Reducing the Risk of Deep Vein Thrombosis (DVT) whilst in hospital and following your discharge home

Transcription

1 Reducing the Risk of Deep Vein Thrombosis (DVT) whilst in hospital and following your discharge home 1 Part of: South Tyneside and Sunderland Healthcare Group

2 Introduction This leaflet explains what Deep Vein Thrombosis (DVT) is and how to avoid developing a DVT while you are in hospital and when you first return home. What is a thrombosis? A thrombosis is a clot which can block a blood vessel. In the veins it is called a venous thrombosis. Blood clots form more commonly in the legs, where there are very fine veins just beneath the skin and deeper veins between the muscles. If the thrombosis occurs in a fine vein under the skin, there may be reddening and soreness of the skin known as thrombo-phlebitis. Thrombosis in the deeper veins (deep vein thrombosis) is more serious and can develop without any symptoms. It may cause aching or cramp like pain, especially when walking. You may notice swelling of one foot or ankle as fluid is forced out of the blood vessels into the tissues under the skin. Part of the blood clot may break free - this is known as an embolism - and travel through the circulation to the lungs. This is called a pulmonary embolism (PE) which may cause chest pain, a cough, or sudden breathlessness. You may cough up blood stained sputum. If the embolism is large, it may obstruct circulation causing breathlessness and dizziness and, in severe cases, may be life threatening. An embolism is only rarely seen after thrombosis of a fine vein under the skin. 2

3 Deep Vein Thrombosis (DVT) What causes a clot? Whenever we cut ourselves, our body responds by thickening the blood, which makes it clot more rapidly. This is our body s natural protective response to prevent you from losing too much blood. Some people s blood clots more readily and they are more likely to develop a thrombosis. How can I avoid a clot? Anyone can develop a blood clot at any age but certain things will increase the risk, for example, after injury or after surgery. Clots can also develop when blood flow through veins is sluggish because of inactivity or long bed rest. Sometimes certain illnesses, diseases and drugs can mean a blood clot is more likely to occur. The risk of you developing a blood clot also increases with age and if you are overweight. Long airline flights, bus and car journeys where there is prolonged sitting can also slow the circulation down and therefore increase your risk. 3

4 Try not to make long journeys (taking longer than three hours) in the four weeks before and after surgery. If you are planning any long journeys within this time please discuss this with your doctor who will give you advice depending on your risks and the surgical procedure. How can I prevent developing a clot? Clots cannot always be prevented but you can reduce your risk. Your nurse and doctor will carry out a risk assessment to determine your risk of developing a clot. This will be based on all your known risk factors, for example age, weight, known illness or diseases, past history of clots and how mobile you are or will be following treatment or surgery. Your risk is calculated and your nurse or doctor will advise you how to reduce a blood clot from forming. Exercise and mobility When you are in hospital you may not use your leg muscles as much as you do at home. This is because you will be spending more time in bed or sitting in a chair. It is important not to cross your legs. You should carry out leg and foot exercises as instructed by your nurse or physiotherapist to keep your blood moving. This will reduce the likelihood of clots forming. Your nurse and physiotherapist will get you up and moving as soon as possible after surgery. You should also make sure you keep moving about when you are discharged home, and follow the advice or your nurse and physiotherapist until your movement is back to your usual level. 4

5 Keep well hydrated If you become dehydrated your blood becomes thicker and stickier which makes clotting more likely. It is important to drink plenty of fluids to prevent this from happening. Check with your doctor or nurse when you should start drinking fluids following your surgery or investigation and make sure there are no restrictions to the fluids you drink. Make sure you have a drink at each mealtime and every time you re offered a drink in between meals, as well as having one beside you to drink throughout the day. It is also important to ensure you keep drinking when you re discharged home. You should try to drink two litres of fluids a day of non-alcoholic drinks, for example water, juice, tea, coffee. Special stockings (also known as antiembolic stockings) If it is decided that you require special stockings in hospital, the nurse will measure your legs so that the correct size stockings can then be fitted. You may need to be measured again if your leg size changes. The stockings are available in thigh or knee length. It is important to follow the advice below when wearing the stockings: You should wear the stockings throughout the day and night for up to six weeks. Your nurse will tell you how long you will need them. You can remove the stockings for bathing and put them back on within 30 minutes Do not use oily products on your legs as this may affect the fabric of the stockings 5

6 Do not allow the stockings to roll down your leg as they may become too tight and will restrict your blood flow Remove the stockings daily to check the condition of your skin. If your skin is discoloured or red please tell your nurse or doctor as soon as possible Sequential Compression Devices (sometimes called SCD) These devices are applied to your calves and gently massage your legs to improve your circulation. They are only used in certain conditions or procedures in hospital and you will only have to wear them until you are able to walk about. You may find that these devices feel strange at first but you will soon get used to them. The garments compress or squeeze your legs starting at your ankle first then your calf The compression or squeezing lasts for about 10 seconds and then the devices relax allowing your veins to refill with blood Please help your nurse by checking your devices are inflating and are not switched off Please tell the nurse if your devices feel too tight or too loose Medication: Low molecular weight heparin (LMWH) e.g. Enoxaparin Low molecular weight heparin is a medicine given as an injection. This medicine is known as an anticoagulant and is used to reduce the risk of blood clots forming. It can also be used to treat patients who develop a blood clot Some patients will only require this while they are in hospital, but others may need further injections or tablets following discharge from hospital. You may also need blood tests while having this medicine. If you have any concerns about this speak to your doctor, nurse or hospital pharmacist. 6

7 It is normal for small bruises to appear where the injection is given but these disappear quickly when the medicine is stopped. It is very important that you follow the advice of your doctor and nurse by correctly using the medicines and devices prescribed for you, get moving as instructed and drink plenty of fluids. If you become unwell at home If you experience sudden shortness of breath, chest pain or coughing up bright red blood stained sputum you must seek medical attention urgently and should attend the Accident and Emergency Department. If you develop redness, swelling or pain in either of your calves you must seek medical attention urgently. Contact If you have any questions or are unsure about anything to do with your treatment, ask your nurse, doctor or pharmacist for more information. Further Information This can be obtained from the following websites: http;// 7

8 South Tyneside District Hospital Harton Lane South Shields Tyne & Wear NE34 0PL Tel: For information about our Trust: We are committed to raising the standard of written information for patients, their carers, people who use the NHS and the general public. This information can be made available in another format or language on request. For further copies of this leaflet please contact on the telephone number above. Production date: June 2018 Author: STFT Code: 0618/518 Review date: June 2021