Reducing the risk of Deep Vein Thrombosis and Pulmonary Embolism

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What is Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)?

Your blood flows through your body in blood vessels called veins and arteries. If there is damage to these vessels, for example if you cut yourself, the blood usually forms a plug or ‘clot’ to stop any bleeding. However sometimes the blood’s clotting mechanism can form a blood clot in the veins when it is not supposed to. When this happens, the clot is called a ‘thrombus’. If the clot occurs in a deep vein it is called a Deep Vein Thrombosis (DVT). It most commonly occurs in leg or pelvic veins. Sometimes a clot can become loose and travel through the blood stream to your lungs. This is called a Pulmonary Embolism (PE).

What are the signs of DVT and PE?
• Pain or swelling in your leg
• The skin on your leg feels hot or discoloured (red, purple, or blue), other than bruising around the area if you have had an operation
• The veins near the surface of your legs appear larger than normal or you notice them more
• Shortness of breath
• Pain in your chest or upper back
• Coughing up blood

If you notice any of these symptoms, either in hospital or after discharge, please seek urgent medical advice. What we do to reduce the risk of venous thromboembolism (VTE) i.e. DVTs and PEs.
Hospital admission, due to illness and immobility, is associated with an increased risk of a venous thromboembolism (VTE). Other risk factors include previous thrombosis, a recent cancer diagnosis, pregnancy, some hormonal medications, family history and clotting disorders. All patients admitted to hospital will have a VTE and bleeding risk assessment. It is also important that we
know all the medicines that you are taking.

If you are assessed as being at increased risk of a VTE you may be offered one of the following:
• Anti-embolism stockings. These are tight stockings which squeeze your feet and lower legs and thighs helping your blood to circulate around your legs. You may not be offered these if you have recently had a stroke, if you have problems with the veins in your legs or if they are known not to be effective in the condition you have been admitted with.
• Intermittent pneumatic compression. A self-inflating leg sleeve that provides pressure to your legs to improve your circulation.
• Anticoagulant medicines. These ‘thin’ the blood and help prevent clots from forming. They may be an injection just under the skin or a tablet. The medication most commonly used in Milton Keynes Hospital is a low molecular weight heparin (dalteparin). This is of porcine (pig) origin. If you have any concerns, regarding medications of animal origin, please discuss with your medical team who will discuss other options with you.
• We will encourage you to mobilise as soon as you are able Your team should discuss the benefits and risks with you but please ask the staff looking after you if you have any questions.

When you go home
To reduce your risk of a VTE please mobilise as much as possible, stay well hydrated and maintain a healthy weight. Some patients may also be asked to continue anticoagulant medications at home. If you are continuing injections, you will be given a sharps box to dispose of the needles safely.

If you develop any of the symptoms described above, please seek immediate medical advice.