Prophylaxis of venous thromboembolism in trauma: What you need to know.

Abstract

Deep venous thrombosis and pulmonary embolism account for significant morbidity and mortality in trauma patients. Most adult major trauma patients should be initiated on mechanical and chemical prophylaxis at the time of admission, with minimal delays for traumatic brain injury, spinal cord injury, active hemorrhage, and solid organ injury patients. Low molecular weight heparin remains the standard of care with ongoing consideration for optimal dosing strategies. Alternatives including unfractionated heparin, aspirin, and direct oral anticoagulants can be considered in specific patient populations. Extended duration prophylaxis is indicated in high-risk trauma patients.