The ultrasound DVT pathway has been updated to include a stat dose of 15mg oral Rivaroxaban where there is a delay >6 hours to ultrasound. This is an alternative to administering Clexane.
Ensure to check contraindications and cautions - see link here for the Ultrasound DVT information
The on-call Haematologist should be called for Friday delays where >1 dose may be required over the weekend.
In addition to this change, note:
- Always calculate the Wells score FIRST unless special case (thrombophlebitis, pregnancy, upper limb)
- The D-dimer is only required IF Wells <2
- Clexane is only funded as a stat dose pre scan where delay to scan >6hours. If DVT confirmed, POAC funds one teaching session for Clexane if required, the drug (post diagnosis) is covered by Pharmac SA if required
- Call thrombosis service here to discuss any distal /recurrence DVT cases as patients may not require same day hospital review