Should intermittent pneumatic compression (IPC) be a first-line, appropriate choice for patients at moderate risk of VTE?
At the University of California, San Diego (UCSD) Medical Center, a 300-bed referral center, the team originally wanted to keep IPC as an option for patients at moderate risk for VTE, despite the lack of solid evidence in the literature for medical patients. Team audits revealed about 55 percent compliance with IPC, however, and the UCSD team adapted the approach of the American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy, which relegates IPC to patients with contraindications for pharmacologic prophylaxis or as a secondary method to enhance the effectiveness of pharmacologic prophylaxis. Which patients need IPC in addition to pharmacologic prophylaxis? At UCSD, the team decided the very high-risk patient must have it, while other patients could have it. Which patients should have 5,000 units of heparin every 12 hours as an option versus 5,000 units of heparin every 8 hours? UCSD initially had four levels of VTE risk. They allowed 5,000 units of he
