Preventing Venous Thromboembolism - (PVE)
What is VTE?

Venous thromboembolism is a deep vein thrombosis (DVT) or a pulmonary embolism (PE).

A DVT is a blood clot (thrombus) that forms in a deep vein. It is most common in your leg or pelvis and can cause swelling and pain. A longer term DVT can cause painful swelling and ulcers. If a clot becomes dislodged and reaches your lungs it is called PE. This can cause:

  • coughing (with blood stained phlegm)
  • chest pain
  • breathlessness 

VTE diagnosis needs immediate treatment. If you develop any of these symptoms in hospital or after you have left hospital get medical advice straight away.

Is VTE common?

VTE occurs in about 1 in 500 people. You may have heard in the news about DVT in people flying for long periods and suffering from ‘economy class syndrome’. You are actually much more likely to get VTE if you are going into hospital because of illness or surgery.

Who is at risk of VTE?

As well as being in hospital there are other things that mean you may be at greater risk of VTE. These include:

  • a previous VTE
  • a recent diagnosis of cancer
  • certain blood conditions such as clotting disorders
  • certain contraceptive and hormone replacement tablets
Will my risk be assessed?

The Government has recognised that VTE is an important problem and has advised doctors and nurses that everyone being admitted should have a VTE risk assessment. If you are at risk, your doctor or nurse will talk to you about what can be done to reduce your risk. They will follow national guidelines and offer you protection against VTE. 

What can I do to reduce my risk?

If your hospital admission has been planned several weeks in advance, there are some precautions that you can take to reduce your risk of VE:

  • Talk to your doctor about your contraceptive or hormone replacement tablets. Your doctor may consider stopping them a few weeks before you operation.
  • If possible, in the month before your operation, avoid continuous travel of more than 3 hours.
  • Keep a healthy weight.
When in hospital
  • Keep active by moving around or walking. Leg exercises are valuable. You can ask to see a physiotherapist if you would like some leg exercises.
  • Ask your doctor or nurse “What is being done to reduce my risk of VTE?”
  • Drink plenty of fluid to keep hydrated.
In hospital, what will be done to reduce my risk of VTE?

You will be assessed by your doctor on admission to see if you need to be given preventative treatment to reduce the risk of VTE (prophylaxis).

If you need an anaesthetic your anaesthetist will decide which type of anaesthesia is best for you.

Anti-embolism stockings will be fitted if appropriate. You will be measured and fitted with stockings and be shown how to wear them. Please report any symptoms in your feet or legs when wearing them to a member staff. These stockings will reduce your risk of VTE.

The clinical team may advise you to wear a special inflatable sleeve or cuff around your legs while you are in bed. This will inflate automatically. It will provide pressure at regular intervals to increase blood flow out of your legs. If the cuffs have been removed for more than 3 hours they should not be reapplied, unless advised by staff.

Finally your doctor might consider that you take an anticoagulant injection or tablet. This reduces the chance of your blood clotting and stop VTE from forming.

What happens after I leave hospital?

Anti-embolism stockings should be worn from admission until you return to your level of mobility. If you have been advised to continue anticoagulation medicine at home and you need help with administration of injections or tablets, please ask your nurse before you leave. It is important to keep active. Avoid sitting down all day when you get home. Drink plenty of liquid. Do any exercises you have been given.

If you develop any signs or symptoms of VTE at home such as:

  • Swelling or pain in your leg or hip
  • Chest pains
  • Breathlessness
  • A cough, possibly with bloody phlegm

seek medical advice immediately. Either from your GP or your nearest hospital emergency department.

Where can I find out more?

Please ask your doctor or nurse for more information. Alternatively the NHS website provides patient information on VTE NHS website  and NICE guidelines.

 

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For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302