Information for patients

Preventing Blood Clots What you should know This leaflet outlines the important things you or your carer should know about preventing blood clots, before, during and after your stay in hospital. Your healthcare professional will be able to answer any further questions you may have.

3 E  mbolus travels through the heart and blocks blood vessels in lung pulmonary arteries embolus

lung

heart

healthy lung tissue

lung tissue deprived of blood

blood flow from heart

2 E  mbolus travels through bloodstream to heart blood flow to heart

embolus blood clot

DPS ref: 06171-14(RP)

Anticoagulant Monitoring Service Tel: 01473 703228

vein

1 T  hrombus develops in vein and breaks free

Issue 2: December 2014  Review date: November 2017 © The Ipswich Hospital NHS Trust, 2011-2014. All rights reserved. Not to be reproduced in whole, or in part, without the permission of the copyright owner.

vein valve

What is a DVT? DVT is a common medical condition that occurs when a thrombus (blood clot) forms in a deep vein, usually in the leg or pelvis, leading to either partially or completely blocked circulation.

How serious is DVT? If the blood clot in the leg breaks away and travels to the lungs, it will cause pulmonary embolism (PE). PE may result in breathing difficulties and may be fatal. DVT may cause long-term problems such as leg swelling, leg ulcers and varicose veins. DVT and PE are known under the collective term of venous thromboembolism (VTE).

How common is it? • More people die from VTE than the combined figures of those who die from AIDS, breast cancer and road traffic accidents. • Almost 30,000 people in this country die each year from VTE. • VTE is one of the commonest avoidable causes of hospital deaths. • One in three surgical patients may develop DVT if no preventative measures are given.

Am I at risk of DVT? Everyone is at risk of developing a DVT. There are also several risk factors which may increase your chance of developing a DVT. These include: • age – the older you are, the higher the risk; • acute medical illness including heart failure, chronic respiratory diseases, major infection or cancer; • major surgery including hip or knee replacements; • immobility when you are unwell; • pregnancy; Page 3

• taking the combined contraceptive pill, HRT or chemotherapy drugs; • previous history of DVT or PE, or a strong family history of either; and • obesity.

How do I know if I have a DVT or PE (VTE)? Many people with VTE have no obvious symptoms at all. The most common symptoms include: • pain, tenderness and swelling of the leg, usually in the calf; • mild fever with hotness in the area of the thrombosis; • redness in the leg; • shortness of breath; • chest pain when you breathe; and • collapse. These symptoms may occur while you are in hospital or after you have returned home. If you do develop any of the above symptoms while in hospital, please speak to your nurse or doctor. If you develop any symptoms after your discharge from hospital, please arrange to see your GP or, if you are particularly concerned, go to your nearest Emergency Department (A&E).

How is Ipswich Hospital trying to prevent me developing VTE? A doctor will carry out a VTE risk assessment when you are admitted to hospital. This is recorded on your drug chart and reviewed regularly. If you are assessed as being at risk, the doctor will take actions to reduce the risk by: • prescribing injections of a drug called low molecular weight heparin into the skin of your abdomen to prevent clots forming; Page 4

• p  rescribing special stockings which will help the blood flow in your legs; and • encouraging you to perform the leg exercises illustrated in this booklet.

How can I reduce the risk of developing VTE while I am in hospital and when I go home? • Walk regularly if you are able to do so. This is the most important thing you can do to reduce your risk of developing DVT, both in hospital and when you return home.

If you require any assistance while you are in hospital, please speak to your nurse or physiotherapist.

• Perform the leg exercises illustrated in this booklet regularly while in bed or sitting in a chair. • Keep hydrated. • Do not cross your legs. • Eat a balanced diet and maintain a healthy weight.

How do I do these exercises? Simple leg movements can help maintain healthy circulation in the legs and each exercise should be performed 10 times each hour. If you have had any surgery, check with your physiotherapist that these exercises are safe for you to do. If you are in bed, perform exercises 1, 2 and 3. Exercise 1 Straighten your leg and push the back of your knee onto the bed. Hold for 5 seconds then relax. Repeat with your other leg.

Page 5

Exercise 2 Flex your ankle, bringing your foot up so that your toes point towards your head, then extend them to point towards the end of the bed. Repeat with your other foot.

Exercise 3 Tighten your buttock muscles and hold for five seconds, then relax. If you are sitting in a chair, perform exercises 4 and 5. Exercise 4 Lift your toes, then your heels, up and then down.

Page 6

Exercise 5 Lift your leg out in front, and hold for five seconds.

When you are discharged Your risk of DVT / PE may continue for up to 90 days after you are discharged from hospital. Therefore: • walk regularly if you are able to do so; • continue to do these exercises until you are back to your usual level of mobility; • drink plenty of fluids to avoid dehydration; • do not cross your legs; • eat a balanced diet and maintain a healthy weight; and • if you develop any symptoms of DVT or PE (see page 4) contact your GP immediately or go to the nearest Emergency Department (A&E or Casualty).

Page 7

Produced by: The Ipswich Hospital NHS Trust Heath Road, Ipswich, Suffolk IP4 5PD Hospital switchboard: 01473 712233 www.ipswichhospital.nhs.uk