Deep vein thrombosis prevention: Difference between revisions
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==Primary prevention== | ==Primary prevention== | ||
Walking is an effective preventative measure.<ref>{{cite book|last=Perry|first=Anne Griffen|title=Clinical Nursing Skills and Techniques|year=2010|publisher=Mosby|location=St. Louis, MO|isbn=978-0-323-05289-4|page=243}}</ref> Walking activates the body's muscle "pumps", increasing venous velocity and preventing low blood flow. | Walking is an effective preventative measure.<ref>{{cite book|last=Perry|first=Anne Griffen|title=Clinical Nursing Skills and Techniques|year=2010|publisher=Mosby|location=St. Louis, MO|isbn=978-0-323-05289-4|page=243}}</ref> Walking activates the body's muscle "pumps", increasing venous velocity and preventing low blood flow. | ||
Anticoagulants and mechanical measures may also be used. | Anticoagulants and mechanical measures may also be used.In 2012, the [[American College of Chest Physicians]] (ACCP) released their 9th edition of [[clinical guideline]]s,<ref>{{cite journal |title=Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines |journal=Chest |volume=141 |issue=suppl 2 |year=2012 |url=http://chestjournal.chestpubs.org/content/141/2_suppl.toc |publisher=American College of Chest Physicians}}</ref> which included recommendations on VTE prevention.<ref name="Kahn">{{cite journal|author= Kahn SR, Lim W, Dunn AS, ''et al''.|title= Prevention of VTE in Nonsurgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines |journal=Chest|volume=141|issue=suppl 2|pages= e195S–e226S|year=2012|pmid=22315261|doi=10.1378/chest.11-2296}}</ref> The recommendations were given strengths with "grades", depending upon the evidence for them. | ||
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! Grade | |||
! Description of 2012 ACCP grade<ref>For more detailed text descriptions of the grades, including benefits vs. the risks and burdens, the methodologic strength of supporting evidence, and implications, see Table 4 of [http://chestjournal.chestpubs.org/content/141/2_suppl/53S.full.pdf+html Guyatt ''et al''.], p. 62S</ref> | |||
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| 1A | |||
| Strong recommendation, high-quality evidence | |||
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| 1B | |||
| Strong recommendation, moderate-quality evidence | |||
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| 1C | |||
| Strong recommendation, low- or very-low-quality evidence | |||
|- | |||
| 2A | |||
| Weak recommendation, high-quality evidence | |||
|- | |||
| 2B | |||
| Weak recommendation, moderate-quality evidence | |||
|- | |||
| 2C | |||
| Weak recommendation, low- or very-low-quality evidence<ref name="Methodology">{{cite journal| author=Guyatt GH, Norris SL, Schulman S, ''et al''.| title=Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines | journal=Chest | year=2012 | volume=141 | issue=suppl 2 | pages= 53S–70S | pmid=22315256 | doi=10.1378/chest.11-2288 |url=http://chestjournal.chestpubs.org/content/141/2_suppl/53S.full.pdf+html}}</ref> | |||
|} | |||
===Lifestyle modifications=== | ===Lifestyle modifications=== | ||
The most common lifestyle risk factors for venous thromboembolism are: | The most common lifestyle risk factors for venous thromboembolism are: | ||
Revision as of 19:52, 25 April 2012
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Deep Vein Thrombosis Microchapters |
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Diagnosis |
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Treatment |
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Special Scenario |
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Trials |
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Case Studies |
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Deep vein thrombosis prevention On the Web |
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Risk calculators and risk factors for Deep vein thrombosis prevention |
Overview
Primary prevention includes the strategies that help to avoid the development of disease. Awareness of Deep venous thrombosis is the best way to prevent this condition.
Primary prevention
Walking is an effective preventative measure.[1] Walking activates the body's muscle "pumps", increasing venous velocity and preventing low blood flow. Anticoagulants and mechanical measures may also be used.In 2012, the American College of Chest Physicians (ACCP) released their 9th edition of clinical guidelines,[2] which included recommendations on VTE prevention.[3] The recommendations were given strengths with "grades", depending upon the evidence for them.
| Grade | Description of 2012 ACCP grade[4] |
|---|---|
| 1A | Strong recommendation, high-quality evidence |
| 1B | Strong recommendation, moderate-quality evidence |
| 1C | Strong recommendation, low- or very-low-quality evidence |
| 2A | Weak recommendation, high-quality evidence |
| 2B | Weak recommendation, moderate-quality evidence |
| 2C | Weak recommendation, low- or very-low-quality evidence[5] |
Lifestyle modifications
The most common lifestyle risk factors for venous thromboembolism are:
- Obesity,
- Inactivity,
- Cigarette smoking,
- Avoid dehydration,
- Maintain normal blood pressure.
Travelers
There is clinical evidence that suggest, wearing compression socks, on long haul flights, reduces the incidence of thrombosis. A randomised study in 2001 compared two sets of long haul airline passengers, one set wore travel compression hosiery the others did not. The passengers were all scanned and tested to check for the incidence of DVT. The results showed that asymptomatic DVT occurred in 10% of the passengers who did not wear compression socks. The group wearing compression had no DVTs. The authors concluded that wearing elastic compression hosiery reduces the incidence of DVT in long haul airline passengers.[6].
Related Chapters
References
- ↑ Perry, Anne Griffen (2010). Clinical Nursing Skills and Techniques. St. Louis, MO: Mosby. p. 243. ISBN 978-0-323-05289-4.
- ↑ "Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. American College of Chest Physicians. 141 (suppl 2). 2012.
- ↑ Kahn SR, Lim W, Dunn AS; et al. (2012). "Prevention of VTE in Nonsurgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (suppl 2): e195S–e226S. doi:10.1378/chest.11-2296. PMID 22315261.
- ↑ For more detailed text descriptions of the grades, including benefits vs. the risks and burdens, the methodologic strength of supporting evidence, and implications, see Table 4 of Guyatt et al., p. 62S
- ↑ Guyatt GH, Norris SL, Schulman S; et al. (2012). "Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (suppl 2): 53S–70S. doi:10.1378/chest.11-2288. PMID 22315256.
- ↑ Scurr JH, Machin SJ, Bailey-King S, Mackie IJ, McDonald S, Smith PD. Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial. Lancet 2001;12(9267):1485-9. PMID 11377600.