In the Emergency Department (ED) lower leg immobilisation after injury is a necessary treatment but is also a known risk factor for the development of venous thromboembolism (VTE). This accounts for approximately 2% of all VTE cases which are potentially preventable with early pharmacological thromboprophylaxis.

Inclusion Criteria (must fit ALL):

• 16 years or over
• Isolated lower limb injury that will be treated in a rigid splint or cast, OR will be non-weight bearing; (Exclude patient with MT shoe who can weight bear)
• Not already anti-coagulated
• Being discharged

Contraindications – D/W Haematologist

• Known Haemophilia or other bleeding disorder
• Known Thrombocytopaenia or previous heparin induced thrombocytopaenia
• Cerebral haemorrhage within 3 months
• Severe hypertension systolic >200 or diastolic >120 mmHg
• Active peptic ulcer or history of varices or upper GI bleed <2 weeks
• Major trauma or Head Injury or Surgery to the eye or nervous system <4 weeks
• Hypersensitivity to Rivaroxaban OR Tinzaparin
• Clinical judgement that risks outweigh benefit

Tests