Venous Thrombo-Embolism (VTE) Information for service users and carers RDaSH leading the way with care Older People s Mental Health Services
Reducing risk of unwanted blood clots whilst in hospital About blood clots? Blood clotting is a natural, protective mechanism that is triggered by the body in response to a cut or wound. The blood clotting process is a complex sequence of chemical reactions involving proteins and platelets to form a plug (thrombus) which prevents you from bleeding too much. In some people unwanted clots can form in the vein deep within the leg, this is called deep vein thrombosis or DVT for short. This can result from immobility (e.g. prolonged bed rest) or inflammatory illnesses and may be trivial or life threatening dependent upon the size of the clot. The clot may partially or completely block blood flow causing symptoms of pain, hotness or redness and swelling in the leg. If a clot becomes dislodged from the vein in the leg, it can travel through the circulation to reach, and block, the blood vessels in the lungs, a condition called pulmonary embolism (PE). This would cause symptoms of shortness of breath, chest pain that worsens when you breathe in and coughing up blood. Both can be treated but it is important to reduce the risk in the first place. www.rdash.nhs.uk 3
Why might I be at risk of developing blood clots? There are several risk factors that increase your chances of developing a DVT or PE. These are commonly seen in patients in hospital and will be reviewed when you are admitted to hospital. The main risk factors include: Reduced mobility including long journeys, hospital admissions Age over 60 years old Overweight Dehydration Pregnancy Trauma(fractures) Major operations Acute medical illness Other known heart, lung, bowel or kidney diseases. Inflamed varicose veins Cancer and its treatment Some oral contraceptives or hormone replacements therapy (HRT) see below* Smoking Previous history of DVT or PE A known blood abnormality causing a clotting tendency (thrombophilia) or family history of clots * We generally advise that for women who are either on the pill or are undergoing a procedure associated with increased risk of clotting, measures will be taken to address this. 4 Venous Thrombo-Embolism (VTE)
What can be done to reduce the risk of developing a DVT or PE whilst in hospital When admitted, your risk of a DVT or PE will be assessed and if necessary appropriate measures put in place and reviewed throughout your admission. These include: Keeping as mobile as possible walking, exercise your legs in bed or your chair. Drink plenty Anti-thrombotic stockings (TED Stockings) These should be worn day and night and not removed for more than 30 minutes a day (for bathing) until you are back to your normal level of mobility. It is important that the stockings are fitted properly, so that they will have the desired effect of preventing clotting. If your stockings are falling down or too tight, speak to a trained nurse, who will be able to measure your legs and issue more appropriate stockings. Medications If you are felt to be at a high risk of clotting, you may also be prescribed an anticoagulant or blood thinner. These work with the body s natural anti-clotting system to prevent blood clots. This could be a tablet or an injection and will continue while you are less mobile. This will be reviewed whilst you are in hospital and may continue once you are discharged from hospital. Do not hesitate to ask about anything that concerns you injecting at home is easy, and it is important that you or a relative feel confident about doing so. If you are unable to manage this, a district nurse may be asked to visit to give you the injection. www.rdash.nhs.uk 5
It is unlikely that you will experience any problems with these medications, however, you should contact your doctor immediately, day or night if you: Feel chest pain or develop shortness of breath. Injure yourself, particularly on your head, eyes or joints. Cut yourself and bleed heavily. Have nose bleeds or your gums bleed heavily. Have a very heavy menstrual period. Notice unexpected bruises, such as brown or black spots on the skin. Vomit blood or something that looks like coffee grounds. Pass blood in your urine or motions (either obvious blood or sticky, black stools). Please also inform other healthcare practitioners including GP, Practice nurses, Dentist, Pharmacist (e.g. if purchasing over the counter medicines) that you are taking the anticoagulant medication as it may affect their choice of treatment. This includes in preparation for any pre-planned surgery or procedures. Do not take over the counter medicines such as aspirin and ibuprofen whilst taking an anticoagulant without consulting your doctor first. If you have any questions after going home please call your GP. 6 Venous Thrombo-Embolism (VTE)
This information is correct at the time of publishing Last Reviewed: June 2016 get We are a smokefree organisation. Please provide a smoke free environment approved for your healthcare provider. DP8041/07.16