Dvt

its been a long time since i've seen a dvt on a patient that was able to ambulate, so i really can't comment on the bed rest status, but that particular patient was on bedrest, with use of the bedpan/urinal. that would make sense to me, since any contraction of the particular muscle could dislodge the clot. are they now having them use crutches or somehow making that extremity nwb?

i think bedrest orders have pretty much gone the way of the dinosaur at our facility because it's basically unenforceable. we caution patients not to bear weight on the affected extremity, and they are encouraged to keep it elevated at all times, but many patients insist that they can't use a bedpan (i have to admit, i myself am in that category, so i can empathize ), and you can't make someone who's aa&ox3 stay in bed.

that said, we often see dvt among our super-obese population, many of whom are frequent flyers because of their co-morbidities, e.g. diabetes and circulation problems. we also see it in ivdus, and occasionally even in a new mom who didn't walk around enough after her c-section (i developed it after i had my last child 13 1/2 years ago.....oh, if i'd known then what i know now!). with the drug users, it's usually in an arm rather than the legs, but we also deal with a lot of lower-extremity dvt in middle-aged, ambulatory patients, and it rarely has anything to do with surgery since we use scd's on just about everyone, including outpatients, who have any procedure that requires general anesthesia.