Venous thromboembolism (VTE )is the name given to a deep vein thrombosis (DVT) or a pulmonary embolism (PE).

A DVT is a thrombus (blood clot) that forms in a deep vein, most commonly in your leg or pelvis and can cause swelling and pain. In a longer term, DVT can cause painful, swelling and ulcers. If a clot becomes dislodged and reaches your lungs, this is called PE. This can cause coughing (with blood stained phlegm), chest pain and breathlessness. VTE diagnosis required immediate treatment. If you develop any of these symptoms either in hospital or after discharge, please seek medical advice immediately.

Is VTE common?

VTE occurs in the general population in about one 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?

In addition to admission to hospital, there are other factors that place you at greater risk of VTE. These include a previous VTE, a recent diagnosis of cancer and certain blood conditions such as clotting disorders. In addition, certain contraceptive and hormone replacement tablets can increase your risk.

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 completed. If you are at risk, your doctor or nurse will discuss with you what can be done to reduce your risk ad will follow national guidelines and offered you protection against VTE. 

What can I do to reduce my risk of VTE?
  • 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 in the weeks before you operation.
  • If possible, in the month before your operation, avoid continuous travel of more than three 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 for your need to be given preventative treatment to reduce the risk of VTE (prophylaxis).

If you require an anaesthetic your anaesthetist will decide which type of anaesthesia is most appropriate for you.

Anti-embolism stockings will be fitted if it considered appropriate by your doctor. You will be measured and fitted with stockings and be shown how to wear them. Please report any new symptoms in your feet or legs when wearing them to a member of nursing or medical 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 and provide pressure at regular intervals, increasing blood flow out of your legs. If the cuffs have been removed for more than three hours they should not be reapplied, unless advised by staff.

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

What happens after I have been discharged from 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 discharge. It is important to keep active (avoid sitting down all day) when you get home, drink plenty of liquid and 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

then seek medical advice immediately, either from your GP or your nearest hospital emergency department.

Where can I found 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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Feedback

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