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Patient Safety Alert for LMWH

20th January 2015

NHS England has issued a patient safety alert (NHS/PSA/W/2015/001) warning of the risk of harm from using low molecular weight heparin (LMWH) when contra-indicated, and highlighting the importance of assessing each patient individually as to whether the benefits of using LMWHs outweigh the risks. This follows several reports of harm and death. Contra-indications include but are not limited to:

  • active bleeding
  • acquired bleeding disorder e.g. acute liver failure
  • concurrent use of anticoagulants known to increase risk of bleeding
  • concurrent use of antiplatelets and other interacting medicines
  • lumbar puncture/epidural/spinal anaesthesia within the previous four hours, or expected within the next 12 hours.

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