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ulations for DVT should not foster a false sense of confidence, experts
note.
"You might ask, 'If they're low-risk, why are we taking these steps
with this patient? If they don't need it, why are we using this? The
cost of healthcare is outrageous enough already,'" says Ms. Butler.
"The answer is, there's still the risk that the young, healthy patient will
suffer an unfortunate result, and we'll have to bear the knowledge
that we had the resources to do something about it, that we could
have averted it."
"We'll zone in on the high-risk patients, but we must exercise cau-
tion with all the others, too," says Ms. Razzano. "It's a common mis-
take, assuming a patient is low-risk and nothing is needed."
But the unexpected is not unknown to surgery. "Starting anesthesia
means starting the clotting cascade," she says. "Even with short cases,
like knee scopes, there's no guarantee you'll be in and out in just 15 or 20
minutes. Failure to exercise preventative measures could be setting up a
catastrophe."
Preemptive measures begin with mechanical compression: the appli-
cation of thromboembolic deterrent stockings (also known as com-
pression stockings or TED hose) and/or sequential compression
devices (SCDs), whose pneumatic sleeves create intermittent contrac-
tions in the legs to assist blood flow and prevent circulatory stasis.
Both options are simple but effective. "Most institutions default to
applying compression to everyone, because DVT really is a silent thing,
and in most cases SCDs aren't going to hurt the patient," says Ms. Butler.
According to researchers, compression may be the most all-around
effective prophylaxis against DVT. A pathological assessment known as
Virchow's Triad attributes thrombosis to the confluence of 3 conditions:
vessel wall injury, stasis in blood flow and changes in coagulation.
Stockings remedy vessel damage and stasis, while SCDs combat stasis
D E E P - V E I N T H R O M B O S I S
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