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Alexandra Butler

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Everything posted by Alexandra Butler

  1. Community Post
    I've had a couple of patients recently ask me if they can use vibration plates following their VTE diagnosis and I'm not really sure what to answer with A quick google says not to use them if you have had a recent DVT diagnosis but nothing about PE My questions are: How recent is recent? Can they use them after after 3 months of treatment? Should we advise PE patients not to use them either despite the general information from the companies only specifically saying DVT (I think we should include PE) Does anyone have any experience of advising when they can be used? Thanks for your help 🤗
  2. Community Post
    Hi Sue I have been very fortunate and have a contact at our Coroner's in Leamington Spa - our Bereavement Team have been helpful with creating the link as well. They do not inform us of any PE deaths as such but if any of my recent VTE patients go to Coroner, they are happy for me to contact them for the 1a COD. Leicester are helpful if I ring them as well if we have to send the patient there for a more indepth post mortem It's not ideal but unless we have something issued as a guideline nationally, I think that there will be variations everywhere. @Becs Walsh - do you not have something from the Coroner that helps you or did I dream that one?
  3. Community Post
    Hi Tinaa we state that chemotherapy patients are cohorted and we do not risk assess them
  4. Community Post
    My first thought Sue is why did they use Aspirin for thromboprophylaxis - that isn't right is it or have I missed some guidelines that say different? When you say large lady - how large? Our Aspirin guidelines for THR and TKR say to use LMWH or apixaban if they weigh over 150kg and I think if I remember correctly Leicester say that too It does fall within the 90 days so theoretically it is a provoked HAT but I agree with you that it needs further investigations - I've had a 38 year old man referred to my provoked clinic with a high d-dimer and the provoking factor stated on the referral being a CRP of 214 at the time of the DVT diagnosis but to be fair it was a very extensive DVT so I'm referring him on to the Consultant clinic for further review as I'm not happy either Basically, I agree, needs further review and not stop at 3 months if the clinic appointment hasn't happened at that point
  5. Community Post
    I have discovered that one of our breast surgeons and some of our colorectal surgeons are giving prescriptions to the day case breast cancer patients and colorectal cancer surgery patients to have thromboprophylaxis enoxaparin the night prior to being admitted for theatre I'm sure that this isn't in NG89 and I was wondering if any of your surgeons do this and have any evidence to support this practice
  6. Community Post
    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?
  7. Community Post
    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 🙄

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