Preventing Venous Thromboembolism

Transcription

1 Preventing Venous Thromboembolism (VTE) Patient Information Thrombosis Patient Safety Committee

2 What is VTE? VTE is the name given to either a deep vein thrombosis (DVT) or a pulmonary embolism (PE). A DVT is a thrombus (blood clot) that forms in a deep vein, most commonly in your leg or pelvis, and which can cause swelling and pain. In the longer term, DVT can cause painful, long-term swelling and ulcers. VTE requires immediate treatment. If you develop any of these symptoms either in hospital or after discharge, please seek medical advice immediately. Is VTE common? VTE occurs in the general population in about one in 500 people each year. You may have heard in the news about DVT in people flying for long periods ( economy class syndrome ), but you are actually much more likely to get VTE if you are going into hospital because of illness or for surgery. If a blood clot becomes dislodged and passes through your circulation to reach your lungs, this is called a PE and can cause coughing (sometimes with blood stained phlegm), chest pain and breathlessness. A large blood clot passing into the lungs can even cause collapse and death. Who is at risk of VTE? In addition to admission to hospital, there are other factors which place you at greater risk of VTE. These include a previous VTE, a recent diagnosis of cancer, and certain blood clotting disorders. In addition, oral contraceptive and hormone replacement tablets can increase your risk. 2 3

3 Will my risk of VTE be assessed? The Government recognises VTE is an important problem in hospitals and has advised doctors and nurses that everyone being admitted to hospital should have a risk assessment completed. Your individual risk for VTE will be assessed by your clinical team. If you are at risk, your doctor or nurse will discuss with you what can be done to reduce your risk and will follow national guidelines to offer you protection against VTE. What can I do to reduce my risk of VTE? If your hospital admission has been planned several weeks in advance, there are some precautions which you can take to reduce your risk of VTE: Talk to your doctor about your contraceptive or hormone replacement tablets. Your doctor may consider stopping them in the weeks before your operation. Avoid travelling continuously for more than three hours where your mobility is impaired in the month before your operation if possible. Keep a healthy weight. When in hospital: Keep moving or walking when possible. Leg exercises are also useful and you can ask to see a physiotherapist if you would like to learn some leg exercises. Drink plenty of fluid to keep hydrated. Ask your doctor or nurse: What is being done to reduce my risk of VTE? In hospital, what will be done to reduce my risk of VTE? Anti-embolism stockings may be considered appropriate by your doctor. You will be measured and fitted with knee or thigh-length stockings depending on your leg measurements. You should be shown how to wear them and advised to report any new symptoms that develop in your feet or legs. 4 5

4 The clinical team may ask you to wear a special inflatable sleeve or cuff around your legs while you are in bed. This will inflate automatically and provide pressure at regular intervals, increasing blood flow out of your legs. If they have been removed for more than three hours they should not be reapplied unless agreed by a doctor. Finally, your doctor might consider that you should take an anticoagulant injection or tablet. These reduce the chance of your blood clotting and can stop VTE from forming. The drug normally prescribed in hospital is heparin, which is given by injection. You should be aware that heparin contains animal products and you should discuss this with the doctor treating you if this is a concern. There are also some drugs available in tablet form which are used mainly in people having orthopaedic surgery, which may be offered to you. Heparin can cause allergic reactions and rarely (<1%) can cause a condition making people more prone to serious blood clots. What happens after I have been discharged from hospital? Anti-embolism stockings should be worn from admission until you return to your usual level of mobility. These should be removed daily to wash the leg and to check for any skin problems such as rash, discoloration or blistering. The stockings themselves should be washed every 2-3 days according to the manufacturer s instructions, so a spare set may be required if you need to wear them for a prolonged period of time. If you have been advised to continue anticoagulation medicine at home and you need help with administration of injections or tablets, please ask your nurse before discharge. If you develop any signs or symptoms of VTE at home, or if you have any problems with unexpected bleeding, then seek medical advice immediately, either from your General Practioner or your nearest hospital emergency department. Because anticoagulant medicines thin the blood, they can make people more prone to bleeding. Your doctor will consider any risk factors that you may have for bleeding before prescribing anticoagulants, but you should also report any unexpected bleeding if this occurs. 6 7

5 Comments, compliments, concerns or complaints South Tees Hospitals NHS Foundation Trust is concerned about the quality of care you receive and strives to maintain high standards of health care. However we do appreciate that there may be an occasion where you, or your family, feel dissatisfied with the standard of service you receive. Please do not hesitate to tell us about your concerns as this helps us to learn from your experience and to improve services for future patients. Patient Advice and Liaison Service (PALS) This service aims to advise and support patients, families and carers and help sort out problems quickly on your behalf. This service is available, and based, at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services. Please ask a member of staff for further information. Author: Thrombosis Patient Safety Committee The James Cook University Hospital Marton Road, Middlesbrough, TS4 3BW. Tel: Version 4, Issue Date: June 2014, Revision Date: June 2016 MICB3029