Dvt

[sweetieann]

If a patient has an actual DVT, are compression stockings usually worn? I can see how on one hand, they should be because it will prevent furthur pooling of blood/the clot getting bigger. My only question is-couldn't the compression cause the clot to dislodge/break off and become a PE?

Thanks!

[Virgo_RN, BSN, RN]

Actually, once the person is able to ambulate, compression stockings are recommended for up to six months following the DVT.

[sweetieann]

if a person is already wearing compression stockings for edema and then they have a suspected but not yet confirmed possible DVT, should they continue to wear the stockings until a definitive diagnosis made? They ordered dopplers on the patient, but they are ambulating around now.

[Virgo_RN, BSN, RN]

I would say yes. However, if they have a suspected DVT, they probably should not be ambulating and should have that extremity elevated above the level of their heart.

Is the person anticoagulated?

[sweetieann]

The physician assistant ordered a doppler study but no mention of bedrest of anything. No anticoagulation. This is at a psych hospital, pt pretty medically stable. Had some swelling of one ankle. Thanks for your help!

[Virgo_RN, BSN, RN]

Hopefully the doppler's negative.

[Daytonite, BSN, RN]

if a patient has an actual dvt, are compression stockings usually worn?

yes. the reason is to maintain tissue perfusion and the oxygenation of the cells.

my only question is-couldn't the compression cause the clot to dislodge/break off and become a pe?

no, the compression stockings are pushing blood of the

superficial

venous network into the

deeper

veins. these clots are usually trapped in the

deep venous network

of the lower extremity. if the clot is going to break off and embolize it will do it with vigorous ambulation. these clots, however, tend to be rather stringy and run for a bit of length along these veins of the leg which is why you generally get a "cord" of redness. they are usually pretty well lodged in these veins.

[Flightline, BSN, RN]

Thanks Daytonite. That's some good info I wasn't aware of.

[GrumpyRN63, ADN, RN]

Once the pt is dx w/ a DVT( in the acute period) we no longer place venodynes on that leg,--- nor is the pt kept on bedrest, that was done many moons ago