Diagnosed with DVT....now what?

We have them stay off the extremity and keep it elevated. No ice or heat. No pneumatic compression device to that extremity if it's a leg. No IV/blood draws if it's an arm. Dose with heparin SC or drip initially. Monitor for signs of a PE.

We have them stay off the extremity and keep it elevated. No ice or heat. No pneumatic compression device to that extremity if it's a leg. No IV/blood draws if it's an arm. Dose with heparin SC or drip initially. Monitor for signs of a PE.

If this pt has no gait trouble, would you allow them to use the bathroom in the pt's room?

When I had a DVT/PE I was able to use the bathroom. I was hooked up to heparin and just brought it with me. I am so glad I didn't have to use the bedpan!

I had a pt die spontaneously of a PE with a known DVT...it wasn't on my shift but it really upset me. I realized I didn't know much about what you do after you already have a DVT. All my books just talk about prevention and the heparin/coumadin treatment but not much about restrictions otherwise.

On my floor, we used to do strict bedrest with a bedpan and everything and a heparin gtt. Same floor 6 years later, they are on bedrest with BRP, getting Coumadin PO and Lovenox SQ.

I actually remember reading a thread here recently about differnt hospital's policies on this. From what I could tell, policies and theories on this are very different from hospital to hospital.

SQ Heparin or heparin gtt. No SCDs (venodyne boots). Limit movement of the leg. Initial bedrest. Obv no squeezing of the calf.

If this pt has no gait trouble, would you allow them to use the bathroom in the pt's room?

Yes, but bathroom privileges only.

I had a pt die spontaneously of a PE with a known DVT...it wasn't on my shift but it really upset me. I realized I didn't know much about what you do after you already have a DVT. All my books just talk about prevention and the heparin/coumadin treatment but not much about restrictions otherwise.

Get orders from the doc...and assess, assess, assess.....if ANYTHING changes, call the doc.... :)

BRP privileges, Heparin drip or Heparin SQ 5000 units BID, Coumadin 5 MG PO either BID or Q HS, Lovenox SQ (dose varied depending on MD, sometimes mg/kg or a standard 40 MG BID), extremity elevated, assess signs of PE, such as tachypnea, tachycardia, diaphoresis, chest pain, agitation and anxiety

Where I work we don't place any activity restrictions on patients with DVT's. There's no evidence that early ambulation increases the risk of PE or death in a patient with a DVT. You still very well may see a PE develop in a patient with a PE, although that's due to same factor that caused the DVT, not ambulating with the DVT. The consensus of best practice recommendations seems to be that there is no advantage to bed rest with a DVT and that the negative health effects of bed rest make early ambulation in DVT patients best practice.