Pulmonary Embolism: Prevention

00:01 Continuing our discussion here.

00:02 All hospitalized patients should be assessed for DVT and PE risk and, when appropriate, DVT prophylaxis is absolutely recommended.

00:12 Subcutaneous heparin. What does that do? It works on anti-thrombin III quickly.

00:19 And it's subcutaneous, it has to be parental, always in a hospital setting. Is that clear? Now, you might have friends and family, whatever that might be taking - there are experimental heparin drugs and they're assumed to be FDA approved, but don't worry about that right now. This is your point; hospital setting, subcu and it breaks down your clot in thrombin very very quickly. You're gonna be using your PTT.

00:44 We also have something called enoxaparin, this is a low molecular weight type of heparin and these are drugs that are relatively safe to use in pregnancy as well cuz you wanna - you want to avoid which drug during pregnancy, warfarin at all cost.

01:00 Now, with that said, pregnancy - a patient is pregnant. Is she at risk for a DVT? Yes.

01:09 We just said anyone who has excess estrogen is pro-thrombotic, right? And so therefore, are you thinking about giving a blood thinner in a pregnant lady? It is a possibility.

01:19 Do not give warfarin, you're going to wage war upon the fetus and kill your fetus, you don't want that.

01:24 So heparin is gonna cross the blood placenta barrier and the fetus is in fact going to be saved, maintained.

01:35 Now, in terms of prophylaxis, it's continuous.

01:37 So what you would do in here, you're going to then apply compression socks, TEDS/SCDs, compression stockings, okay.

01:44 And this - therefore, you would not be developing your DVT prophylaxis, prophylaxis, prophylaxis for PE.