Jul 11, 2021
Written By: Caleb Dusdal
Peer Review By: Sarah Donnelly
In patients complaining of leg pain and/or swelling, evaluate the likelihood of deep venous thrombosis (DVT) as investigation and treatment should differ according to the risk.
In patients with high probability for thrombotic disease (e.g., extensive leg clot, suspected pulmonary embolism) start anticoagulant therapy if tests will be delayed.
Identify patients likely to benefit from DVT prophylaxis.
Utilize investigations for DVT allowing for their limitations (e.g., Ultrasound and D-dimer).
In patients with established DVT, use oral anticoagulation appropriately, (e.g., start promptly, watch for drug interactions, monitor lab values and adjust dose when appropriate, stop warfarin when appropriate, provide patient teaching).
Consider the possibility of an underlying coagulopathy in patients with DVT, especially when unexpected.
Use compression stockings in appropriate patients, to prevent and treat post-phlebetic syndrome.