VTE. V enous T hrombo E mbolism. VTE – aims of this module. To define the terms associated with VTE and offer maximum care to treat patients. To enable patients to have greater understanding of their risks, and how to prevent venous thromboembolism. VTE – What does this include?.
To define the terms associated with VTE and offer maximum care to treat patients.
To enable patients to have greater understanding of their risks, and how to prevent venous thromboembolism.
ThrombusVTE - deep vein thrombosis (DVT) & pulmonary embolism (PE)
Circulatory Stasis. (sluggish flow in the veins)
Endothelial injury to veins. (due to trauma or inflammatory processes)
Hypercoagulable state. (inherited or acquired pro-coagulant factors in the circulation)
VTE is a major cause of morbidity and mortality in the UK
VTE deaths are 5 times more than total deaths from Hospital Acquired Infection, Ca Breast, RTA and Acquired Immune Deficiency syndrome.
60,000 die per year from VTE.
25,000 of these are hospital patients
Cost to NHS is £650 million
Acute VTE symptoms in the patient
Painful, swollen leg
Incapacity or sudden death
Time & money spent on investigation & treatment of a potentially avoidable condition
Most patients admitted to hospital Particularly where there is;
Acute & Chronic illness
DocumentedRisk Assessment is vital as …
It alerts both the patient & healthcare team to VTE risk & triggers practical VTE prevention measures (eg hydration, mobilization)
Chemical +/- mechanical prophylaxis is highly effective at preventing VTE in high risk patients
It is a DoH requirement
Mean time to develop a VTE after elective hip surgery? 22 days.
Mean time to develop a VTE after elective knee surgery? 10 days
What to do about VTE risk at SFT not immediateIs the patient immobile with at least 1 risk factor for VTE?
No specific action
Is LMWH contraindicated?
Very High = Both
Mobilisation as soon as possible
Regular leg exercises
Good positioning / posture / avoid hypothermia
Low Molecular Weight Heparin (LMWH) Dalteparin 5000iu od @ 18:00
THR or TKR for 5 weeks or 2 weeks
Rivaroxaban 10mg od @ 18:00
Document VTE risk assessment here not immediate
By kind permission of Richard Curtis and Tony Robinson