Venous Thromboembolism, Prevention

ExitCare ImageA venous thromboembolism is a blood clot that forms in a vein. A blood clot in a deep vein is called a deep venous thrombosis (DVT). A blood clot in the lungs is called a pulmonary embolism (PE). Blood clots are dangerous and can cause death. Blood clots can form in the:

  • Lungs.

  • Legs.

  • Arms.

CAUSES

  • A blood clot can form in a vein from different conditions. A blood clot can develop due to:

  • Blood flow within a vein that is sluggish or very slow.

  • Medical conditions that make the blood clot easily.

  • Vein damage.

RISK FACTORS

Risk factors can increase your risk of developing a blood clot. Risk factors can include:

  • Smoking.

  • Obesity.

  • Age.

  • Immobility or sedentary lifestyle.

  • Sitting or standing for long periods of time.

  • Chronic or long-term bedrest.

  • Medical or past history of blood clots.

  • Family history of blood clots.

  • Hip, leg, or pelvis injury or trauma.

  • Major surgery, especially surgery on the hip, knee, or abdomen.

  • Pregnancy and childbirth.

  • Birth control pills and hormone replacement therapy.

  • Medical conditions such as

  • Peripheral vascular disease (PVD).

  • Diabetes.

  • Cancer.

SYMPTOMS

ExitCare ImageSymptoms of VTE can depend on where the clot is located and if the clot breaks off and travels to another organ. Sometimes, there may be no symptoms.

  • DVT symptoms can include:

  • Swelling of the leg or arm, especially on one side.

  • Warmth and redness of the leg or arm, especially on one side.

  • Pain in an arm or leg. Leg pain may be more noticeable or worse when standing or walking.

  • PE symptoms can include:

  • Shortness of breath.

  • Coughing.

  • Coughing up blood or blood-tinged mucus (hemoptysis).

  • Chest pain or chest pain with deep breaths (pleuritic chest pain).

  • Apprehension, anxiety, or a feeling of impending doom.

  • Rapid heartbeat.

PREVENTION

  • Exercise regularly. Take a brisk 30 minute walk every day. Staying active and moving around can help prevent blood clots.

  • Avoid sitting or lying in bed for long periods of time. Change your position often, especially during a long trip.

  • Women, especially those over the age of 35, should consider the risks and benefits of taking estrogen medicines. This includes birth control pills and hormone replacement therapy.

  • Do not smoke, especially if you take estrogen medicines. If you smoke, talk to your caregiver on how to quit.

  • Eat plenty of fruits and vegetables. Ask your caregiver or dietitian if there are foods you should avoid.

  • Maintain a weight as suggested by your caregiver.

  • Wear loose-fitting clothing. Avoid constrictive or tight clothing around your legs or waist.

  • Try not to bump or injure your legs. Avoid crossing your legs when you are sitting.

  • Do not use pillows under your knees unless told by your caregiver.

  • Take all medicines that your caregiver prescribes you.

  • Wear special stockings (compression stockings or TED hose) if your caregiver prescribes them.

  • Wearing compression stockings (support hose) can make the leg veins more narrow. This increases blood flow in the legs and can help prevent blood clots.

  • It is important to wear compression stockings correctly. Do not let them bunch up when you are wearing them.

TRAVEL

Long distance travel can increase the risk of a blood clot. To prevent a blood clot when traveling:

  • You should exercise your legs by walking or by pumping your muscles every hour. To help prevent poor circulation on long trips, stand, stretch, and walk up and down the aisle of your airplane, train, or bus as often as possible to get the blood moving.

  • Do squats if you are able. If you are unable to do squats, raise your foot on the balls of your feet and tighten your lower leg muscles (particularly the calve muscles) while seated. Pointing (flexing and extending) your toes while tightening your calves while seated are also good exercises to do every hour during long trips. They help increase blood flow and reduce risk of DVT.

  • Stay well hydrated. Drink water regularly when traveling, especially when you are sitting or immobile for long periods of time.

  • Use of drugs to prevent DVT during routine travel is not generally recommended. Before taking any drugs to reduce risk of DVT, consult your caregiver.

SURGERY AND HOSPITALIZATION

  • People who are at high risk for a blood clot may be given a blood thinning medicine (anticoagulant) when they are hospitalized even if they are not going to have surgery.

  • A long trip prior to surgery can increase the risk of a clot for patients undergoing hip and knee replacements. Talk to your caregiver about travel plans before your surgery.

  • After hip or knee surgery, your caregiver may give you anticoagulants to help prevent blood clots.

  • Anticoagulants may be given to people at high risk of developing thromboembolism, before, during, or sometimes after surgery, including people with clotting disorders or with a history of past thromboembolism.

TRAVEL AFTER SURGERY

  • In orthopedic surgery, the cutting of bones prompts the body to increase clotting factors in the blood. Due to the size of the bones involved in hip and knee replacements, there is a higher risk of blood clotting than other orthopedic surgeries.

  • There is a risk of clotting for up to 4–6 weeks after surgery. Flying or traveling long distances can increase your risk of a clot. As a result, those who travel long distances may need additional preventive measures after their procedure.

  • Drink only non-alcoholic beverages during your flight, train, or car travel. Alcohol can dehydrate you and increase your risk of getting blood clots.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop chest pain.

  • You develop severe shortness of breath.

  • You have breathing problems after traveling.

  • You develop swelling or pain in the leg.

  • You begin to cough up bloody mucus or phlegm (sputum).

  • You feel dizzy or faint.