It requires institutional buy-in from your hospital. It's best done as a project coordinated between ED, pharmacy, hospitalist, and outpatient medicine. We DC DVT's from the ED, but only during hours when pharmacy is able to do lovenox teaching and we can ensure close follow up for transition to warfarin. We aren't beginning NOACs, and we still admit PE's.
At my hospital, for large thrombus DVT's (up to femoral head), our IR guys like to do catheter directed lysis/thrombectomy, so we admit those.
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outpatient dvt
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