TABLE 1

Contraindications to Thromboprophylaxis

Mechanical thromboprophylaxis	1. Bilateral amputee
	2. Bilateral lower extremity trauma or medical issue
	3. Peripheral arterial insufficiency
Pharmacologic thromboprophylaxis	1. Anesthesia/analgesia (neuraxial), single dose within past 24 h^{^a}
	2. Anesthesia/analgesia (neuraxial), within past 6 h^{^b}
	3. Anticoagulated
	4. Aspirin or other irreversible platelet inhibitor within past 7 d
	5. AVM, aneurysm, CNS mass, Moyamoya
	6. Bleeding (active, major) requiring transfusion, bleeding into vital organ, hemodynamic instability
	7. Bleeding disorder/tendency or history of unexplained or spontaneous hemorrhage
	8. Blood pressure (increased): SBP or DBP greater than 95th percentile for age, height, gender
	9. Catheter placement (indwelling) epidural/spinal^{^a}
	10. Catheter removal epidural/spinal within past 2 h^{^a}^,^{^b}
	11. Coagulopathy: INR >1.5, aPTT ≥44 s, platelet count <50 000/mm³, or fibrinogen <100 g/dL
	12. Comfort measures only
	13. HIT history
	14. Hepatic disease without known INR
	15. Neurosurgery, head trauma within 3 d
	16. Spinal hematoma or spinal stabilization surgery within past 24 h

aPTT activated partial thromboplastin time; AVM, arteriovenous malformation; CNS, central nervous system; DBP, diastolic blood pressure; HIT, heparin-induced thrombocytopenia; INR, international normalized ratio; SBP, systolic blood pressure.
↵a For twice-daily enoxaparin dosing.
↵b For once-daily enoxaparin dosing.