VTE prevention

All patients should be considered for thromboprophylaxis as part of a mandatory risk assessment procedure. Download risk assessment protocols for adult inpatients  and obstetric patients.

VTE diagnosis

VTE diagnosis is based on pre-test probability and D-dimer testing. Download our DVT investigation proforma and PE diagnostic algorithm.

VTE treatment and anticoagulant prescribing

Our Prescription chart for anticoagulant prescribing describes dosing for heparin, LMWH, and warfarin for treatment of DVT/PE without haemodynamic compromise, treatment of unstable angina and arrhythmia. Download our Early discharge proforma for low risk PE patients.

Anticoagulation during invasive procedures

Management of anticoagulation perioperatively varies depending on the thrombosis risk and the risk of bleeding. Download our Guideline on oral anticoagulation during invasive procedures.

NPSA patient safety alert

The NPSA alert, issued in March 2007, identified prescribing of oral anticoagulation and heparin as major causes of adverse events and hospital admissions and highlighted 15 risk factors and nine action points to be implemented to improve patient safety. The actions points addressed staff training, clinical protocols, anticoagulation services, patient information, monitoring standards, standardising prescribing, improving safe practice and audit. The alert required action, and set deadlines for agreeing an action plan of 2nd July 2007 and completing the actions by 31st March 2008.

Download 

At the King's Thrombosis Centre, Lynda Bonner and Rosalind Perrott are responsible for implementing the NPSA alert actions. Please see a list of relevant procedures and guidelines below for download and click here to download a recent article by Rosalind Perrott on the NPSA alert.

• Clinical management plan for use by Supplementary Prescribers
• Discharging patients on warfarin
• Guideline on oral anticoagulation during invasive procedures
• Managing interactions with warfarin
• Managing patients who cannot self administer warfarin
• Nutritional guidelines for patients on warfarin
• Prescription chart for anticoagulant prescribing
• Warfarin management in care homes

Laboratory services

KingsPath is the Clinical Diagnostic Pathology Service at King's College Hospital. The laboratory provides a wide range of coagulation tests including routine coagulation studies, factor assays, testing for lupus anticoagulant and inhibitors, platelet function tests and thrombophilia work-up. Recent additions to the research laboratory include thromboelastography and thrombin generation assays. Click here to find out more.