Venous Thromboembolism
Key Points
Key Points
- Physical therapists should play a significant role in identifying patients who are at high risk for a venous thromboembolism (VTE). Once these individuals are identified, preventive measures such as referral for medication, initiation of activity or mobilization, and education should be implemented to decrease the risk of a first or reoccurring VTE.
- Physical therapists should be aware of the signs and symptoms of an VTE.
- When signs and symptoms are present, the likelihood of a VTE should be determined through the standardized tools, and the results shared with the interprofessional team to consider treatment options.
- In patients with a diagnosed upper extremity (UE) or lower extremity (LE) deep vein thrombosis (DVT), once a medication’s therapeutic levels or an acceptable time period has been reached after administration, mobilization should begin.
- Although there are risks associated with mobilization, the risk of inactivity is greater.
- In patients with a diagnosed pulmonary embolism (PE), mobility should begin as soon as the patient is medically stable and the medication administered has either reached therapeutic levels or an acceptable time period has passed.
- Complications following VTE can continue for years or even a lifetime. Physical therapists can help decrease these complications through education, mechanical compression, and exercise.
Management
...Management...
...Key Action Statements...
...1. Advocate for a culture of mobilit...
...ent 2. During initial interview and physical...
Statement 3. When a patient presents with...
...t 4. When a patient is identifie...
...tatement 5. When a patient presents with p...
...tatement 6. When a patient present wi...
...7. When a patient presents with dyspnea, chest pa...
...nt 8. When a patient presents with...
...nt 9. With a recently diagnosed VTE t...
...atement 10. When a patient with a recently di...
...11. When a patient with a recently diagnosed upp...
Statement 12. When a patient has a newl...
...13. When a patient has an inferior vena ca...
.... When a patient presents with a documented LE...
...tement 15. When a patient with a non...
...nt 16. When a patient presents with a m...
...tatement 17. When a patient with...
...t 18. When a patient presents with lon...
...ent 19. When a patient presents wi...
...adua Prediction ScoreThe Padua Predi...
...Khorana Risk ScoreThe Khorana Risk s...
...ells Criteria for the Prediction of Deep Ve...
...ble 4. The Revised Geneva Clinical Predic...
Table 5. Current Anticoagulation Options fo...
...ng Term Medical Management of Venous Thromboe...
...Table 7. Risk Factors...
Table 8. Definition of Hemodynamic Instab...
...HAS-BLED ScoreHAS-BLED Score is used...
Table 10. Classification of PE and Risk o...
...gure 1. Actions for a Suspected UE or L...
...2. Constans Criteri...
...gure 3. Mobilization with an Acute UE or LE DVT...
...1. Risk of Recurrent VTE Es...