Accepted at 3:33 p.m. Sep, 01, 2025 by andrewmathias8
Author: mohannadkh10
Co-authors: andrewmathias8
Related Note: 1511028698049 1
Rationale for change

For a long time, I thought we needed to start with heparin in the treatment of acute DVT because of this card.
This makes some cards (e.g., nid:1503361365813) not make sense.

According to Amboss, DOACs are the preferred agents for treating acute DVT. When we use them, we don’t need to bridge from heparin, we start directly in the ER.

The Amboss article supports this
https://next.amboss.com/us/article/fh0kWf?q=deep+vein+thrombosis

"Initial parenteral anticoagulation (with LMWH, fondaparinux, or UFH) should be initiated at the same time as warfarin and before dabigatran and edoxaban. Initial parenteral anticoagulation is not required for patients receiving rivaroxaban or apixaban. [7][24]"


I couldn’t find a UW question that directly tests this

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