Diagnosed with DVT....now what?

[MeTheRN]

When taking care of a pt with a known DVT, what are their restrictions? Can they still ambulate? Elevate their leg? What should be avoided? Warm/cold compress?

[MunoRN, RN]

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.

[TonyaM73, ASN, RN]

WOW! Our vasular surgeon recommends bedrest until ptt/inr are therapeutic. I have seen a pt with an unknown DVT get a PE with disasterous results. Pt stood up to get to a wheelchair for a test and said "oh Jesus here I come" and then died! I tell all my DVT pts this if they are griping about the bedrest thing. I tell them it is only for a little while until they get therapeutic. I keep them strict bedrest until the PTT/INR get up to level.

[psu_213, BSN, RN]

I remember reading a journal article a few years ago that suggested that bedrest is essentially of no benefit (compared with ambulation ad lib) in terms of how often a pt "threw" a DVT. Either way though, you must go by facility policy or what the doctor writes for activity (ad lib, BRP, strict bedrest, etc).