Dvt Flashcards
(36 cards)
Definition of DVT
Formation of one or more blood clots in the body’s large veins (usually in lower extremities)
Where does dvt begin
Venous valve cusps
How does DVT cause a PE
the thrombus dislodges and travels in the blood to the pulmonary artery
What factors contribute to DVT
-direct trauma to vessels, blood coaguability ,oral contraceptives, pregnancies, repetitive motions
How does blood coaguablity contribute to DVT
it is increased in patients who were on anti coagulants that have been stopped abruptly
How does pregnancy contribute to DVT
Increases the clotting factors
How does repetitive motions contribute to DVT
It may cause irritation to the vessel leading to inflammation
Example of fdirect trauma that causes DVT
Fracture, vein diseases, chemical irritation from IV medication
Symptoms of DVT
Oedema of lower extremities
Warmth of the affected limb
Pain
Pyrexia
Colour changes
What causes pyrexia of DVT site
Systemic increase in body temperature caused by accumulation of tissue at thrombosis site
What causes Oedema
Uninhibited blood flow due to obstruction
What causes warmth of affected limb
Localised venous congestion and accumulation of tissue metabolites
What causes pain at the site
(HOMANS SIGN) causes by inflammation of the vein wall.
Can be throbbing, cramping
What Color changes occur at site
Pallor of leg or peripheral skin erythema (redness)
Wells screening tool
Uses patients clinical history and physical examination of symptoms to dpredict likelihood of Dvt
Ways of diagnosing DVT
Doppler ultrasound
CT scan
Blood tests
What is the haematology screening
It detects the presence of fibrin degration products in the blood like D-DIMER
What is D-DIMER
it is released in the blood durian a DVT episode
What is the normal rate of D-DIMER in blood
Less than .50
(<.50)
What does raised D-DIMER indicate
The presence of PE or DVT
What is the NICE 2015 recommendation
Wells score is done first
and patients who get 2 get a leg ultrasound
If nothing is found
Haematology screening is done for D-DIMER
leg vein ultrasound is then repeated after 6-8 days
Overall management of DVT
Anti coag therapy combined with mechanical thromboectomy and ultrasound guided thrombilytic therapy
Pharmacological management of DVT
NOACS (novel oral anticoagulant) e,g abixanan
OACS (oral anticoagulants) e,g warfarin (long term anticoagulant therapy)
LMWH (low molecular weight heparin) subcutaneous e,g enoxaparin
Unfractioned therapy (prevents further development of DVT and given iv continuously or intermittent subcutaneous)
What is unfractioned therapy
Prevents further DVT developments
Given continuously in IV
or subcutaneous intermittently
