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Department of Haematology Patient Information Preventing blood clots while you are in hospital This information outlines the important things you or your carer should know about preventing blood clots. During your hospital admission the healthcare team will assess your level of risk for DVT or PE. Below are the answers to some commonly asked questions. What is a deep vein thrombosis (DVT)? A deep vein thrombosis or DVT is a blood clot, in a vein (a blood vessel) usually in the leg. It can also occur in other places, such as the arm. What is a pulmonary embolism (PE)? An embolism is when a part of the clot breaks off and travels around the body. A pulmonary embolism occurs when: • part of the clot from a DVT breaks off • it moves up the leg • it travels through the heart • it then gets trapped or lodged in a lung (or pulmonary) artery. What is a VTE? Doctors use the term venous thromboembolism, shortened to VTE, to refer to a DVT and/or PE. These are related conditions as DVT can lead to PE (see above). The treatment is the same for both conditions in most cases. What are the signs and symptoms of having DVT or PE? Some people have no symptoms of a DVT. However, some or all of the following symptoms may occur: • pain • tenderness • swelling of the leg (usually the calf); the skin may appear shiny • change in colour with the leg appearing a dusky blue, red or purple colour. If the DVT is in the thigh veins, the whole leg maybe swollen. The symptoms of PE can include: • shortness of breath, which may be severe and sudden or be of gradual onset • chest pain which may be worse on inhalation (breathing in) • sudden collapse • coughing up blood. The symptoms of DVT may also be present. Who is at risk of blood clots? Certain factors put you at risk of VTE: • admission to hospital • a previous VTE • a recent diagnosis of cancer • certain blood conditions such as clotting disorders. • pregnancy • certain contraceptive and hormone replacement tablets. • being overweight. Will my risk of blood clots be assessed? The Government recognises VTE is the top hospital priority and advised doctors and nurses that everyone being admitted should have a risk assessment completed. Your individual risk for VTE will be assessed by your clinical team. If you are at risk, your doctor or nurse will discuss with you what can be done to reduce your risk. They will follow national guidelines to offer you protection against VTE. What can I do to reduce my risk of blood clots? You can significantly reduce your risk of having blood clot by: • drinking lots of fluids - unless advised otherwise - to keep you hydrated • keeping as mobile as possible by walking, moving your legs or ankles. If this is difficult for you, a physiotherapist can teach you some exercises. • asking your doctor or nurse about reducing your risk of VTE. Ensure you tell your healthcare team what other medications you are taking no matter how small or insignificant you think these are. What will be done to reduce my risk of blood clots while I am in the hospital? • Compression stockings (also called graduated compression stockings) can also be used. These are sometimes given to relieve pain and swelling. These will be fitted by a nurse and should not be bought over the counter at the pharmacy. Your doctor may ask you to wear stockings for at least two years after DVT. • • If you are having an operation, talk to your anaesthetist about which type of anaesthesia is most appropriate for you. Medications to help slow down the blood clotting. Usually, treatment is started with two anticoagulant drugs, heparin and warfarin. It is sometimes necessary to continue this treatment at home. What should I do once I go home? • If you have had stockings fitted, you should continue to wear these until you are at your level usual level of mobility. • Maintaining a healthy weight can also help to lower your risk. • If you have been given medication to take home to prevent blood clots, further information will be given about this. It is important that you complete the course of this medication and keep your GP informed. . Contact your doctor if you experience any problems such as bleeding. Who can I contact for further information? If you have any questions or would like any more information on preventing blood clots, please ask your doctor, nurse or pharmacist or contact your anticoagulant team on 0208 725 5443. For further information please refer to www.nice.org/uk/guidance/CG92 March 2011, for review March 2014