Thromboembolic Disorder Assessment: DVT/PE

THROMBOEMBOLIC DISORDER ASSESSMENT: DVT/PE
Risk Factors

• Injury to vein

— Fractures

— Severe muscle injury

— Major surgery (abdomen, pelvis, hip, or legs)

• Reduced blood flow

— Confinement to bed (eg, due to a medical condition or post-surgery)

— Limited movement (eg, cast on a leg to help heal an injured bone)

— Prolonged sitting

— Paralysis

• Increased estrogen

— Oral contraceptive use

— Hormone replacement therapy

— Pregnancy (post-partum period)

• Chronic medical illnesses

— Heart disease

— Lung disease

— Cancer and its treatment

— Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

• Other

— Previous DVT/PE

— Family history DVT/PE

— Age (risk increases as age increases)

— Obesity

— Central vein catheter

— Inherited clotting disorders

Prevention

• Advise patient to move around as soon as possible after limited mobility (eg, post surgery).

• Use graduated compression stockings or medications to prevent DVT.

• Warn patient if sitting for long periods of time, such as traveling for >4hrs:

— Get up and walk around every 2−3hrs.

— Do leg exercises.

— Wear loose fitting clothing.

• Initiate therapeutic lifestyle changes: exercise regularly; maintain healthy weight; smoking cessation.

Signs & Symptoms
DVT PE

• Swelling

• Pain

• Tenderness

• Redness of the skin

• Difficulty breathing

• Tachycardia or irregular heartbeat

• Chest pain or discomfort

• Hemoptysis

• Hypotension, lightheadedness, or fainting

Treatment

• Anticoagulants

— Injectable: heparin, low molecular weight heparin (LMWH), fondaparinux

— Oral: warfarin, dabigatran, rivaroxaban, apixaban, edoxaban

• Thrombolytics

• Inferior vena cava filter

• Thrombectomy/embolectomy

REFERENCES

Adapted from: www.cdc.gov/ncbddd/dvt/facts.html.

Adapted from: https://www.cdc.gov/ncbddd/dvt/diagnosis-treatment.html.

For a list of medications used to prevent or treat DVT/PE, visit: www.eMPR.com.

(Rev. 6/2019)

This article originally appeared on MPR