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AUDIT ON TIMING OF ANTICOAGULATION & REGIONAL ANAESTHESIA IN OBSTETRICS
ESRA Academy. PRASAD L. Sep 8, 2016; 138554; 0422 Topic: PROCEDURE BASED - EVIDENCE BASED RA AND PERIOPERATIVE ANALGESIA
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Dr. LINGA PRASAD
Dr. LINGA PRASAD

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Abstract
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Background and Aims:

Previous Survey in the department identified varied practices by colleagues regarding prescription of Thromboprophylaxis including the timing and dosing of medications. Timing of Neuraxial block and venous thromboembolism (VTE) prophylaxis should be optimal to balance the risks and benefits. So we conducted an Audit in our department to compare our practice against the national recommendations.

Methods:

A paper-based questionnaire was given to all anaesthetic colleagues in the department regarding VTE assessment and documentation, Dosage, Timing of actual dose given against prescribed time, are they aware of any national Guidelines. The data was collected, analysed and presented at Audit Meeting.

Results:

The results showed Non-adherence to Prescribed timing of drug, Too early administration in 11% and 63% of cases didn’t get VTE prophylaxis on prescribed time; Lack of awareness about the national guidelines, need for pre-operative risk assessment of VTE and optimising the dosing according to body weight.

Conclusions:

Our Audit demonstrated varied practise of VTE assessment of obstetric patients, as against national standards. We need to standardise our practice, educate all staff to optimise the risks and benefits of Thromboprophylaxis to patients undergoing Caesarean section. We recommend omitting the morning prophylactic dose on the day of surgery, administering the prophylactic dose 4 hours after Neuraxial block or removal of Epidural catheter, Calculate dose based on Body weight, avoid Neuraxial block for 12 hours after prophylactic dose and 24 hours after treatment dose of LMWH. Prescribe first dose on Front of drug Chart and Handover to Midwife.

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