DVTs!

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Specializes in Telemetry.

So I would like the masses to provide me with their standards of care related to DVT patients. I've worked in several hospitals and there is the sect that says the patient should not get up and walk around at all, period, no matter what.

The second set, if they have been on anti-coagulation therapy for 24 hours then they can walk to the bathroom and you can use a wheelchair to take them to tests...minimal walking but they don't have to lay in bed all day.

Thrid set says there is no substantial proof that inhibiting a DVT patient from ambulating makes any real difference from them throwing a clot or not. So they can walk around if they want to.

So I was wondering what the majority around here do? As a traveler nurse I get rather thrown as I worked for the 'do not let them up ever' sect first, then the 'let them get up because it doesn't matter' sect second. I'm now working for a hospital that says no to getting up...didn't know that and let my patient go to doppler in a wheelchair...got my ass chewed by the nurse in the ultrasound area who was also kind enough to tell me what an idiot she thought I was.

As I've dealt with the different scenarios I'd really like to know the articles that say that preventing them from ambulating doesn't really help prevent throwing a clot...just so I can prove that I nursing thinking skills were not so off base as this woman thinks they were.

Thank you for your input.

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I'm sorry you got chewed.... I'm not much help with this, as I've been out of the loop for a few years, and know that the 'rules' may have changed 86 times since then- lol.

When I was admitted for multiple PEs, I was allowed up- but guess the risk was over by then- lol.... :eek:

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Specializes in Telemetry.

Ha! I looked up some articles. Preventing ambulation has NOT proven to help prevent PEs or the development of new DVTs. Suggestions are now for compression (SCDs) and ambulation in early DVT treatment. I wish I could stick my tounge out at that lady now.

Pulmonary Medicine: Bed rest versus ambulation in the intial treatment of patients with proximal deep vein thrombsus. Dr. Hugo Partsch 2002

Siminars in Vascular Surgery: Ambulation and Compression After Deep Vein Thrombosis: Dispelling Myths. Dr. Hugo Partsch, 2005

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Specializes in Community, OB, Nursery.

Yeah, the few times we've suspected DVTs on my unit (postpartum) or had a readmit for same, they've not had activity restriction. That's been the case for at least the last 3-4 years, maybe longer.

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Specializes in Med-Surg/Oncology.

I don't work on a post-surgical floor, but we still do encourage all patients than can ambulate to do so regularly. The ones that can't, we make sure they have TEDs and SCDs on most of the day.

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Specializes in Developmental Disabilites,.

On my floor we encourage them to get up and walk around to prevent to formation of new blood clots as the pt has proven they are prone to them.

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Specializes in pcu/stepdown/telemetry.

If we are ruling out dvt we may keep them in bed till the stat dopplers are done. There is a policy that our physical therapy dept has that said they can only work with pt's on heparin/lovenox for at least 6 hours after the dvt is found. However,I have never seen a cardiologist/ vascular surgeon put my pt on bed rest for a DVT. I don't know the absolute answer to it because it depends on the hospitals policy. We use heparin SQ and IPC to prevent venous stasis on the lower extremities as dvt prophylaxis and early ambulation.If they are on blood thinners there is no reason they should be on bed rest.

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Specializes in ER, ICU.

You should have asked her to cite a study that shows what you did was wrong. Read one here http://ptjournal.apta.org/content/84/3/268.full.

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You should have asked her to cite a study that shows what you did was wrong. Read one here http://ptjournal.apta.org/content/84/3/268.full.

The article is 7 years old..... :confused:

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Specializes in LTC, Hospice, Case Management.

From my personal treatment..13 year years ago had a DVT and was put on "strict" bedrest. I refused to use the bedpan but otherwise complied with the bedrest.

Had second DVT last October and wasn't even admitted to the hospital.

In both cases it was extremely difficult and painful to walk so I didn't want to go far anyway. Even at home it was hard to get from one room to the next for at least a week and a half. (And I have to add, I am certainly NO WHIMP - not even close). Think of waking up in the middle of the night with an extreme leg cramp and walking around with that. Feels exactly the same way but it doesn't quit in a few minutes.

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I'm just a student with no personal experience or expertise, but we were taught that most of the time, if a person had been ambulatory prior to the DVT being found, then it was likely safe for them to continue with their usual activity.

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I'm just a student with no personal experience or expertise, but we were taught that most of the time, if a person had been ambulatory prior to the DVT being found, then it was likely safe for them to continue with their usual activity.

You are not JUST a student :) You are a student beginning your career in nursing. You matter. You are worth being heard. :)

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