Responses to NICE guidance around mandatory 7 day Prophylaxis

There were two letters published in the British Journal of Haematology around the new guidance from NICE NG 89 to give all patients a minimum of 7 days prophylaxis looking at the cost and whether there is any evidence to support such a change. The articles are available at and

This was also discussed at the CLOT BSH session in Glasgow last year with an overwhelming vote that the new NICE guidance does not improve on previous guidance. If any centres are following this guidance would be great if you could contact CLOT or give your thoughts on this change.

New device cuts risk of deadly blood clots in stroke patients, study finds

This article was published in the Independent newspaper on the 22nd April 2019 which highlights that the device which sends electrical impulses down the legs of stroke patients can reduce the risk of deadly blood clots compared to standard treatment, new research shows.

The article is available at


Rivaroxaban for Thromboprophylaxis after Hospitalization for Medical Illness

Interesting article in view of the updated NICE guidance around mandatory 7 day VTE prophylaxis for all patients looking at whether giving 45 days of prophyaxis significantly reduces hospital acquired VTE and what is the bleed risk associated with this. The abstract is available at

For NHS staff should be able to access full article using Athens sign in. The CLOT session at the BSH in Glasgow this year is a further debate whether the new NICE guidelines improve on previous plan to attend


British Society of Haematology Membership Changes

CLOT for several years has worked with the BSH to put on a session at their annual scientific meeting which is next held in Glasgow from the 1st to the 3rd April 2019. The BSH are very keen to expand membership among nurses and allied health professional and for this reason from 2019 will offer free membership to all staff up to and including band 7 staff. Further information is available at and CLOT would encourage all our members to take advantage of this offer.

The use of the gekoTM device and the activation of the foot and calf pumps for prevention of venous thromboembolism in patients with acute stroke

Current UK practice for DVT prophylaxis, in acute stroke, is based upon data from the CLOTS 3 study and routinely comprises of IPC or a prophylactic-dose of Low Molecular Weight Heparin (LMWH), when the bleed risk is reduced. However, regardless of the merits of these interventions, a large number of patients remain contraindicated to these therapies leaving them exposed to developing DVT (Deep Vein thrombosis) or PE (Pulmonary Embolism).

The Royal Stoke University Hospital, UHNM NHS Trust have conducted a clinical audit to assess patient compliance to a new neuromuscular electrostimulation device called the geko™ device, to evaluate its VTE prophylaxis capability in patients admitted for either ischemic or haemorrhagic stroke. Patients unsuitable for VTE drug prophylaxis or contraindicated to IPC were prescribed the geko™ device.

The audit included 455 patients. In total 6/455 (1.3%) patients developed symptomatic VTE (3 DVTs and 3 PEs) within 90 days. Of these, 4 patients (1.6%) were prescribed IPC, 1 patient (1.3%) was prescribed the gekoTM device as a secondary intervention and 1 patient (1.5%) patient was prescribed anticoagulation. There was no DVT or PE in patients treated with the gekoTM device as the primary VTE prophylaxis.

Jodie Williams, Clinical Nurse Specialist at the Royal Stoke University Hospital, UHNM NHS Trust says, “The audit has proven the geko™ device as well tolerated and its introduction has marked a significant change in our VTE nursing practice on the acute stroke ward. The device is easy to fit and patients are much easier to mobilize. We now routinely check that patients are fitted with either the geko™ device or intermittent pneumatic compression (IPC) on our wards rounds. These checks provide confidence that all at-risk acute stroke patients are compliant with one of the available mechanical VTE interventions at all times”.

Dr Indira Natarajan, Consultant Stroke Physician and Clinical Director of Neurosciences at the Royal Stoke University Hospital, UHNM NHS Trust comments, “The geko™ device is a new paradigm in antithrombotic therapy for acute stroke. The clinical audit has revealed that we are aligned to the CLOTS 3 study which reports as many as 36% of patients are contraindicated or become intolerant to IPC. It is to this unmet need cohort that we now routinely fit the geko™ device, and this has ensured that all acute stroke patients can now receive VTE prophylaxis, where previously no prophylaxis was given”.

The geko™ is a battery powered, disposable, neuromuscular electrostimulation device designed to increase blood flow in the deep veins of the leg. The geko™ gently stimulates the common peroneal nerve activating the calf and foot muscle pumps increasing venous, arterial and microcirculatory blood flow. The blood flow increase is equal to 60% of walking, without a patient having to move or exert energy.

About Firstkind and Sky Medical Technology Ltd

Sky Medical Technology, the parent of Firstkind Ltd, is a highly innovative UK based medical devices company that has developed a ground-breaking neuromuscular electrostimulation technology platform, OnPulse®. The company develops a range of products tailored to the needs of different medical application areas selling both direct and through strategic partnerships or distributors in each major clinical area. Clinical areas of interest include oedema control, DVT prevention, wound healing and elite sport recovery. The goal in each clinical area is to improve clinical outcomes and patient care whilst saving health system resources.

For more information visit:

About North Midlands NHS Trust

The stroke service is jointly provided by University Hospitals of North Midlands NHS Trust and the Staffordshire and Stoke on Trent Partnership Trust. They have a combined acute stroke unit (hyper-acute beds and acute beds) and a specialist stroke rehabilitation unit at Haywood Hospital.

For more information visit:

Media contact:

Sue Davenport 
+44 (0)1494 572044 
Sky Medical Technology Limited 
Hawk House 
Peregrine Business Park 
Gomm Road 
High Wycombe 
HP13 7DL 
United Kingdom