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Discussion

DVT question

I have a few questions about DVT. I would really be greatful for any answers.

How would diagnose DVT on a patient except for Homan's sign since that could increase the risk of dislodgement.

Also, if a patient would have DVT where would the pain be located? Would it be above or below the location of the clot?

Thank you :D

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    In my experience, the pain is often in the general area surrounding the clot. The area may also be red, swollen, or warm to the touch. The only definitive way to diagnosis a DVT is by a Venous Doppler of the extremity to determine if/where there is blockage present.

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    • Experts

    http://www.ncbi.nlm.nih.gov/pubmed/10526599

    "Homans's sign is often used in the diagnosis of deep venous thrombosis of the leg. A positive Homans's sign (calf pain at dorsiflexion of the foot) is thought to be associated with the presence of thrombosis. However, Homans's sign has a very poor predictive value for the presence or absence of deep vein thrombosis, like any other symptom or clinical sign of this disease."

    The best method within the scope of practice of a nurse is to measure bilateral calf circumference and then compare. The left and right should be almost identical. If one side is significantly larger than the other it might be a DVT.

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    Homan's sign is a classic sign, but unreliable. My professors tell me NOT to do a Homan's sign if a DVT is suspected because like you said, it could dislodge it.

    Compare the pts 2 legs. Is one leg swollen and warm compared to the other? Like another poster said, measuring calf circumference (at same exact spot on each leg) is a good test.

    Doppler IS the best method for actual Dx.

    The pain should be diffuse throughout the whole calf of the affected extremity.

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