Second Wave of CoronaVirus and Guidelines How to Control it - Is it controablle after Adminstration of prophylactic Doses?

In the second wave of Corona virus pandemic some guidelines given by NICE should be follow. 

Prominent symptom of Critically ill patients of Covid-19 is venous thromboembolism. 

Guidelines given about reducing the chances of venous thromboembolism In critically ill patients are :

 Assess the patient about risk of bleeding  when patient admitted into hospital or after confirmed  diagnosis . 

In the case of confirmed diagnosis, use or prescribe the prophylactic doses of VTE (unless contraindicated) or low molecular weight heaprin (LMWH) . 

Dose adjustment must be required in patients with high body weight and any impaired renal functions . 

 Also in case of non-availability of heparin , fondaparinux sodium or UFH (unfractionated heparin ) is indicated . Also need to mentioned here both medications and heparin are not indicated or use off label under the age of 18. 

After the admission in hospital start the therapy within 14 hours and continue for 7 days (or as required) . 

 If patients have on anti coagulation therapy for any other indication, then it must be continue or not stop until and unless recommended by doctor w.r.t. any clincal circumstances. 

If current therapy doesn't work then switch the anticoagulant medication (anticoagulation drug from previous therapy)  must be switch to LMWH . 

If patient condition is deteriorating and not control then assess the risk of causing venous thromboembolism and start the prophylactic treatment if necessary . And reaccess it on daily basis. 

Hospital or any other organisation where patient is admitted, responsible for daily assessment of COVID 19 symptoms . And also give prophylactic doses of VTE. 

When patient complete their prophylactic treatment of VTE And discharge from hospital . Patient  must continue their dose regimen at home . Must prepare about suitable arrangements that patients not face any problems in their medicine consumption . 

EndNote 

Patient must be assess for their COVID 19 symptoms and if confirm their COVID 19 Pneumonia symptoms , it is advise to start VTE prophylactic doses ( after reevaluating their risk of VTE vs risk of bleeding).