tions to seek medical attention immediately for the signs of VTE,
including:
• leg pain, cramps or discomfort;
• shortness of breath at rest or after minor exertion;
• leg swelling;
• anxiety or rapid heart rate;
• fainting episodes; and
• chest pain.
Follow up with a phone call to patients 30 — or, if possible, 90 —
days after surgery and ask if they've experienced any of the symp-
toms of VTE. Make sure to reach out to all of your patients; even the
patients who were classified as average or low risk of developing
DVT are at risk once they stop taking anticoagulants. Studies have
shown that 77% of people get blood clots after they're discharged,
while 55% get them after anticoagulation shots are stopped.
Once you identify which of your patients have experienced VTE symp-
toms following their discharge from your facility, examine their treat-
ment. Did they undergo prophylaxis? How many days did they take anti-
coagulants for, if at all? Did they take low molecular weight heparin or a
DOAC? Record the answers you get from those calls — if a person had a
risk score of 5 and did not receive anticoagulant prophylaxis, for
instance — in order to track what type of prophylaxis to administer in
the future.
OSM
7 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A n U A R Y 2 0 1 8
Dr. Caprini (jcaprini2@aol.com) is professor emeritus at the Evanston
NorthShore University HealthSystem and senior clinician educator at the
Pritzker School of Medicine in Evanston, Ill.
