Authors: James Simon Dunn, Jason M Kendall / Editor: Gavin Lloyd / Reviewer: Sarah Hickin-Yacoub, Peter Kilgour, Mehdi Teeli / Codes: / Published: 22/02/2024
This session will deal with the assessment and management of possible deep vein thrombosis (DVT) in the emergency department (ED).
After completing this session you will be able to:
- Describe the pathophysiology of Deep Vein Thrombosis (DVT)
- Risk stratify patients presenting with possible DVT
- Plan an appropriate investigative strategy to rule in or out DVT
- Start treatment for patients with proven DVT
References
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- Encyclopaedia Britannica. Rudolf Virchow. [Accessed Feb 2024].
- Jones S. SimpliRed and diagnosis of deep venous thrombosis. BestBets.org. 2003.
- National Institute for Health and Clinical Excellence (NICE). Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. NG 158, 2020. Updated: 2 August 2023.
- Wells PS, Anderson DR, Rodger M, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003 Sep 25;349(13):1227-35.
- Wells PS, Owen C, et al. Does this patient have deep vein thrombosis? JAMA. 2006 Jan 11;295(2):199-207.
- Schutgens RE, Ackermark P, Haas FJ, et al. Combination of a normal D-dimer concentration and a non-high pretest clinical probability score is a safe strategy to exclude deep venous thrombosis. Circulation. 2003 Feb 4;107(4):593-7.
- Gardiner C, Pennaneac’h C, et al. An evaluation of rapid D-dimer assays for the exclusion of deep vein thrombosis. Br J Haematol. 2005 Mar;128(6):842-8.
- Goodacre S, Sampson F, et al. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging. 2005 Oct 3;5:6.
- Bller HR, Davidson BL, Decousus H, Gallus A, et al. Fondaparinux or enoxaparin for the initial treatment of symptomatic deep venous thrombosis: a randomized trial. Ann Intern Med. 2004 Jun 1;140(11):867-73.
- Broderick C, Watson L, Armon MP. Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb. Cochrane Database of Systematic Reviews 2021, Issue 1. Art. No.: CD002783.
- Greenfield LJ, Proctor MC. Twenty-year clinical experience with the Greenfield filter. Cardiovasc Surg. 1995 Apr;3(2):199-205.
- Othieno R, Okpo E, Forster R. Home versus inpatient treatment for deep vein thrombosis. Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD003076..
- National Institute for Health and Clinical Excellence (NICE). Venous thromboembolism: diagnosis and anticoagulation treatment. 2023.