We are updating out thromboprophylaxis policy at NGH:

We still have a link to COVID-19 thromboprophylaxis, although we don’t routinely do this in practice. The NICE interim rapid guidance for thromboprophylaxis in COVID-19 is still referenced in the NICE thromboprophylaxis policy and so we can’t be seen to be deviating from national policy. Can I ask what the exemplar centres are doing about COVID-19 so we can decide if we should keep this in our policy?

Hi Tinaa

I have to be honest and say that I've just found a flaw in our policy - we do not mention COVID at all!!

Now I need to review ours too  - thanks 🙄

Hi, at UHL we referrence the COVID-19 rapid guideline: managing COVID-19 NICE guideline: 5 Preventing and managing acute complications | COVID-19 rapid guideline: managing COVID-19 | Guidance | NICE - whether or not anybody uses the link is another question!

Hi Tinaa, we reverted back to standard thromboprophylaxis some time ago at King's.

Hi All,

Anyone using Fondaparinux ?

Oh yes - we have alot of patients on it at GSTT - some APS patients and others who have struggled or clotted on other anticoagulation for thromboprophylaxis.  Practice has evolved over the past couple of years and we now check anti-Xa levels at least annually.  Patients get on very well with it.  

 

Not specifically for Covid patients but we are seeing an increase in use of fonda for thromboprophylaxis and treatment of VTE. I'm not confident that the decision to prescribe instead of LMWH is a particularly well-informed one, either on the part of patients or medics/ nurses/ midwives. 

We have one patient on it long-term for VTE, I remember we needed to do an IFR for the CCG (as was) to agree to pay for it.

And in terms of covid guideline, ours still says what the NICE guideline says, in practice I think the majority get standard prophylaxis, not extended past hospitalisation.