So, you have a swollen or tender calf. You have just got off a plane or come out of hospital and you are worried that you may have a DVT (Deep Vein Thrombosis). What should you do? Well read on and find out.
Early diagnosis and prompt treatment of Deep Vein Thrombosis is very important. Clots in the deep veins of the legs can travel to the lungs causing pulmonary embolism and death. In fact pulmonary embolism is second only to heart attack as a cause of sudden death. The media seems to regularly report the unexpected death of apparently previously healthy people from DVT. What is striking in these reports is that many of these people who suffered a fatal DVT had already sought medical advice and raised the possibility of DVT but they were dismissed. There is no doubt that DVT is difficult to diagnose. Sometimes the signs and symptoms are subtle and they may point to other problems such as a muscle injury or cramps. Many GPs only see a few cases of DVT in their professional career, so it is unfair to blame family doctors when they sometimes get it wrong. That’s why vein experts and the National Institute for Health and Care Excellence have produced guidance. If doctors were to use this guidance, DVTs could be diagnosed more quickly and more accurately. In this short article, I will give you the information you need to ensure that your doctor follows this guidance.
If you go to your doctor or nurse with a suspected DVT, ask for clinical assessment using the Wells score. Your doctor should ask you your history and examine you and using this scoring system, the diagnosis of DVT will be calculated as being either likely or unlikely. You can read the Wells score on the NICE website and print it off to take to your doctor. Ask your doctor if he knows the Wells score and ask him or her to tell you your score.
In addition to your Wells Score you should have a blood test called a D-dimer. It is raised in people with DVT and in conjunction with a Wells Score it will determine whether you should have an ultrasound leg scan of the deep veins. What happens after your Wells Score and D-dimer test is described on the NICE website but I show here what should happen to you if your score is “likely” or “unlikely”. Pause the video to look at it in detail or print of the advice from the NICE website. Make sure your doctor follows this advice and if he or she does not, ask why. If you need a vein ultrasound scan and there is a delay or more than 4 hours, ask your doctor to start blood thinning injections.
In summary, if you think you have a DVT, ask your doctor or other health professional to apply the Wells Scoring System in addition to a D-dimer blood test and to follow the advice on the NICE website. Insist on having an explanation if this advice is not followed – ask questions. I don’t think it is too dramatic to say that this information may save your life.
If you would like more information, visit our website or request a free information pack. In addition, if you would like to request a consultation and scan call 01935 873 951
Reference
https://www.nice.org.uk/guidance/cg144/chapter/recommendations#table-1-two-level-dvt-wells-scorea