DVT - dx and mx

Question 1

What is the management of a suspected DVT?

Answer 1

1. Assessment of their general medical history
2. Perform a physical examination
3. DVT is suspected - use Well’s score

Question 2

What is the well’s score if DVT is likely?

Answer 2

> 2 or more points

Question 3

What is the well’s score if DVT is unlikely?

Answer 3

1 point or less

Question 4

What is the management if well’s score shows DVT is unlikely?

Answer 4

1. Offer a D dimer
   - if result is positive -
2. • within 4 hours *
     - proximal leg vein ultra sound
3. if not available within 4 hours
   - 24 hour dose of parenteral anti coagulant
   - followed by proximal leg vein ultrasound
   - within 24 hours of request

Question 5

What is the managment if well’s score shows DVT is likely?

Answer 5

1. proximal leg vein ultrasound within 4 hours
2. if negative;
   a D dimer test
   (if 4 hour proximal leg vein ultrasound not available then anti coag and ultrasound within 24 hours)
3. If D dimer is positive +
   - leg vein ultra sound scan 6 - 8 days later for all patients with positive D dimer test and negative proximal leg vein ultrasound.