Shelly,

Since August of 1998, we have been treating ER patients at Mercy Franciscan with
Lovenox, even sending them home with instructions on  self-injection, and
getting the scan within 24 hours.  This has worked out well.  We have been able
to reduce our call hours to weekends and holidays only from 9am to 3pm.  That
way a tech is available 7 days a week and we have eliminated "burn-out" and been
able to hire and keep more techs.  Hence. our call rotation is now only once
every 6 weeks.  Not Bad!

We are currently evaluating and tracking patients treated with Lovenox.  At one
of our 2 hospitals, July 99-Dec99, 17 patients were scanned from the ED.  Twelve
had negative scans.  Of the five that were positive, 2 had BK DVT, 1 had SVT,
and 2 had AK DVT and were already admitted and treated with heparin.  Ten of the
17 were given Lovenox.  Of those 10, 8 were scanned the same day and 9 were
scanned the next day.  There were no adverse effects or patients with AK DVT
sent home.

This requires the co-operation of the ER docs and Vascular Lab readers.  Our
readers (Vascular surgeons) screen the calls from the ED after hours and
determine if the patient needs to be scanned same day or next day.  Then the
determination is made whether or not to give Lovenox.

Connie McCoy