Clinical Proforma
Lower Limb Immobilisation VTE Risk
Interactive lower limb immobilisation VTE assessment with progressive reveal, clipboard summary, and print / PDF export.
This tool is provided for clinical support and documentation assistance. Final clinical decisions remain the responsibility of the treating clinician.
Live
Potential high-risk immobilisation
| Expected rigid / non-weight-bearing immobilisation for 7 days or more | |
|---|---|
| Local high-risk injuries:Achilles | |
Patient-specific risk factors
| Age |
Years
|
|---|---|
| Sex genetic | |
| Height |
|
| Weight (booking weight if pregnant) |
|
| BMI |
kg/m²
|
| Pregnant | |
| <6 weeks post-partum | |
| Immobilisation typeSelect recommended immobilisation category (i.e. from eTrauma/vFC) | |
| Patient-specific risk factors | |
| Family history of VTE (1st degree relative) | |
| Personal history of VTE / known thrombophilia | |
| Combined oral contraceptive / oestrogen HRT Oral/Depot Oestrogen or Oestrogen Receptor Modulators (Tamoxifen, Raloxifene, Clomiphene) | |
| Cancer diagnosis within past 5 years | |
| Immobilisation within past 3 months (hospital admission, bedridden, flight >6h, lower limb paralysis) | |
| Surgery within past 3 months | |
| PMHx of one/more of heart failure, rheumatoid arthritis, CKD, COPD, inflammatory bowel disease | |
| Varicose veins | |
Specific injury categories
| Low-risk |
|
|---|---|
| Intermediate-risk |
|
| High-risk |
|
Thromboprophylaxis contraindications
| Contraindications | |
|---|---|
| Active bleeding / peptic ulcer / bleeding disorder | |
| Already taking anticoagulation | |
| Platelets < 30 (30-50 d/w Haematology) | |
| Cerebral haemorrhage < 7 days ago | |
| Ischaemic stroke < 14 days ago | |
| Uncontrolled hypertension (>180/120 on repeat recommended assessment) | |
| Any brain / spine / eye / ear / cardiothoracic surgery / TAVR in last 2 weeks | |
| Acute bacterial endocarditis | |
| Known Creatinine Clearance (CrCl) < 15 | |
| Creatinine | µmol/L |
| Calculated Creatinine Clearance | mL/min |
Concern for non-acute renal / platelet deterioration requiring bloods?
Apixaban
| Hypersensitivity | |
|---|---|
| Pregnancy / Breastfeeding | |
| Known liver disease with coagulopathy | |
| 2+ drug interaction classes |
|
| Antiphospholipid syndrome | |
Apixaban 2.5mg BD for 2 weeks recommended.
Enoxaparin contraindications
| Contraindications | |
|---|---|
| Hypersensitivity | |
| Previous HIT (Heparin-induced thrombocytopenia) | |
Summary
View a formatted clinical summary or copy a plain-text version for pasting into the clinical record.
Live pathway status
TRIP(cast) score: 1
Current stepAwaiting pathway entry questions
Derived values
BMI: —
BSA: —
CrCl: —
Related documents
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