Prevention of deep vein thrombosis and pulmonary embolus

Recognition of venous thromboembolism (VTE) depends on clinical suspicion, implementation of a scoring algorithm and (where indicated) a D-dimer assay. Treatment consists of support and anitcoagulation to reduce the risk of extension. Effective prophylaxis in appropriate groups is the most effective way of reducing morbidity from VTE. For prophylaxis, low molecular weight heparins (LMWHs) are as effective at preventing VTE as unfractionated heparin, with the advantages of once-daily administration, fewer side effects and no requirement for monitoring activated partial thromboplastin time. Neuraxial block following the administration of LMWH may give rise to significant complications.