Assessment of DVT

2018 Dr. Paul Tervit.


Wells Score for DVT
  • Active malignancy
  • Paralysis, paresis, recent immobilisation
  • Bedridden >3d, surgery in last 12 w
  • Localised tenderness along deep venous system
  • Entire leg swollen
  • Calf swelling > 3cm compared to the other leg
  • Pitting odema confinded to the symptomatic leg
  • Collateral superficial veins (nonvaricose)
  • Previous documented DVT
  • Alternative diagnosis at least as likely as DVT (-2)

Clexane Dosing
Weight (kg):
Renal impairment (CrCl < 30)?

Dabigitran It is important that the person receives 5 doses of therapeutic Enoxaparin (Clexane) 1.5mg/kg (adjust for renal impairment) for 5 days PRIOR to commencing the Dabigatran.
Never use Dabigatran and Enoxaparin (Clexane) at the same time - Dabigatran to start on day 6.

Dabigatran 150mg bd is the recommended dosage for a person with confirmed DVT (110mg bd dose is not appropriate for DVT treatment).

There are no data to support use in patients with severe renal impairment (<30 ml/min creatinine clearance); treatment in this population with dabigatran etexilate is not recommended

Patient ONLY to commence Dabigatran once Enoxaparin (Clexane) treatment has finished.
The first dose of Dabigatran should be given 24 hours after the 5th dose of Enoxaparin (Clexane.)

POAC Resources: