Just a random question - do any of your Trust Gastroenterology omit thromboprophylaxis the night before an ERCP 

We have had several VTE events recently involving these patients and the Gastro team are saying that it is omitted due it being a high bleeding risk - all of the previous Trusts that I have worked in have not done this as far as I can recall as thromboprophylaxis is a low enough level for a spinal the morning after a dose, so it should be acceptable for an ERCP

Or am I having a senior moment? 

Hi Alex

I haven't heard of that, as far as I know, it can go ahead 12 hrs after thromboprophylaxis.

 

I shall ask the team

 

We have seen some of this practice here - omitting the night before ERCP or biopsies and sometimes the evening after. I can't think of a good reason for omitting any prophylactic doses around the time of ERCP and the practice has been challenged. 

feedback from the surgical team here:

We were asked to include ERCP as a high bleeding risk in the very beginning and it was always listed on back of the paper VTE form

However, that would mean omitting on the day and not the night before. Enoxaparin is prescribed at 18:00 so that it is safe to perform high risk surgery the next day

Best wishes