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SAFETY
fatal within minutes or hours. Who's at risk? Anyone who undergoes
surgery, because injuries to vessels when surgeons operate and
changes in blood chemistry caused by dehydration or general anesthetics increase the likelihood of clots forming. That said, more invasive procedures in the abdomen or lower extremities put patients at
increased risk. Other factors that heighten DVT possibilities include
advanced age, obesity, recent physical trauma, varicose veins, personal or family history of circulation problems, surgeries lasting longer
than 45 minutes, and hip or knee replacement surgery.
Pick the prophylaxis
Muscles in prone, anesthetized patients aren't working as they
normally would; even sleeping individuals move slightly every few
minutes to keep blood flowing properly. Two effective preventative
measures against DVT:
• Sequential compression devices. SCDs combat venous stasis and
coagulation changes by squeezing legs to stimulate muscles and move
blood through the veins.
• Anti-embolism stockings. Stockings protect against venous stasis and
vessel wall damage by keeping leg muscles tight and firm, which
reduces pooling of blood in the veins.
Using both in combination therefore protects patients against all 3
risk factors of DVT. The stimulation and constriction combine to regulate the blood's chemistry and break down any blood clots that might
form.
We put SCDs on all patients, except those undergoing quick eye cases,
although some surgeons write orders to add stockings to the prevention
effort. Compression devices and stockings should be applied in the preop holding area and kept on patients throughout surgery (when possible) and during their recoveries. Stockings come in thigh-length and
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