TY - JOUR T1 - In reply: Is it time to initiate venous thromobolism prophylaxis for acute and ambulatory outpatients with lower limb immobilisation? JF - Emergency Medicine Journal JO - Emerg Med J SP - 390 LP - 390 DO - 10.1136/emermed-2020-209741 VL - 37 IS - 6 AU - Adrian Cois AU - Bory Kea Y1 - 2020/06/01 UR - http://emj.bmj.com/content/37/6/390.abstract N2 - Dear Editor in Chief,We read with great interest Horner and colleagues’ recent practice review regarding thromboprophylaxis for isolated lower extremity injury.1 The insight gained from this article, in addition to other recent large reviews, will improve the shared decision-making discussions we have with patients about prevention and risk of venous thromboembolism (VTE) with immobilisation. We have two comments regarding the generalisability and implementation of the study data.Although immobilisation of the lower limb following injury is also a common management strategy from the emergency department (ED) in the USA, we have observed that there is little consideration of VTE prophylaxis compared with Europe. In the USA, there is minimal consensus and lack of distinct guidelines on the routine … ER -