Tessa Quinn
Deep Vein Thrombosis (DVT) is a blood clot in a deep vein, usually in the legs. It can be caused by damage to a vein from surgery or inflammation, injury, or infection. DVT is considered a medical emergency and can be life-threatening if the clot breaks loose and travels to the lungs, causing a pulmonary embolism. Hospitalization increases the risk of DVT due to reduced mobility, and DVTs are more common after a hospital stay. To prevent thromboembolism in the hospital, patients may be given treatments such as blood-thinning medications, compression stockings, and compression devices on the calves. Moving the legs and avoiding crossing them while sitting can also help prevent DVT.
How to prevent thromboedema in the hospital
| Characteristics | Values |
|---|---|
| Movement | Move around more frequently to prevent fluid buildup in the tissues. |
| Compression devices | Compression devices on calves can help prevent thromboedema in the hospital. |
| Compression stockings | Wear compression stockings to prevent blood from pooling in the legs. |
| Elevate the legs | Elevate the legs when lying down or sitting to reduce swelling. |
| Surgery | In some cases, surgery may be required to treat thromboedema. |
| Medication | Medications called anticoagulants (blood thinners) can help prevent blood clots from getting bigger. |
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What You'll Learn
Compression devices and stockings
Compression stockings are a key treatment for deep vein thrombosis (DVT), which is a blood clot in a deep vein, usually in the leg. DVT can be caused by damage to a vein from surgery, inflammation, infection, injury, or certain medical conditions. It is also associated with a lack of movement, such as during long-distance travel, bed rest, or being in hospital. Compression stockings are specially designed to fit tightly and gently squeeze the legs to promote blood flow, thereby reducing the risk of blood clots and improving circulation. They are tightest around the ankles and become less constrictive towards the knees and thighs, forcing blood through narrower channels and increasing the volume of blood returning to the heart. This helps to prevent blood from pooling in the legs and causing clots.
Compression stockings are available in different lengths and pressures, and can be purchased over the counter or prescribed by a doctor. Prescription-grade compression stockings are fitted by trained staff who take measurements to ensure a correct fit. They also teach the patient how to put the stockings on and take them off, as this can be challenging. Compression stockings should be worn correctly, lying flat against the skin, with no bunching or folding, as this can cause blood flow problems or cut off circulation. They are typically worn for the entire day, and the use of "stocking aid" devices can assist those who struggle to put them on.
Compression devices are also used in hospitals to prevent DVT in patients who are bedridden. These machines are applied to the calves of patients to squeeze and release fabric-covered devices, increasing blood flow and preventing clots. Unlike compression stockings, these devices are not prescribed outside of hospitals.
Compression stockings are a safe and effective treatment for DVT, but caution should be exercised for those with advanced peripheral obstructive arterial disease, heart failure, septic phlebitis, oozing dermatitis, or advanced peripheral neuropathy. Compression therapy can also be used to treat lymphedema, or swelling due to an abnormal accumulation of lymph fluid, which can result from a blockage in the lymphatic system.
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Blood-thinning medications
There are two main types of blood-thinning medications: antiplatelets and anticoagulants. Antiplatelet medication is often used as the first line of treatment after a transient ischaemic attack (TIA) or ischaemic stroke. This could include drugs such as aspirin, clopidogrel, and occasionally dipyridamole. In some cases, patients may transition to anticoagulants, while others may remain on antiplatelets.
Anticoagulants are a diverse group of medications that can be administered through injections, intravenous (IV) drugs, or oral medications. They are often used to prevent blood clots from forming or growing larger, thereby reducing the risk of clots in blood vessels. Examples of anticoagulants include warfarin and heparin.
It is important to note that while blood thinners are effective in preventing thromboembolism, they also come with certain risks. One of the most significant side effects is increased bleeding. Patients taking blood thinners may experience more bleeding than usual, even from minor cuts or bruises. This is because blood thinners interfere with the body's natural clotting process, which is crucial for sealing wounds and preventing blood loss. As such, it is crucial for patients taking blood thinners to be cautious and report any falls, injuries, or signs of unusual bleeding to their doctor immediately.
Additionally, certain foods and medications can affect how blood thinners work. For example, vitamin K-rich foods like green leafy vegetables, chickpeas, avocado, and olive oil can interfere with the effectiveness of warfarin. Alcohol consumption and certain fruit juices, such as grapefruit, cranberry, or pomegranate juice, may also increase the risk of bleeding. Therefore, patients taking blood thinners should maintain a consistent diet and inform their doctors about any medications or supplements they are taking to ensure safe and effective use.
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Avoid sitting or standing still
Sitting or standing still for long periods of time can increase the risk of thromboembolism, especially in a hospital setting where patients are bedridden. Here are some tips to avoid sitting or standing still:
Move Around Frequently
If you've been sitting or standing still for an extended period, try to get up and move around. Even a short walk can help improve blood flow and reduce the risk of blood clots. This is especially important if you've been travelling long distances, as sitting for long periods during travel can increase the risk of thromboembolism.
Perform Lower Body Exercises
If you are unable to walk, you can do lower body exercises while sitting or lying down. Try raising and lowering your heels while keeping your toes on the floor. This helps to activate your calf muscles and improve blood flow in the legs.
Avoid Crossing Your Legs
Crossing your legs while sitting can restrict blood flow, so try to avoid doing this for extended periods. Instead, sit with your feet uncrossed and flat on the floor.
Elevate Your Legs
When lying down or sitting, try to elevate your legs. This can help reduce swelling and improve blood flow. Use pillows or cushions to prop your legs up comfortably.
Wear Compression Stockings
Compression stockings help to improve blood flow and reduce swelling in the legs. They are specially designed knee-high socks that apply gentle pressure to your legs. These can be recommended by your doctor or healthcare provider.
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Raise and move legs often
Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in the leg. It can be caused by damage to a vein from surgery or inflammation and damage due to infection or injury. It can also be caused by sitting or standing without moving for a long time, which can cause fluid to build up in the tissues. This is why DVTs are more common after a hospital stay, as patients are often lying in bed most of the time.
One way to prevent thromboembolism in the hospital is to raise and move your legs often. This can help to prevent blood clots from forming in the legs and can also reduce swelling. If you've been lying down or sitting for a long period, try to move your legs as soon as possible. When sitting, avoid crossing your legs, as this can block blood flow. If you are travelling, take frequent breaks to stretch your legs and move around. If you are bedridden, try doing some lower leg exercises. For example, you can try raising and lowering your heels while keeping your toes on the floor.
If you are in the hospital, your doctor may recommend wearing compression stockings to help prevent blood clots in the legs. These special socks help prevent blood from pooling in the legs and can also reduce leg swelling. They are typically worn during the day and may be recommended for a few years. Compression stockings press on the legs, improving blood flow.
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Surgery and filters
Deep vein thrombosis (DVT) is a blood clot in a vein located deep within the body, usually in the leg. DVTs can be caused by damage to a vein from surgery or inflammation and damage due to infection or injury. They can also be caused by sitting or lying down for long periods, which is common after surgery.
If a patient cannot take medication to thin their blood, or if they have blood clots while taking blood thinners, a surgeon may need to insert an inferior vena cava (IVC) filter. This procedure is done under local anaesthesia, with the surgeon inserting the IVC filter through a catheter into a large vein in the patient's groin or neck, and then into the vena cava, the body's largest vein.
Another surgical option is a thrombectomy, which is a surgery to remove a blood clot from a blood vessel (artery or vein). Thrombectomies can help restore blood flow to vital organs and reduce the risk of severe disability, limb loss, or death. Thrombectomies may be required when blood clots cannot be treated with medication.
Lymphedema is an abnormal buildup of protein-rich fluid in any part of the body, often caused by damage to the lymphatic system, such as after surgery. While early-stage lymphedema can be treated with non-surgical interventions, advanced stages may require surgery. Surgical options include vascularized lymph node transfer surgery, where healthy lymph nodes are transplanted to the affected area, and the Charles procedure, where affected tissue is removed and used as skin grafts to repair the area.
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