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THROMBOPHLEBITIS - Coggle Diagram
THROMBOPHLEBITIS
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Management
Arrange emergency admission if suspected potentially life threatening complication; DVT/PE/Sepsis/Severe infection
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Referral to Haematology Thrombosis Clinic /seek Specialist advice if lower limb SVT (within 3cm of Saphenofemoral junction - consider anticoagulation)/ Prophylactic anti-coagulation /serial duplex Ultrasound assessment if risk factors / recurrent SVT/Uncertainty of optimal management
Arrange referral to Vascular Service/specialist if concomitant varicose veins. If suspected serious underlying cause for SVT
If admission not required - Signpost to NHS patient leaflet (Phlebitis).
Simple analgesia for symptom relief NSAID if not contraindicated/paracetamol. SVT may be palpable /tender for weeks
Self care measures - apply warm/moist/flannel to affected limb.
Keep leg elevated.
Use affected limb, remain mobile /active
Consider graduated elastic compression stockings - prescribe stocking if arterial insufficiency has been excluded
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Diagnosis
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Suspect SVT of lower limb - redness/tenderness/palpable/firm lump or cord typically in pre-existing varicose veins.
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Assessment
Symptoms - pain/itch/onset /duration/severity/impact on faily functioning and any aggravating or relieving factors
develop over hours-days and resolve in days to weeks.
Any risk factors /complications e.g. VTE
Any previous episodes of SVT/VTE/migratory thrombophlebitis.
Family history of VTE
Any previous treatement
Examine - both legs on standing/tenderness/hard vein/palpable cord/ erythema/brown pigmentation. Location/severity of any varicose veins /signs of chronic venous insufficiency/venous leg ulcer/skin pigmentation/oedema. signs of complication e.g.VTE
Do not use D-dimer blood test to diagnose suspected SVT
Consider if there is alternative diagnosis or concurrent condition e.g.DVT