Understanding

Deep Vein Thrombosis & Pulmonary Embolus

What is a DVT?

Deep vein thrombosis is the

formation of a blood clot in the lower.
It is the leading cause of preventable
mortality in hospitalized patients.

Risk Factors?
T
H
R
O
M
B
O
S
I
S

Trauma
Hormone
Road Traffic
Accidents
Operations
Malignancy
Blood Disorder
Older Adults
Serious Illness
Immobility
Splenectomy

Signs and Symptoms of DVT

Pain
Swelling
Redness
Tenderness
Visible Surface Veins
Leg Fatigue
Positive Homans Sign
Positive Lowenbergs Sign

Diagnostic Testing
D-Dimer Test
D-dimer tests are used to help rule out the
presence of blood clot (thrombus).

Venous Duplex Ultrasound

Venous ultrasound uses sound waves to produce
pictures of the body's veins. It is used to locate blood
clots in the veins of the leg

Complications of DVT

Pulmonary
Embolism

What is Pulmonary Embolus

A Pulmonary Embolism is a lifethreatening complication caused by
the detachment of a clot that has
traveled to the lungs.
DVT and pulmonary embolism
constitute a single disease process
known as venous thromboembolism..

Signs and Symptoms

Pulmonary Embolus
Dyspnea
Angina while breathing in
Hemoptysis
Hypoxia
Tachypnea
Tachycardia
Syncope
Hypotension
and sudden death

Preventing DVTs
Prevents Pulmonary Embolus
Exercise
Maintain a healthy weight
Smoking Cessation
Avoid alcoholic beverages
Limit long duration flights

Treatment for DVTs

Bed rest
Ambulation
Legs elevated
SCD on unaffected leg
Anticoagulants
Thrombectomy
IVC filtration
Consult your HCP
Compression Stockings

DVT and Anticoagulants

Warfarin (Coumadin)
Heparin
Enoxaparin (Lovanax)
Xarelto

Facts about Warfarin (Coumadin)

Taken PO
Onset Slow 3 days
Monitor Effects
INR (coagulation system)
Normal INR Range 1 to 2
INR Range while on Warfarin 2 to 3
INR of >3 indicates a risk for bleeding
The antidote for Warfarin is Vitamin K

Facts about Heparin

Given IV or Subcutaneous
Onset: Immediate
Needle Length 5/6 25-27 gauge needle
Monitor Effects
APTT (characterizes blood coagulation)
Normal APTT Range 30 to 40 seconds
APTT Range while on Heparin 60 to 80 seconds
Antidote for Heparin is Protamine Sulfate
Complication HIT Heparin induced Thrombocytopenia
Occurs 3-5 weeks after medication administration

Facts about Enoxaparin

(Lovanax)
Anticoagulant
Low molecular weight Heparin
Used to prevent DVT
Monitor platelets count
Given Subcutaneous in the abdomen
2x daily
Do not remove air bubble.
Side Effect Nausea & Vomiting

Facts about Xarelto

Once daily
P.O.
No routine monitoring
No dose adjustments
NO ANTIDOTE
Half Life is 5 9 hours
Expensive
Fewer Intracranial bleeds than Warfarin
SE GI Bleed

Patient Education & Check list

1. Do not double up on doses.
2. Avoid contact sports or strenuous exercise
3. Wear gloves when using sharp objects like scissors and
knives.
4. Use an electric razor.
5. Wear shoes when outside.
6. Use a soft toothbrush
7. Use waxed dental floss to clean your teeth.
8. If your doctor allows sports like biking, wear a helmet.
9. Wear a medical alert bracelet.
10. If you fall go to the hospital right away.
11. No OTC medicines, vitamins, or supplements like.
12. Call your doctor if you experience nausea or vomiting