AAFP: CVT Outpatient Screening Criteria

Inclusion Criteria
Beschreibung

Inclusion Criteria

Acute, symptomatic, proximal or distal DVT documented by venogram/Doppler U/S
Beschreibung

Inclusion Criteria

Datentyp

boolean

Patient agrees to outpatient therapy
Beschreibung

Inclusion Criteria

Datentyp

boolean

Exclusion Criteria
Beschreibung

Exclusion Criteria

Current, active bleeding, active peptic or ulcer disease, congenital or acquired bleeding disorder or disease process in which, in the judgement of the physician, there may be an increased risk of bleeding (e.g. hepatic or renal insufficiency, recent surgery or stroke)
Beschreibung

Exclusion Criteria

Datentyp

boolean

Concurrent symptomatic pulmonary emboli
Beschreibung

Exclusion Criteria

Datentyp

boolean

Expected hospitalization greater than five days due to co-existing conditions
Beschreibung

Exclusion Criteria

Datentyp

boolean

Known hypercoagulability: familiar or acquired
Beschreibung

Exclusion Criteria

Datentyp

boolean

Pregnant or breast-feeding
Beschreibung

Exclusion Criteria

Datentyp

boolean

Uncontrolled hypertension
Beschreibung

Exclusion Criteria

Datentyp

boolean

Extensive iliofemoral DVT
Beschreibung

Exclusion Criteria

Datentyp

boolean

Likelihood of non-compliance due to cognitive limitations, alcohol/drug abuse, dementia, psychiatric disorders, etc.
Beschreibung

Exclusion Criteria

Datentyp

boolean

if yes, please describe
Beschreibung

Exclusion Criteria - Likelihoof of non-compliance

Datentyp

text

Decision
Beschreibung

Decision

Patient meets criteria for outpatient Lovenox therapy. Begin patient education.
Beschreibung

Decision

Datentyp

boolean

Lovenox self-administration and anticoagulation precautions.
Beschreibung

Decision

Datentyp

boolean

Patient does not qualify for outpatient Lovenox therapy.
Beschreibung

Decision

Datentyp

boolean

Signature
Beschreibung

Signature

Datentyp

text

Print Name
Beschreibung

Print Name

Datentyp

text

Date and Time
Beschreibung

Date and Time

Datentyp

datetime

Ähnliche Modelle

AAFP: CVT Outpatient Screening Criteria

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Inclusion Criteria
Inclusion Criteria
Item
Acute, symptomatic, proximal or distal DVT documented by venogram/Doppler U/S
boolean
Inclusion Criteria
Item
Patient agrees to outpatient therapy
boolean
Item Group
Exclusion Criteria
Exclusion Criteria
Item
Current, active bleeding, active peptic or ulcer disease, congenital or acquired bleeding disorder or disease process in which, in the judgement of the physician, there may be an increased risk of bleeding (e.g. hepatic or renal insufficiency, recent surgery or stroke)
boolean
Exclusion Criteria
Item
Concurrent symptomatic pulmonary emboli
boolean
Exclusion Criteria
Item
Expected hospitalization greater than five days due to co-existing conditions
boolean
Exclusion Criteria
Item
Known hypercoagulability: familiar or acquired
boolean
Exclusion Criteria
Item
Pregnant or breast-feeding
boolean
Exclusion Criteria
Item
Uncontrolled hypertension
boolean
Exclusion Criteria
Item
Extensive iliofemoral DVT
boolean
Exclusion Criteria
Item
Likelihood of non-compliance due to cognitive limitations, alcohol/drug abuse, dementia, psychiatric disorders, etc.
boolean
Exclusion Criteria - Likelihoof of non-compliance
Item
if yes, please describe
text
Item Group
Decision
Decision
Item
Patient meets criteria for outpatient Lovenox therapy. Begin patient education.
boolean
Decision
Item
Lovenox self-administration and anticoagulation precautions.
boolean
Decision
Item
Patient does not qualify for outpatient Lovenox therapy.
boolean
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime