Along with many Members of the Trust, I attended the recent Members’ presentation by Rebecca Bushby on Venous Thromboembolism. Rebecca is a VTE Prevention Nurse Specialist at Ashford and St Peter’s and has recently had an article published on the “Safety and Efficacy of Enoxaparin for Thromboprophylaxis in Obese Patients” accepted by ‘Thrombus’, a highly respected publication, showing her considerable knowledge of the subject.
Having worked in medicine for more years than I care to remember, I thought I knew a bit about VTE – how wrong can one be? Having listened to Rebecca for a few minutes, her knowledge and enthusiasm bowled me over, and I realised that my comprehension was very lacking!!
I was aware that clots could form in leg veins after long periods of sitting or lying, especially after bed rest. I also was aware that clots could form in the pelvis, but in the arm? That was certainly new to me. How big can a clot be? I naively thought the size of a pea. But we were told potentially the length of a limb and the substance of jam! How fast could that clot move into the heart and lungs? – only a couple of seconds! The thought of a clot that size travelling through the body in a few seconds and lodging in the lungs is frightening, but how reassuring that this can be treated if caught in time. Lower molecular weight heparin seems to be the anticoagulant of choice, which can be given by injection..
Rebecca told us obesity and bariatric surgery have been recognised as increasing the risk of VTE and supporting literature was available for Members to read. It was interesting to learn that VTE caused at least 10 times more deaths than MRSA. The patient information leaflet on “Hospital Associated Thrombosis” is very informative. Do try to read this, if possible, before you are admitted to hospital.
The Trust is working very hard on avoiding any VTE in patients admitted to hospital and patients are often given small doses of anticoagulant prior to surgery, especially for hip and knee operations. VTE is one of the main reasons for mobilising patients soon after surgery, and as soon as possible after bed rest. Patients are encouraged to report pains and/or swelling in the legs, lower abdomen and arms.
The message is before coming into hospital, be aware, keep taking fluids and keep moving!
After surgery, be aware, keep taking fluids, wear the stockings, and keep moving!
This article was written by by Danny Sparkes, Public Governor for Runnymede