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Deep Vein Thrombosis (Risk Factors (Oral contraceptive pill - large…
Deep Vein Thrombosis
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Prevention
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Those at low risk (<40 years old, surgery <30mins) do not need heparin. Just mobilise and hydrate
Definition
Thrombosis is a blood coagulation inside a vessel, driven by the formation of thrombin
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Thrombosis can occur in arterial circulation: high pressure, platelet rich
Thrombosis can occur in venous circulation: low pressure, fibrin rich
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Pathophysiology
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There is tenderness, warmth and discolouration
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Treatment
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Drugs
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Warfarin
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Prevents synthesis of active factors of clotting factors II, VII, IX, X
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Aspirin
Not an anticoagulant, it is an anti-platelet
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Pulmonary Embolism
Definition
Embolism travels from leg to lung. Blood flow is blocked to the lungs so it cannot be oxygenated and circulation stops
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Investigations
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Ventilation/perfusion scan - there will be a mismatch in pulmonary embolism as one lung will have air but no blood
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Treatment
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Ensure normal Hb, platelets, renal function
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If patient cannot be on anti-coagulants, use an IVC filter
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Investigations
D-Dimer Test: a normal result excludes DVT but a positive result does not confirm diagnosis (as pregnancy, post surgery, inflammation can all raise D-dimer anyway)
Ultrasound compression test to find veins - if the vein is unable to be squashed then it is full of a clot
Wells score, <1 point means DVT is unlikely, >2 points means DVT is likely
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