 24 hours
 Heparin-induced thrombocytopenia (HIT): consider using fondaparinux
 Severe trauma to head or spinal cord or extremities
 Epidural anesthesia/spinal block within 12 hours of initiation of anticoagulation (concurrent
use of an epidural catheter and anticoagulation other than low prophylactic doses of
unfractionated heparin should require review and approval by service who performed the
epidural or spinal procedure, eg, anesthesia/pain service and in many cases should be
avoided entirely)
 Currently receiving warfarin or heparin or LMWH or direct thrombin inhibitor for other
indications
Relative contraindications
 Coagulopathy (INR > 1.5)
 Intracranial lesion or neoplasm
 Severe thrombocytopenia (platelet count < 50,000/mcL)
 Intracranial hemorrhage within past 6 months
 Gastrointestinal or genitourinary hemorrhage within past 6 months.