How to Protect Your Patient from DVT

Abstract

higher the risk of developing DVT: * age over 40 * history of venous problems * obesity * immobilization * lengthy surgical procedure * malignancy * congestive heart failure * cardiac arrhythmias * surgery in which thromboembolism is a common complication (for example, abdominal, pelvic, or orthopedic surgery). Of these risk factors, the most significant are the first two-age over 40 and a history of venous problems. Many of your patients probably have at least some of these risk factors. Deep vein thrombosis and its sequelae-chronic venous insufficiency and pulmonary embolismare widespread. In fact, each year in the United States, two million cases of DVT, 800,000 cases of chronic venous insufficiency, and 600,000 cases of pulmonary embolism are diagnosed. (The incidence of all three conditions is rising most rapidly among young IV drug abusers.) One study projects that among patients undergoing elective general surgery, 4,000 to 8,000 postoperative deaths a year could be prevented if appropriate measures were taken to prevent venous complications. All patients at risk for DVT require the standard nursing interventions for decreasing venous stasis in the lower extremities. These include passive and active leg exercises, turning at least every two hours, elevating the legs so the feet are six inches above the level of the heart (without bending the knees or waist or by putting pillows under the knees), and encouraging early ambulation after surgery. In addition, many of these patients will benefit from the use of graduated compression stockings or a pneumatic compression device. To see how these devices can minimize the risk of DVT, let's return to the three patients we just met and explore their situations in more detail.