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How toreduce your risk of developing deep vein thrombosis (DVT)

What is a DVT?

A deep vein thrombosis (DVT) is the term used to describe a blood clot in one of the veins, most commonly found in the leg. Typically a DVT causes pain and swelling in the affected limb but you may not feel any symptoms at all. If the blood clot becomes loose it can travel through the bloodstream to the lungs. This is called pulmonary embolus (PE). Typically a PE causes chest pain and breathlessness and can be life-threatening. DVT and PE together are known as venous thromboembolism (VTE). Both DVT and PE can be treated effectively with anticoagulants but it is better to prevent them occurring in the first place.

What is the risk of developing a DVT?

A DVT can happen to anyone but is more likely to develop if you have had surgery or been admitted to hospital. Reduced movement and the effect of an illness or surgery means the blood is more prone to clotting.

How do we assess if you are at risk?

When you are admitted to hospital or your admission is being planned for surgery, we will complete a risk assessment. This will tell us if you are at an increased risk of developing a DVT.We will repeat this risk assessment within 24 hours of admission.

You are more likely to be at risk if:

You are having surgery lasting over an hour
You have active cancer or are having cancer treatment
You are aged 60 years or over
You have a serious illness
You have already experienced problems with blood clotting.

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Further information

Please use the links below to get more information on DVT.

Contact details

If you have any questions about DVTs or VTE, please contact your GP or call:

Sarah Mills, Lead Nurse for VTE on 020 3246 0421

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What signs and symptoms should I look out for?

Pain in the chest or upper back
Difficulty breathing
Coughing up blood
Swelling in the legs (usually only one leg)
Leg pain and tenderness
Change in skin colour on the leg
Skin hot to touch

If you have any of the above seek urgent medical attention from your GP or local Emergency Department

Please Note:

The drug Heparin is made from animal products.

If you would like to discuss this aspect of treatment because of this fact then please speak to the doctor looking after you.

If you have any other queries, please speak to a doctor or nurse on your ward.

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You spend three or more days in bed or in a chair.
You or a close relative has had a DVT or PE before
You are overweight or obese
You havea chronic disease such as diabetes, heart disease, chronic obstructive pulmonary disease (COPD)or another infectious or inflammatory condition.
You use hormone replacement therapy (HRT) or the combined oral contraceptive pill (OCP)
You have bad varicose veins
You are pregnant or within six weeks of giving birth, particularly if you have had a caesarean section, have any of the above conditions, are aged over 35 or have pre-eclampsia.

How can I reduce the risk of DVT?

Inform the team looking after you if you think you are at risk.

If you are coming to hospital for elective or planned surgery and are taking either the combined oral contraceptive pill or hormone replacement therapy you should discuss this in advance with your healthcare team and consider stopping these drugs four weeks before admission. If you do stop the combined pill you should consider other forms of contraception in discussion with your healthcare team.

How we will help you to reduce your risk of DVT

If you are at high risk of DVT, we can give you a small injection of Heparin, a blood thinning drug that reduces the risk of a clot forming. In some cases, another blood thinning agent (anticoagulant) may be used.

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We may be unable to give you Heparin or other anticoagulant if you:

Have recently had surgery or are due to have surgery where there is a high risk of bleeding.
Have a bleeding disorder (such as acute liver failure)
Are taking other medications that make your blood less ‘sticky’ such as warfarin, aspirin or clopridogrel( with aspirin and clopidogrel, your team will have to discuss the risks and benefits of anticoagulants with you)

Have had recently had a stroke
Have a low platelet count (cells in the blood that stop bleeding)
Have high blood pressure which isn’t being managed
Have inherited bleeding problems such as haemophilia or Von Willebrand’s disease

What else will help to reduce risk of DVT?

If you are having surgery it may be possible to fit tight elastic stockings to encourage blood flow.

If you are unable to get out of bed for a prolonged period we can fit an inflating and deflating sleeve around your leg which will help the blood flow. This is known as intermittent pneumatic compression (IPC).

Reasons why you may not be able to have stockings

If you have any of the conditions listed below, wearing stockings may cause more harm than good. Therefore we do not offer anti-embolism stockings if you have:

Known arterial disease or have had arterial bypass surgery
Lack of feeling in your fingers and toes
Fragile skin
Dermatitis, gangrene or recent skin graft
Known allergy to stocking material

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Heart failure
Severe leg swelling
Unusual leg size or a shape preventing correct fit
Severe venous ulcer

Fitting and wearing stockings

Your legs will be measured from two fingers below the back of the knee to the base of the heel and around the largest part of the calf.You will be shown how to put on the correct size of stocking as the stockings need to be taken off and put on at least once a day. This is for hygiene reasons and so the leg can be checked for any problems.

You maybe asked to wear your stockings after you go home, especially if you have had surgery.

What happens once i go home?

Before you leave hospital, the team looking after you in hospital may ask you (especially if you have had certain types of surgery) to continuetaking daily Heparin injections. Youmay be shown how to give this yourself or a district nurse can be organised to give them to you. The team willdiscuss these options with you and tell you how to look out for symptoms of DVT.

Once you are discharged, you should move around and drink plenty of water to reduce your risk of getting a DVT

You are at an increased risk of developing a clot for up to threemonths following discharge from hospital.

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