Blood Clots

Every year, millions of people across the world develop a blood clot in a vein. It's known as venous thromboembolism (VTE) and is a serious, potentially fatal, medical condition.

VTE is the collective name for:

• Deep Vein Thrombosis (DVT): A blood clot in one of the deep veins in the body, usually in one of the legs.
• Pulmonary Embolism: A blood clot in the blood vessel that carries blood from the heart to the lungs.

Although serious, most blood clots can be completely avoided. The key is to be aware if you're at risk and take some simple preventative steps.

This document covers blood clots in veins. If you want information on blood clots in arteries, which is a common cause of heart attack and stroke, see the topic on arterial thrombosis.

Who gets blood clots?

Anyone can get a blood clot, but you're more at risk if you can't move around much or if you're unwell. Some people are more at risk of developing VTE than others. The risk increases if you visit the hospital and you:

• Have undergone major surgery
• Have long periods of immobility or a reduction in your usual level of mobility
• Are over 60 years old
• Are overweight or obese
• Have had a blood clot before
• Are having hormone replacement therapy (HRT)
• Are pregnant or have recently given birth
• Are dehydrated
• Have cancer or are having cancer treatment
• Have an inherited or acquired clotting problem
• Have a condition that causes your blood to clot more easily than normal, such as antiphospholipid syndrome
• Are suffering from an acute medical illness have more than one medical condition such as heart disease, diabetes or a respiratory illness
• Have inflammatory disease such as Crohn's or rheumatoid arthritis

Hospital-acquired blood clots

The World Health Organization (WHO) recognizes that deaths from hospital blood clots are preventable and has recommended that all patients admitted to the hospital should be assessed for their risk of developing blood clots, and measures to reduce this risk should be taken when appropriate.

About blood clots

Blood normally flows quickly and uninterrupted through our veins. Sometimes, however, clots can form that either reduce the blood flow or stop it completely.

A deep vein thrombosis (DVT) is a blood clot in a vein, usually in the leg or pelvis, most commonly caused by immobility.

A pulmonary embolism (PE) can occur if part of the blood clot breaks off and travels to the lung. Venous thromboembolism (VTE) is a term that includes deep vein thrombosis and pulmonary embolism. Preventing blood clots is a priority for CCAD Caregivers. Our physicians, nurses, pharmacists and other clinical caregivers all play an important role in keeping you safe.

From simple leg exercises to wearing special stockings, there are a number of measures that will help minimise your risks of suffering a hospital-acquired blood clot (VTE).

Assessing your risk of blood clots & prevention

On admission to CCAD, each patient has their risk for blood clots (VTE) assessed and, if necessary, is then given preventative measures.

If it has not been discussed with you, please feel free to ask your physician, nurse or pharmacist what is being done to reduce your risk of blood clots (VTE).

You may be given one or more of the following treatments

Medication

Drugs used to prevent and treat blood clots are called anticoagulants. They are sometimes given in tablet form if they are going to be used for a prolonged period or by injection if a faster-acting drug is needed.

While in the hospital, it is likely that the drug used will be an injection of heparin.

In some situations, medication may need to be continued once you have been discharged from the hospital. For some patients, this may be an injection. If this is the case then you or a member of your family will be supported and shown how to give it.

Compression devices or sequential compression stockings

These are inflatable sleeves that are fitted around the leg or foot while you are immobile in your hospital bed. They inflate at regular intervals and the pressure increases the flow of blood back to the heart.

Don't be afraid to ask clinical caregivers about reducing your risk of blood clots as it could save your life.

Questions you might like to ask your healthcare team about blood clots

• Am I at risk of blood clots?
• How likely am I to have bleeding problems?
• What happens if I have problems with my medication or treatment to help prevent clots?
• Will my operation cause blood clots?

While in the hospital

While you're in the hospital, you will reduce your chances of a blood clot if you:

• Drink plenty of fluids to keep hydrated
• Wear your compression stockings day and night (except when you're washing)
• Wear any other compression devices you've been given
• Take any blood-thinning medicines you've been offered
• Get up and move around as soon as you're advised to

After leaving the hospital

You're still at risk of developing a blood clot in the days and weeks after leaving the hospital, so you might be advised to continue preventative measures for a short period. Your care team will discuss this with you before you are discharged. It is important to continue any treatments that you have started until they have finished. If you have concerns about side effects, please discuss them with your Primary Care Physician (PCP) as soon as possible.

You may need to keep using anticoagulants for several weeks. You should also take care to stay as mobile as possible and keep yourself well hydrated. It is important to move around as soon as possible, especially after surgery. This is sometimes the only measure that needs to be taken.

Leg exercises

Point your toes down and bend the foot up at regular intervals as this helps to pump blood back to the heart. Rotate your ankles. Do this at least ten times an hour when you are inactive for long periods of time.

Drink plenty of fluids

Dehydration can also increase your risk of DVT, so make sure you drink enough water or other fluid.

If you experience any of the following VTE symptoms or bleeding once you are at home, you should seek urgent medical advice from your PCP or nearest emergency department, otherwise, call 999:

• Cramping pain, redness, warmth, or swelling in one of your legs - these are symptoms of DVT
• Breathlessness, chest pain, fainting or coughing up blood - these are symptoms of a pulmonary embolism

If you develop symptoms of a blood clot, see your PCP or go to your nearest Emergency Department.